"Why does cold water upset my digestion but not others?" "We follow the same wellness plan — they feel energised, I get overheated." "I have chronic spots, cold hands, and insomnia — where do I start?" The answer is constitutional medicine (ti zhi). TCM recognises that every person’s body has its own innate tendencies — formed by inherited constitution and shaped by lifestyle — that determine disease susceptibility, environmental sensitivity, and the most effective wellness approach. In April 2026, China formally implemented its first national standard for TCM constitution classification: GB/T 46939–2025 Classification and Determination of Traditional Chinese Medicine Constitutions. This standard defines nine constitutional types and provides a streamlined 27-question self-assessment (average completion time: 4.23 minutes). This guide presents the national standard self-assessment in accessible form, with targeted care recommendations for each type.

I. How to Use the Self-Assessment

Score each statement: Never = 1 · Rarely = 2 · Often = 3 · Always = 4. Add the scores for each constitution’s three questions. Total ≥10: confirmed constitution. Total 8–9: constitutional tendency. Total <8: not this constitution. Most people are a mixed constitution (two or more types overlapping) — pure single constitutions account for less than 10% of the population. When two types are present, identify the dominant one and treat it as the priority. Self-assessment results are wellness guidance; for pronounced symptoms, consult a licensed TCM practitioner.

II. The Nine Constitutions: Self-Assessment

1. Balanced (Ping He Zhi) — The healthy baseline
① Complexion, skin, and hair are lustrous; eyes are bright and alert. (1–4)
② Not easily fatigued; abundant energy; tolerates both heat and cold; good sleep. (1–4)
③ Good appetite; regular bowel and urinary function; cheerful; adapts well to environmental changes. (1–4)
Score ≥10 = Balanced constitution; 8–9 = Balanced tendency.

2. Qi Deficient (Qi Xu Zhi) — Insufficient vital energy
① Low voice; short of breath; reluctant to speak; easily fatigued; low spirits. (1–4)
② Prone to spontaneous sweating; becomes breathless with minimal activity; muscle tone poor. (1–4)
③ Pale-red tongue with scalloped edges; frequent colds; slow recovery after illness. (1–4)

3. Yang Deficient (Yang Xu Zhi) — Insufficient warming force
① Chronically cold; cold hands and feet, worse in winter; prefers warm food and drinks. (1–4)
② Low energy; frequent night urination; loose stools; abdomen relieved by warmth and pressure. (1–4)
③ Pale swollen tongue; deep slow pulse; tendency to oedema, dysmenorrhoea. (1–4)

4. Yin Deficient (Yin Xu Zhi) — Insufficient nourishing fluid
① Hot palms and soles; dry mouth and throat; slight nasal dryness; prefers cool drinks. (1–4)
② Afternoon flushing; night sweats; restless insomnia; dry hard stool; lean build. (1–4)
③ Red tongue with scanty coating; thin rapid pulse; tendency to sore throats and dizziness. (1–4)

5. Phlegm-Damp (Tan Shi Zhi) — Accumulated Phlegm-Damp
① Overweight; soft flabby abdomen; oily facial skin. (1–4)
② Heavy sweating with sticky quality; chest oppression; heavy phlegm; drowsy; sticky mouth. (1–4)
③ Thick greasy tongue coating; soggy slow pulse; craves fatty and sweet foods. (1–4)

6. Damp-Heat (Shi Re Zhi) — Damp-Heat accumulation
① Greasy facial skin; prone to acne and spots; bitter dry mouth; irritable temperament. (1–4)
② Sticky constipated or dry hard stool; scanty dark urine; men: scrotal dampness. (1–4)
③ Yellow greasy tongue coating; slippery rapid pulse; tendency to urinary infections, gout. (1–4)

7. Blood Stasis (Xue Yu Zhi) — Impaired Blood circulation
① Dull dark complexion; pigmentation; easy bruising; dark pale lips. (1–4)
② Limb numbness; chest fullness with stabbing pain; dysmenorrhoea with clots. (1–4)
③ Dark or spotted tongue; rough pulse; tendency to forgetfulness and memory decline. (1–4)

