Harmful cyanobacterial blooms (CyanoHABs) are linked to increasing anthropogenic nitrogen (N) and phosphorus (P) inputs. However, CyanoHABs in many large lakes continue despite extensive abatement efforts, mostly focused on external P loading. Internal nutrient cycling can modify nutrient availability and limitation; thus, understanding the relative importance of external vs. internal nutrient loading is essential for developing effective mitigation strategies for CyanoHABs. We estimated long-term nutrient budgets for Lake Taihu, China, from mass balance models using extensive monitoring of input and output nutrient data from 2005 to 2018 to quantify contributions from internal nutrient loading. The nutrient mass balance showed that 9% and 63% of annual external N and P inputs, respectively, were retained in the lake. Denitrification removed 54% of external N loading and can thus help explain rapid decreases in lake N concentrations and summer N limitation. Water column NH4+ regeneration can help sustain CyanoHABs over the short term and contributed 38-58% of potential NH4+ demand for summer-fall, Microcystis-dominated blooms. Internal P release contributed 23-90% of CyanoHABs P demand, although Taihu was a net P sink on an annual scale. Our results show that internal nutrient cycling helps sustain CyanoHABs in Taihu, despite reductions in external nutrient inputs. Furthermore, N is leaving the lake faster than P, thereby creating persistent N limitation. Therefore, parallel reductions in external N loading, along with P, will be most effective in reducing CyanoHABs and accelerate the recovery process in this and other large, shallow lakes.