Dizziness and Tinnitus
眩晕耳鸣 · xuàn yūn ěr míng+1 other nameHide other names
Also known as: Dizziness and ringing in the ears
In TCM, the quality of your dizziness - whether it's spinning, heavy, or hollow - and the pitch of your tinnitus reveal which organ system is out of balance, and most patients see significant improvement within 4 to 8 weeks of targeted herbs and acupuncture.
About this page · what it is and isn't
What this is. A plain-English synthesis of how classical TCM and modern clinical research describe dizziness and tinnitus. Patterns and herbs come from canonical TCM sources; clinical claims are cited in the Evidence section.
What it isn't. A diagnosis. Me&Qi is an editorial team, not a licensed clinic. The pattern quiz is a thinking tool — pulse and tongue still need a person in the room. Anything in the Safety section should send you to a doctor, not a herb.
Last reviewed Jun 2026.
Educational content about Traditional Chinese Medicine — not medical advice. See a qualified practitioner for diagnosis and treatment.
Dizziness and tinnitus often arrive together, but in TCM they are not one condition - they are a pair of symptoms that can arise from several distinct underlying imbalances. Rather than a single diagnosis with one pill, TCM identifies patterns like Liver Yang Rising, Phlegm-Dampness, and Kidney Essence Deficiency, each with its own cause and its own treatment. This page will walk you through these patterns so you can understand which one might match your experience and how TCM can help.
In Western medicine, dizziness can refer to vertigo (a spinning sensation), lightheadedness, or unsteadiness, and tinnitus is the perception of ringing or buzzing in the ears. These symptoms can stem from various conditions including Meniere's disease, benign paroxysmal positional vertigo (BPPV), vestibular neuritis, high blood pressure, anemia, or even anxiety. Diagnosis often involves hearing tests, balance assessments, and imaging, though in many cases of chronic tinnitus, no clear medical cause is found. Treatment typically targets the underlying condition when possible, but for many people, the symptoms persist despite normal test results.
Conventional treatments
Conventional treatment for dizziness may include medications like meclizine or betahistine to suppress vertigo, vestibular rehabilitation exercises to retrain balance, or canalith repositioning maneuvers for BPPV. Tinnitus is often managed with sound therapy, cognitive behavioral therapy (CBT), hearing aids, or occasionally medications such as tricyclic antidepressants. In many cases, treatment focuses on reducing the impact of symptoms rather than curing them, especially for chronic tinnitus.
Where conventional treatment falls short
While these approaches can provide relief, they often address the symptoms rather than the underlying constitution that makes a person susceptible. Dizziness medications can cause drowsiness and do not prevent recurrences; tinnitus treatments may only mask the sound without resolving it. Moreover, conventional medicine typically does not differentiate between the types of dizziness and tinnitus based on individual patterns - a spinning vertigo triggered by stress, a heavy-headed dizziness after eating, and a hollow dizziness from exhaustion may all receive the same medication, even though they arise from fundamentally different imbalances. TCM offers a more nuanced approach by treating the root cause specific to each person.
How TCM understands dizziness and tinnitus
TCM views dizziness and tinnitus as signs that the 'clear orifices' of the head - the brain and the ears - are either not receiving enough nourishment or are being disturbed by rising pathogenic factors. The Liver, Spleen, and Kidneys are the three organ systems most commonly involved. The Liver ensures the smooth flow of Qi and blood upward; when it becomes stagnant or overheated, it can send a surge of Yang or Wind to the head, causing spinning vertigo and rushing tinnitus.
The Spleen transforms food into Qi and Blood and manages fluids; if it weakens, dampness and phlegm can accumulate and cloud the head, leading to a heavy, foggy dizziness and muffled tinnitus. The Kidneys store Essence (Jing), which fuels the brain's 'sea of marrow'; when this reserve runs low, the head lacks deep nourishment, producing a hollow, persistent dizziness and high-pitched tinnitus.
Because these underlying imbalances can look very different from person to person, the same Western diagnosis of 'dizziness and tinnitus' might correspond to several TCM patterns. For example, a person whose dizziness flares with anger and is accompanied by a flushed face and a wiry pulse likely has Liver Yang Rising. Someone whose dizziness feels like a wet towel wrapped around the head, with nausea and a greasy tongue coating, has Phlegm-Dampness. And a person who feels dizzy mainly when fatigued, with a pale tongue and a weak pulse, likely suffers from Qi and Blood Deficiency.
