Heart and Kidney Yin deficiency with Empty Heat

Image by Devanath from Pixabay

Key Learning Points

  • Though already frazzled, Heart and Kidney Yin deficiency with Empty Heat takes you one step even further from balance
  • Though exhausted, you can’t sleep
  • You get palpitations and night sweats and then there’s back pain and constipation
  • Why you got this and what to do about it

Heart and Kidney Yin deficiency with Empty Heat is one step further along the spectrum from Heart Yin deficiency with Empty Heat.

This syndrome exists when life has been out of balance for too long. Contemplate the picture of the two balls!

Most of this site tries to not be too technical, but this page probably makes more sense to acupuncturists. If you’re not an acupuncturist you may get a flavour of it by just ploughing on!

As you read more about Chinese medicine, with its constant discussion of health in ENERGY terms – very different from Western medicine – eventually the penny may drop. At least, so we hope.

As we write more pages, some of the unfamiliar terms below will be explained, and there’ll be links to them.

So, to work …

In Chinese medicine, the Heart and Kidney energies should work together. Kidney supplies the original jing-essence that creates Mind, which is housed by the Heart. The Heart sends Fire down to warm the Kidneys: in return the Kidneys send pure fluids up to nourish the Heart. 

So the Heart pushes down, the Kidney pushes up and pulls down, and in health they balance one another. In Heart and Kidney Yin deficiency with Empty Heat, however, the Heart downward pushing and Kidney pulling is severely reduced. This leaves only upward pushing, giving too much Yang, so forming Empty Heat. 

(‘Empty’ because it occurs when there is not enough cooling, Yin energy, to combat it. Imagine a car engine running normally in a cool country. Now imagine that its engine runs out of coolant. The car will overheat, not because it is being worked too hard or because it is a hot country, but because of the lack of Yin – the coolant.)

Empty Heat occurs when the body itself, because it’s out of balance, appears to be hot. Heart and Kidney Yin deficiency with Empty Heat is sometimes mistaken by orthodox doctors for a low, ongoing fever without obvious cause.

This Empty Heat fever may be more a sensation of heat, rather than actually measurable by thermometer. However, in some people there is a small increase in body temperature, usually quantifiable (if at all) towards evening.


First Aid
Image by Alexas_Fotos from Pixabay


(Full Heat occurs when there is an invasion into the body by some external pathogenic factor. In orthodox terms this would be a bacterial or viral infection to which the body responds with fever. Full Heat fevers are easily measurable with a thermometer.)

Causes of Heart and Kidney Yin deficiency with Empty Heat

The causes of Heart and Kidney Yin deficiency with Empty Heat are not so different from those of Heart Yin deficiency with empty Heat.

When, through long years of overwork (constantly on the go) and inadequate or irregular dietary habits, or prompted by the menopause (or for men, too much sex), both Heart and Kidney Yin are exhausted, then all the conditions are in place for empty Heat as well.

Heart and Kidney Yin deficiency with Empty Heat doesn’t usually arrive overnight, although some of its symptoms, like tinnitus, may be noticed suddenly one evening.

Treating it is by no means impossible, but usually takes time.

Unfortunately, these days, people are less willing to wait for treatment to work, or not until they have exhausted other possibilities – by which time their condition will normally have worsened.

However, even then, there is usually room for improvement.

Heart and Kidney Yin deficiency with Empty Heat has anxiety, depression and insomnia as possible expressions of mental (ill-)health. Modern orthodox treatments include medication – often with undesirable side-effects – and psychotherapy, which if it does nothing else should help sufferers learn to slow down. 

Slowing down in itself is not enough, however, because by the time this syndrome has taken effect, there are large gaps in the patient’s ability to recover naturally.

Treatment of some kind is needed: you won’t get better by taking a long holiday, good though that would be!


Edinburgh Castle
Image by kolibri5 from Pixabay

Edinburgh Castle by Evening – Take Time to Enjoy the View!


As explained above, when there is a yin deficiency, yang seems stronger. Both Heart and Kidney in good condition have powerful means to slow the body, the Heart through directing life to healthier ways and the Kidneys through providing the jing-essence and Water to nourish and cool the Heart Fire.

