Ginny Chen, LAc, MSAOM
Vertigo
People who suffer from vertigo episodes feel dizzy as well as if the world is spinning or swaying. In the same way that coughing, headaches, and stomach discomfort are all signs of diseases, vertigo is a symptom instead of an actual disease. The crucial point is that vertigo could be caused by an underlying illness. Sudden dizziness with a spinning sensation can be terrifying for individuals of any age. Vertigo causes an unimaginable amount of psychological and physical stress.
Vertigo can be a complex condition with various causes. Depending on accompanying symptoms, it can be categorized as peripheral or inner ear vertigo or central vertigo. If vertigo is accompanied by hearing loss or tinnitus, it is more likely an inner ear condition. On the other hand, if other symptoms of the central nervous system are present, it is central vertigo. Normally, the human body's balance is maintained by the visual, proprioceptive, and vestibular systems of the inner ear. Neural centers or nuclei around the vestibular nerve nucleus in the brainstem are also connected to functions such as nausea, gastrointestinal motility, sweating, and breathing, so these symptoms may occur with vertigo episodes. However, when there are pathological changes in these sensory systems or central nervous system integration nuclei, vertigo can develop. In clinical settings, it is important to ask about the nature, severity, duration, frequency, and accompanying symptoms of vertigo to identify the underlying cause.
According to traditional Chinese medicine, vertigo/dizziness can be categorized into two types: deficiency syndrome and excess syndrome. Deficiency syndrome is more common in elderly patients and may be caused by a deficiency of Qi and blood, deficiency of liver and kidney yin, or deficiency of Marrow and sea (brain). On the other hand, excess syndrome can be caused by phlegm obstruction or liver yang transforming into fire and blocking the head orifices. It should be noted that some cases of vertigo/dizziness may present with symptoms of both deficiency and excess. Thus, seeking advice from a clinical Chinese medicine practitioner for accurate diagnosis and appropriate treatment is recommended.
From Chinese medicine’s differentiated diagnostic perspective, there are generally four types of dizziness/vertigo:
Liver Yang rising: dizziness/vertigo, tinnitus, headache, and distension worsen with stress or anger, the face is flushed, irritable and easy to anger, insomnia, bitter taste in mouth, red tongue, and a stringy or thin and rapid pulse. The prescription used is Tian Ma Gou Teng Yin with modifications.
Qi and Blood deficiency: dizziness/vertigo worsens with movement or fatigue, pale complexion and lackluster hair, palpitations, insomnia, fatigue, reduced appetite, pale tongue, and weak pulse. The prescription used is Gui Pi Tang with modifications.
Kidney Essence deficiency: dizziness/vertigo with listlessness, insomnia, frequent dreams, soreness and weakness in the lower back and knees, spermatorrhea, tinnitus, and a thin pulse. The prescription used is either Zuo Gui Wan or You Gui Wan with modifications.
Phlegm obstruction: dizziness/vertigo with a heavy feeling in the head, chest tightness, nausea, reduced appetite, white and greasy tongue coating, and a slippery pulse. The prescription used is Ban Xia Bai Zhu Tian Ma Tang with modifications.
After diagnosis, some patients with vertigo/dizziness may benefit from acupressure on specific acupuncture points such as GB20, GB12, SJ17, SI19, DU20, Liv3, and LI4. Maintaining a regular schedule and getting sufficient sleep is important for preventing dizziness/vertigo. Moderate exercises like Tai Chi and Qigong are recommended along with a positive mindset and avoiding excessive emotional stress. A balanced and regular diet is also crucial, avoiding overeating, greasy and spicy foods that can harm the spleen, and salty foods that can harm the kidneys. Quitting smoking and alcohol is advised. Patients should balance their physical activity between work and leisure, avoid overexertion, and sudden strong or passive head movements to reduce the occurrence of dizziness/vertigo.