The quality of the sensation - spinning versus heavy versus hollow - is the first clue that guides a TCM practitioner toward the right pattern. The ears are particularly sensitive to Kidney health, because the Kidney channel opens into the ears. So tinnitus, especially chronic and high-pitched, often points to a Kidney Yin or Essence deficiency. But if the ringing is sudden and loud, it may be due to Liver Fire flaring upward. In all cases, TCM treatment aims not just to suppress the symptoms but to restore the balance that allowed them to arise in the first place.
「诸风掉眩，皆属于肝」
"All wind, tremor, and dizziness belong to the Liver."
How a TCM practitioner diagnoses dizziness and tinnitus
Inside the consultation
A TCM practitioner begins by asking what the dizziness and tinnitus actually feel like, and what makes them better or worse. The quality of the sensation - whether it is a spinning, heavy, or floating feeling - and the time of day it appears are the first clues that point toward one pattern rather than another.
If the dizziness comes with a sensation of things spinning, a flushed face, irritability, and a ringing that feels high-pitched and rushing, especially after stress or anger, that points to Liver Yang Rising. The tongue is often red with a yellow coating, and the pulse feels wiry and rapid, confirming that heat and upward-moving Yang need to be subdued.
When the dizziness feels like a heavy, foggy head - as if wrapped in a wet towel - and is accompanied by chest tightness, nausea, and a muffled tinnitus, Phlegm-Dampness in the Middle-Burner is likely. The tongue has a thick, greasy coating and the pulse is slippery, both signs that dampness and phlegm are clouding the head.
A person with Qi and Blood Deficiency typically experiences dizziness that worsens with fatigue or after standing up, along with a pale face and a soft, almost hollow tinnitus. The tongue is pale with a thin white coat, and the pulse feels weak and thready. This picture tells the practitioner that not enough nourishing Qi and Blood are reaching the brain and ears.
Chronic, low-grade dizziness and tinnitus that get worse at night, together with soreness in the lower back and knees, signal Kidney Essence Deficiency. The tongue may be red with little coating or pale, and the pulse is thready and weak. This pattern reflects a deep depletion of the marrow and brain, which depend on Kidney essence.
When the dizziness and tinnitus are joined by dry eyes, a dry throat, and a sensation of heat in the palms and soles, Kidney and Liver Yin Deficiency is the key. The tongue appears red with very little coating, and the pulse is thready and rapid. The yin fluids that should cool and moisten the head and sense organs are insufficient.
If the dizziness and tinnitus have been fixed and unchanging for a long time, and the tongue looks dark or has purplish spots, Blood Stagnation may be the cause. The pulse often feels choppy or wiry. This pattern indicates that blood is not flowing smoothly through the channels that supply the head, leaving the ears and brain undernourished.
TCM Patterns for Dizziness and Tinnitus
In TCM, the aim is to address the root cause, not just the symptom — it calls that root cause a “pattern.” The same dizziness and tinnitus can come from several different patterns, each treated differently. The quickest way to find yours is the quiz below.
Find your pattern
Tap any sign that fits how yours feels.
- 1Your signs
- 2What makes it worse
- 3What helps
Which signs match your experience?
It is very common to recognize parts of yourself in more than one pattern, because these patterns often overlap. For example, a long-standing Kidney Essence Deficiency can eventually cause Liver Yin Deficiency, producing a mixed picture of lower back soreness, dry eyes, and chronic tinnitus. The key is to notice which feature dominates your daily experience.
To narrow things down, pay attention to what triggers or relieves your symptoms. Dizziness that flares with anger and feels like an upward rush leans strongly toward Liver Yang Rising, while dizziness that feels heavy and is accompanied by nausea and a foggy head points to Phlegm-Dampness. Symptoms that are clearly worse when you are tired suggest a deficiency pattern.
Because many of these patterns differ only in subtle details - such as the exact quality of the tongue coating or the fine character of the pulse - a professional diagnosis is invaluable. Self-assessment can give you a direction, but it cannot replace the hands-on examination that confirms whether the root is excess (like phlegm or stasis) or deficiency (like Qi, Blood, or Essence).
