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  • Writer's pictureAlessandra Cossu

The Five Elements in Chinese Medicine

Updated: May 6

According to some traditions, everything in the universe comes from the five elements: wood, fire, earth, water, and metal.

From the smallest atom to a giant whale to the solar system itself, all things are said to be composed of some combination of these elements.

When it comes to human life, some people believe the five elements play a role in the balance of energies in the body, contributing to everything from personality traits to health and well-being.

While it sounds plausible, is this theory supported by science? Can the scientific approach and five element theory live side by side?

Here’s what experts and scientists say about the five elements, plus what they can and can’t teach you about your health.

What is the five-element theory?

Five-element theory, also referred to as Wu Xing or the five phases, has been a part of traditional Chinese medicine (TCM) for centuries.

According to a 2008 report, an early mention can be found in the ancient text Huangdi Neijing, which likely dates back to 300 B.C. Even so, this theory still has many believers today.

“The five elements are used in pretty much every different style of TCM to some extent [to] diagnose and differentiate between different illnesses, dysfunctions, and people,” says Tiffany Cruikshank, licensed acupuncturist, experienced registered yoga teacher, and founder of Yoga Medicine.

The five elements are each associated with an aspect of nature, a connection that runs deep.

“The five elements demonstrate how all aspects of human health, [like] diet, movement, and emotions, are interconnected with nature and our environment,” says Teresa Biggs, a board-certified doctor of oriental medicine (DOM) with more than a decade of clinical experience.

“The five elements demonstrate how all aspects of human health, [like] diet, movement, and emotions, are interconnected with nature and our environment.”

—Teresa Biggs, DOM

The five-element theory is used throughout Eastern medicine and culture. The five elements play a role in:

What does science say?

Science backs the existence of elements in nature, but their existence as a means to inform health treatment isn’t historically supported by research.

Still, more and more research is emerging using evidence-based methods.

One study from 2017 extended the concept of the five elements to a cellular level, noting that incorporating this theory could lead to a better understanding of the relationship between cells.

Another study from 2017 suggested that music therapy based on the five elements could reduce post-stroke depression when combined with acupoint needling or injection.

In 2020, researchers published work based on observational studies of Western medicine, homeopathic medicine, and TCM. They noted that “considering the Five Elements theory in the diagnosis and treatment of the patient could lead to a deeper and more effective… treatment.”

A 2020 overview of TCM and clinical pharmacology offers evidence-based research into using TCM, including the five-element theory.

Researchers note several contributions TCM has made, including:

  • evidenced-based empirical studies

  • correlations and interactions between herbs and pharmaceuticals

  • updated data on toxicity, adverse reactions, quality assurance, and herbal medicine standardization

  • herbal medicines as an alternative to antimicrobial resistance in prescription drugs

Researchers recommended using TCM in conjunction with modern science as a way to prevent disease and strengthen the body with lifestyle changes.

How the five elements work

“The five-element theory mirrors the interdependent, dynamic, ever-changing energy present in nature,” Biggs says.

She explains that there are two cycles connecting each element, where each element has a job to do.

In the generating (or creative) cycle, each element gives way to the next.

In this cycle:

  • fire generates earth

  • earth generates metal

  • metal generates water

  • water generates wood

  • wood generates fire

In the controlling (or destructive) cycle, “one element can control or be controlled by another element,” says Biggs.

In this cycle:

  • water controls fire

  • fire controls metal

  • metal controls wood

  • wood controls earth

  • earth controls water

The five elements and personality

The elements are also part of the lunar year, with the 12 zodiac signs and animals that go along with them, though not all TCM practitioners use this system in their practice.

Each animal represents 1 year and has unique characteristics. For example, 2021 is the Year of the Ox.

Each 12-year cycle also corresponds to an element. Oxen are considered earth creatures, but the years 2020 to 2031 are considered “metal” years.

“Someone who is born during 2021 will have the influence of metal even though [oxen] are an earth creature,” says Tsao-Lin Moy, licensed acupuncturist of Integrative Healing Arts says. “You’ll see both in the person.”

What qualities, exactly, would a person born in a “metal year” possess? And how about people born in years corresponding to the other elements?

Moy provides some generalizations:

  • Wood personalities may be firm and strong but also rigid or uptight.

  • Metal types can be responsible and meticulous though sometimes unbending.

  • Fire types may be boisterous and joyous but also quick to anger.

  • Earth types may be caring and giving but can also be immovable, stubborn, or overbearing.

  • Water personalities can be quiet, reserved, and introspective as well as emotive and sentimental.

Of course, these are simply caricatures of the personality types for easy understanding. When applied to actual people, they become much more complex and nuanced.

Moy clarifies that each element is connected, and we all have bits and pieces of each within us. Still, she says if an element is dominant in a person, it may influence personality traits.

Five-element theory is not a replacement for medical treatment. It’s a holistic (whole-person) approach that can be integrated with your lifestyle and healthcare needs.

Author Beth Ann Mayer, a New York-based writer

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