8. Qi Stagnation (Qi Yu Zhi) — Liver Qi constraint
① Depressed mood; emotionally fragile; persistent dissatisfaction; frequent sighing. (1–4)
② Chest and flank fullness; poor appetite; insomnia; hypersensitive and suspicious. (1–4)
③ Pale-red tongue with thin white coating; wiry pulse; tendency to depression, breast nodules. (1–4)

9. Special/Allergic (Te Bing Zhi) — Heightened reactivity
① Prone to sneezing, nasal congestion, itchy throat; allergic to pollen, dust mites. (1–4)
② Skin easily itches or develops urticaria; history of drug or food allergies. (1–4)
③ Congenital physiological differences or family history of inherited conditions. (1–4)

III. Nine Constitutions: Targeted Care Guide

1. Balanced — maintain, don’t over-supplement
Accounting for approximately 32.75% of the general population (more common in men). No specific therapeutic intervention needed; focus is preservation. Balanced diet without extremes; moderate exercise 3–4×/week (30 min, walking, Tai Chi, jogging); regular sleep before 11pm; seasonal alignment (spring nourish Liver, summer nourish Heart, autumn nourish Lung, winter supplement Kidney); emotionally stable and socially engaged.

2. Qi Deficient — supplement Qi, strengthen Spleen
Disease tendency: frequent colds; low blood pressure; organ prolapse; slow post-illness recovery; reduced immunity.
Diet: Huang Qi, Dang Shen, yam, millet, red dates, longan, lean meat, eggs. Daily: Huang Qi-red date water. Avoid radish, bitter melon, winter melon, mint (Qi-dispersing); avoid cold-raw and oily-spicy foods.
Exercise: gentle rhythmic movement only (Ba Duan Jin, Tai Chi, walking 20–30 min, 3–4×/week). No high-intensity exercise — it depletes Qi.
Lifestyle: bed before 11pm; short noon rest 11am–1pm; avoid overwork and prolonged damp environments; emotional calm reduces Qi expenditure.

3. Yang Deficient — warm Yang, scatter Cold
Disease tendency: chronic diarrhoea; oedema; low blood pressure; cold uterus infertility; dysmenorrhoea; cold-triggered arthritis.
Diet: lamb, beef, ginger, longan, walnut, leek. Daily: ginger-brown sugar water. Strictly avoid cold-raw foods (ice drinks, ice cream, raw fish, cold salads).
Exercise: warming aerobic activity (brisk walking, jogging, skipping) 30 min, 3–4×/week to generate Yang. Avoid cold and damp exercise environments.
Lifestyle: keep abdomen and extremities warm at all times; hot foot soaks nightly (can add ai ye, ginger); sleep before 10pm; daily sunlight on the back (directly supplements Yang); avoid air conditioning for extended periods.

4. Yin Deficient — nourish Yin, moisten Dryness
Disease tendency: diabetes; hypertension; menopausal syndrome; constipation; recurrent sore throat; premature ageing.
Diet: lily bulb, silver ear, wolfberry, pear, watermelon, winter melon, mung bean, lotus root. Daily: lily bulb-silver ear soup. Strictly avoid spicy, warming, dry-fried foods (chilli, lamb, fried foods).
Exercise: gentle and quiet (yoga, Tai Chi, walking); avoid intense sweating exercise (depletes Yin fluids); 20–30 min, 3–4×/week in cooler morning or evening hours.
Lifestyle: absolutely in bed before 11pm (late nights are the primary Yin-depleting habit); cool humid room environment; avoid prolonged heat or sun exposure; emotional equanimity prevents Fire from consuming Yin.

5. Phlegm-Damp — resolve Phlegm, drain Damp, strengthen Spleen
Disease tendency: hyperlipidaemia; hypertension; diabetes; fatty liver; elevated uric acid; obesity-related conditions.
Diet: Yi Yi Ren, Chi Xiao Dou, winter melon, white radish, yam, white hyacinth bean. Daily: Yi Yi Ren-Chi Xiao Dou water (add 2–3 slices ginger for cold-type Damp). Avoid fatty-sweet-sticky foods; avoid seafood and fried foods.
Exercise: intensify aerobic training — 4–5×/week, 30–40 min (brisk walking, jogging, swimming); sweating moderately is the body’s primary Damp-expelling mechanism.
Lifestyle: avoid damp environments and prolonged sitting; stand up every hour; adequate sleep; no late nights (damage Spleen function); frequent outdoor fresh air.