The Heart should, in health, send Fire downwards to warm the Kidneys but lacking Yin, the Heart fails to do this. When the Kidneys are exhausted by constant demands on their resources, their Qi is drained and they cannot anchor the Heart energy.

Kidney Qi exhaustion leads to both Kidney Yin depletion and and Kidney Yang deficiency. Without the support of Kidney Yang, Spleen Yang is weakened and nutrition not absorbed.  Blood then becomes deficient which leads to Heart Blood deficiency.  In turn that reinforces Heart Yin deficiency and the progression to Heart Yin Deficiency with Empty Heat.

So when Yang predominates for an extended period, constant upward movement (Yang is warming and heat rises) generates empty Heat symptoms.

If severe, Heart and Kidney Yin deficiency with Empty Heat becomes self-perpetuating. Inability to sleep means that Kidney Yin is further depleted, making good sleep even more difficult.


The symptoms of Heart and Kidney Yin deficiency with Empty Heat are a mix of both Heart and Kidney Yin deficiency syndromes, with the addition of Empty Heat. So some symptoms pertain to Heart (palpitations), others to Kidney (backache).

In the lists below, many more symptoms could have been included, such as (from Kidney) weak, sore knees, thinning hair and poor teeth but what follow are the more usual ones.

Please don’t think that if you have this syndrome you will have all the symptoms shown! Much depends on your own constitution and mental make-up. (The only one that I have is mild tinnitus, which started years ago when I was overworking and took no notice.)

Symptoms will tend to worsen in the afternoon and evening, when Kidney qi would normally be strong but in this syndrome is weakened.

MENTAL Symptoms of Heart and Kidney Yin deficiency with Empty Heat

‘Shen’ (your Mind) is disturbed: 

  • anxiety (strong to severe)
  • agitation which worsens through the day
  • great mental restlessness
  • inability to relax
  • depression: sometimes a sense of dread
  • poor memory
  • laughter at unsuitable times or in inappropriate situations


PHYSICAL Symptoms of Heart and Kidney Yin deficiency with Empty Heat

Head and Mind

  • Insomnia: waking often, sleep restless: you feel hot but sweating chills you. (As it cools you, sweating also depletes your yin-fluids. When Kidney Yin is depleted, Kidney Yang is also weakened and can’t warm you up again quickly.) 
  • Ear: may have a vertical line running up the outside of the lobule (ear-lobe). 
  • Mouth and throat are often dry, or the lower teeth feel dry. You often want to sip (cool) water or suck a sweet or chew an ice-cube. 
  • Dizziness: not just postural (ie occurring when you sit up or stand up) but at any time. Often experienced as a kind of ‘headiness’ or a rush to the head, with inability to stay vertical. Usually improves after lying down for a while, or after refreshing sleep. Made worse by exertion, mental or physical. 
  • Tinnitus: noises in the ears or head which hum or whistle or buzz or drone. May improve after sleep or a good rest or holiday, but worsens as you tire and towards evening. Worsened by coffee (eg caffeine) and other stimulating drugs (though these worsen all the other symptoms too, but it is tinnitus that people often notice first.) Worsened by very loud noises.
  • Hearing gradually reduces. Worsened by very loud noises or long periods exposed to loud noises, even if liked eg musical. 


  • Heart beat may be faster than normal. 
  • Palpitations – the heart races, often when thinking about it, or if anxious. Sometimes worse later in the day.
  • Back pain, mainly in the lumbar area and particularly at the level of the 2nd and 3rd lumbar vertebra. However, can occur elsewhere, for instance at level of the fifth and sixth dorsal vertebrae. 
  • Nights sweats can be drenching, requiring change of bed-clothing
  • Sleep; disturbed by many dreams; not deep enough or long enough to really refresh you
  • Sexual – men: ejaculation during sleep. Desire may be increased at times, but ejaculating worsens this whole syndrome, leading (for example) to even poorer sleep, more backache, tinnitus etc
  • Sexual – women: reduced libido and/or lack of lubrication
  • Sensation of warmth is more than normal. For example in hands and feet, on palms and soles. The centre of your chest may also feel warm. Your ears may feel hot, even glowing. To others these areas may also feel warm to the touch. 
  • Heat sensation increases later in the day and particularly in the evening. 
  • Phlegm: if you already have phlegm, perhaps from a previous illness, this syndrome will incline it to move towards what is called ‘dry‘ phlegm. And if you have dry phlegm already, having Heart and Kidney Yin Deficiency with Empty Heat will make it much harder to clear. For more on this, and to identify what kind of phlegm you have, read my book Yuck! Phlegm!

