TCM Body Constitution Types: What They Are and What Research Shows

What "constitution" means

In Chinese medicine, body constitution is described as a person's natural health foundation, mostly inherited at birth but shaped over time by lifestyle, diet, emotions and environment. [1] The general idea is traced back more than two thousand years to the Huangdi Neijing (see the Huangdi Neijing). [1]

The nine-type system used today is much newer. A branch called Constitutional Medicine was developed by Professor Wang Qi in the 1970s. [2] One review describes constitution as a relatively stable predisposition category. [3] This is a traditional framework, not a medical diagnosis.

The nine types

The system sorts people into one balanced type (also called gentleness) and eight unbalanced types: qi-deficiency, yang-deficiency, yin-deficiency, phlegm-dampness, damp-heat, blood-stasis, qi-stagnation and inherited-special. [2][4] For plain-language meanings of the key words, see Cold, Heat, Dampness, Phlegm and Common TCM Patterns.

A 2020 review of 1,639 observational studies reported which conditions each type was most often found in. These are associations in cross-sectional studies, not proof of cause.

How the questionnaire works

The standard research tool is the Constitution in Chinese Medicine Questionnaire (CCMQ), developed by Wang Qi's group. The original has 60 items covering the nine types. [2] It became a standard of the China Association of Chinese Medicine in 2009, and constitution-based health management is part of China's basic public health services. [2] A national survey of 21,948 people was used to build a 26-item short form, whose structure matched the nine types in a separate sample of 205 people. [6]

This site does not offer a quiz. A questionnaire score is a screening result, and as the NHS says about tiredness and other symptoms, do not self-diagnose. [7] See why online TCM quizzes are unreliable.

What studies have found

• How common? In 8,665 adults in Hangzhou, 74.2% had one or more body constitutions. [1] The most common unbalanced types were qi-deficiency (16.4%), phlegm-dampness (11.0%) and yang-deficiency (9.4%). [1] More than half of people with an unbalanced type fit more than one. [1]
• Link to stroke. A meta-analysis of 41 studies (11,211 participants) found qi-deficiency and phlegm-dampness 3.47 and 2.34 times more common among stroke patients than the general population. [8] The authors warned the studies were of low or moderate quality. [8]
• Study design. Of the 1,639 studies in the larger review, 88.59% were cross-sectional, which cannot show that a type comes before disease. [5] The authors asked for more rigorous studies. [5]
• Biology. Phlegm-dampness people (74) had higher glucose and blood fats than gentleness-type people (66). [9] Among 249 people, the damp-heat type had lower gut microbiome richness and diversity than the balanced type. [10] A critical review notes the first study's model was tested on the same 140 people, with no outside validation, so its accuracy is probably overstated. [3]
• Label: promising but limited for describing groups; insufficient evidence for any individual use.

Does knowing your type improve outcomes?

One randomized trial of 121 adults with prediabetes in Taiwan compared a TCM-based app that used constitution information, an ordinary health app, and usual care alone. [11] Against usual care, the TCM app improved HbA1c, BMI and some constitution scores. [11] But there were no significant differences between the TCM app and the ordinary app on those outcomes. [11] The authors said larger, longer studies are needed. [11] A trial of 207 adults with chronic disease is planned, but its protocol has been published without results. [12] Label: insufficient evidence that tailoring by constitution adds benefit.

Using this information safely

A constitution label is not a diagnosis and cannot tell you whether tiredness, high blood sugar or low mood needs medical care. Do not stop or change any medicine because of a constitution result. Some Chinese herbal products have been contaminated with toxic compounds and heavy metals, so the same caution applies to any herbal product, whatever label it carries. [13] Read TCM-style supplements vs traditional formulas and tell your doctor about anything you take.