6. Damp-Heat — clear Heat, drain Damp, detoxify
Disease tendency: acne; cholecystitis; urinary infections; elevated uric acid; skin disorders; metabolic abnormalities.
Diet: mung bean, bitter melon, celery, winter melon, lotus root, purslane. Daily: mung bean soup (not excessive). Strictly avoid spicy, oily, sweet foods; no alcohol or smoking.
Exercise: moderate-intensity aerobic 4–5×/week, 30 min (walking, jogging, skipping, swimming) to move Damp-Heat outward. Dry off promptly after sweating.
Lifestyle: in bed before 11pm; well-ventilated dry living environment; avoid prolonged air conditioning; calm temperament reduces Heat generation.

7. Blood Stasis — activate Blood, resolve Stasis, free Qi
Disease tendency: cardiovascular disease; coronary artery disease; stroke; dysmenorrhoea; tumour tendency; poor circulation.
Diet: hawthorn, black wood ear, rose petals, Dang Gui, Dan Shen, tao ren. Daily: rose-hawthorn tea. Avoid cold-raw and oily foods; reduce sweets (worsen stagnation).
Exercise: 4–5×/week, 30–40 min (brisk walking, jogging, Tai Chi) to move Qi-Blood; clockwise abdominal massage daily; avoid prolonged sitting (stand every hour).
Lifestyle: bed before 11pm; keep warm (cold constricts vessels and worsens stagnation); moderate emotional expression — chronic depression deepens Blood Stasis.

8. Qi Stagnation — soothe Liver, resolve constraint, calm Spirit
Disease tendency: depression; anxiety; breast nodules; thyroid nodules; insomnia; menopausal syndrome. Note: the 2025 national standard revision added “depression” and “cognitive frailty” as new disease tendencies for this constitution.
Diet: chen pi, rose petals, fo shou, tangerine, celery, coriander. Daily: chen pi-rose tea. Avoid cold-raw and oily foods; reduce sweets.
Exercise: gentle rhythmic movement (walking, jogging, yoga, Tai Chi) 20–30 min, 3–4×/week; expressive activities (singing, dancing) also release emotional Qi stagnation.
Lifestyle: emotional regulation is the core treatment; communicate regularly rather than suppressing feelings; cultivate absorbing hobbies (gardening, reading, art); adequate sleep before 11pm; outdoor time in nature and sunlight is especially beneficial.

9. Special/Allergic — supplement Qi, consolidate the surface, avoid triggers
Disease tendency: allergic rhinitis; allergic asthma; urticaria; eczema; allergic disease rate approximately 83% in this type; strong familial clustering.
Diet: yam, Yi Yi Ren, red dates, Huang Qi for surface-consolidating Qi support. Strictly identify and eliminate personal allergens (shellfish, mango, milk, etc.). Avoid spicy and stimulating foods.
Exercise: gentle warming activities (walking, Tai Chi, Ba Duan Jin) 20–30 min, 3–4×/week; avoid exercising in high-pollen or dust-mite-heavy environments.
Lifestyle: maintain clean indoor environment (regular washing of bedding; reduce dust mites and mould); avoid contact with identified allergens (pollen, pet dander); stay warm to reduce cold-triggered flares.

IV. Key Reminders for Constitutional Wellness

• Constitutions are not fixed: diet, exercise, sleep, and emotional management over months and years can meaningfully shift constitutional patterns toward Balanced. This is the purpose of constitutional care.
• Mixed constitutions: address the dominant pattern first. If Qi Deficiency + Phlegm-Damp, identify which is more pronounced; treat that as primary and the other as secondary. Trying to address everything simultaneously is less effective than prioritising correctly.
• Self-assessment is for guidance, not diagnosis. Significant or persistent symptoms — severe insomnia, pronounced dysmenorrhoea, repeated allergic episodes — require individual four-examination assessment by a licensed TCM practitioner for personalised prescription.
• Results take time: constitutional change typically requires 1–3 months of consistent application. Do not switch methods after 2 weeks. Persistence and method-consistency are the primary determinants of outcome.