Other symptoms

  • Urine: unless you drink a great deal of water, will be dark and reduced in volume. You’ll be surprised how little you urinate compared with how much you drink. 
  • Stools: may be dry and difficult to pass. 
  • Tongue: red without a tongue coating, and an even redder tip. A crack runs down the mid-line of the tongue towards the tip: the closer this runs to the tongue tip the longer the symptoms of this syndrome will have gone on for. 
  • Pulse: ‘floating’ and ’empty’, rapid. Can be ‘deep’ at the rear positions and ‘overflowing’ at the front positions. (The rear positions are those of the Kidney pulse. Its weakness makes it deep to the touch. The front positions, nearest your wrist, represent the energy of your Upper Burning Space, your chest, with your over-heating Heart and Lung energies within. Overflowing pulses often feel ‘great’ and ‘healthy’ when felt by  the inexperienced: but they are actually ‘over the top’, lacking inner strength: ‘all show and no substance’, representing all Yang and no Yin.
Jonathan Brand colours

Stay in Touch!

No spam, only notifications about new articles and updates.

The latest books
Book a Consultation
Book Consultation
Acupuncture consultation

Book a Video consultation if you want to know more about your symptoms

$MMT = window.$MMT || {}; $MMT.cmd = $MMT.cmd || [];$MMT.cmd.push(function(){ $MMT.display.slots.push(["d2755178-d048-4d00-aedf-899470b89852"]); })
Seeds for Digestion, helping Heart and Kidney yin deficiency with Empty Heat
Copyright Acupuncture-Points.org

How is this treated?

Chinese medicine understands this syndrome, and certainly has ways to treat it.

At root, it aims to calm or release any appearance of Heat, and at the same time, strengthen Yin energy.

That’s easier said than done. Most people with this syndrome have locked themselves into a lifestyle from which it’s hard to escape.

But unless they make changes, any improvement won’t last long.

I once had a patient, a Professor in charge of a large well-known university department. To fund her department she had to supervise a considerable amount of research, and keep applying for grants. She worked at a frantic speed. She developed nearly all the symptoms listed above.

To calm herself down, she smoked – almost all the time. It did reduce her frantic haste a little, but then she couldn’t concentrate. So she drank coffee – a lot. That speeded her up again, so she needed another cigarette to calm down. And so, round and round!

I said that the treatment I gave would probably slow her down, and that for it to work she’d have to accept this.

She said, no, she needed something to enable her to keep working at the same pace without needing to smoke.

I apologised and said I couldn’t do it. So we parted. I don’t know what happened to her except that she left the department soon after.

Acupuncture points often used for this

These often include points on the –

  • upper back, mostly to help soothe what seems like excess yang
A possible point used for Heart Qi stagnation and for Heart and Kidney yin deficiency
Acupuncture at the top of the back, useful sometimes for Heart Qi stagnation.
  • lower abdomen, to steady yin
  • medial legs, to consolidate yin
  • head and ears, to send excess yang downwards



There are ancient herbal formulae to consolidate yin. Other herbs might be added to deal with individual symptoms.

For a change, these formulae don’t usually taste too bad!

Food for Heart and Kidney Yin deficiency with Empty Heat

As with any illness, the more ill you are the less choice you have in finding food that helps.

With this, you don’t want to exacerbate yang, so that reduces spicy foods that you may like. But you shouldn’t take cold food/drink that would drain what meagre supplies of yang that you do have. If you ate lots of cold, very yin food, you probably wouldn’t be able to digest it.

So you’re stuck with stews and soups made from lots of vegetables, including root vegetables. They must be eaten hot. If you take stimulants or spicy foods, take careful note of your symptoms and stop if you develop any like those listed above.

Nuts and seeds are good – in moderation.

Read our pages on

Related Articles

photo of person showing silver-colored ring
Causes of disease

Knee Pain

Knee pain has five main causes. It’s certainly worth trying acupuncture before you resort to surgery!

Read More »

Leave a Reply

Your email address will not be published. Required fields are marked *