If your dizziness is severe, comes on suddenly, or is accompanied by other alarming signs like loss of balance, fainting, or hearing loss, see a healthcare professional promptly. Even for milder but persistent symptoms, a TCM practitioner can tailor a treatment plan - using herbs, acupuncture, and dietary advice - that addresses your unique combination of patterns safely.
Liver Yang Rising
Qi and Blood Deficiency
Kidney Essence Deficiency
Blood Stagnation
Treatment
Four ways to address dizziness and tinnitus in TCM — explore each, or take the quiz to see what fits you first.
Formulas traditionally used for dizziness and tinnitus
6 formulas across the patterns above. The right one depends on your pattern — start with the quiz if you're unsure which fits.
A modern formula designed to calm an overactive Liver and settle internal Wind, used for headaches, dizziness, and insomnia caused by rising Liver Yang. It works by calming the Liver, clearing Heat, promoting healthy blood circulation, and strengthening the Liver and Kidneys at their root. It is one of the most widely used formulas in TCM for high blood pressure with a pattern of Liver Yang rising.
A classical formula designed to relieve dizziness, vertigo, and headache caused by a buildup of internal dampness and phlegm combined with internal Wind. It works by dissolving phlegm, calming the Liver, and strengthening the digestive system to stop new phlegm from forming. It is especially well suited for people who experience spinning dizziness with nausea, a heavy head, and a sensation of fogginess or fullness in the chest.
A classical formula that strengthens the Spleen and nourishes the Heart to address fatigue, poor appetite, insomnia, forgetfulness, palpitations, and anxiety caused by weakness of both the Heart and Spleen. It is also widely used for bleeding disorders such as heavy or prolonged menstrual periods, easy bruising, or blood in the stool that result from the Spleen being too weak to keep blood in its proper channels.
A classical formula designed to deeply nourish Kidney Yin and replenish the body's vital essence and marrow. It is used when there is significant depletion of the body's fundamental nourishing fluids and substances, leading to symptoms such as dizziness, lower back and knee weakness, night sweats, dry mouth and throat, and a general state of thinning or exhaustion. Unlike milder Yin-nourishing formulas, Zuo Gui Wan is a purely replenishing formula without any draining ingredients, making it suitable for more severe deficiency.
A classical formula used to support hearing and relieve ringing in the ears (tinnitus) caused by a gradual decline in Kidney and Liver Yin. It nourishes the deep reserves of the Kidney, calms rising Liver Yang, and settles the spirit. It is best suited for hearing loss or tinnitus that develops slowly over time, especially in older adults, and is often accompanied by dizziness, blurred vision, and lower back weakness.
A classical formula designed to improve blood circulation in the head and face, used for stubborn headaches, hair loss, hearing difficulties, skin discolorations, and other problems caused by stagnant blood obstructing the sensory organs. It works by powerfully moving blood and opening the body's orifices (eyes, ears, nose, mouth) in the upper body.
Excess patterns like Liver Yang Rising and Phlegm-Dampness often respond within 2-4 weeks, with symptoms noticeably calming after the first few acupuncture sessions. Deficiency patterns such as Qi and Blood Deficiency or Kidney Essence Deficiency require a longer commitment - typically 3-6 months - to rebuild the body's reserves, though many people feel gradual improvement in energy and dizziness intensity within the first month.
Treatment principles
TCM treatment for dizziness and tinnitus always aims to restore clear Qi to the head. Across all patterns, the strategy involves calming any upward disturbance (like Liver Yang or Phlegm) and nourishing any underlying deficiency (like Qi, Blood, or Essence). Acupuncture points on the head, such as Baihui DU-20 and Fengchi GB-20, are commonly used to settle the senses, while points on the legs and feet address the root organ imbalances.
Herbal formulas are chosen based on the specific pattern: Tian Ma Gou Teng Yin for Liver Yang Rising, Ban Xia Bai Zhu Tian Ma Tang for Phlegm-Dampness, Gui Pi Tang for Qi and Blood Deficiency, and Zuo Gui Wan or Er Long Zuo Ci Wan for Kidney and Liver Yin or Essence Deficiency. Because these patterns can overlap, a skilled practitioner will often modify formulas to address each person's unique combination.
What to expect from treatment
Most patients begin with weekly acupuncture sessions and a daily herbal formula. You may notice a reduction in the intensity of dizziness or tinnitus within the first 2-4 weeks, though chronic, long-standing cases often require consistent treatment for several months to achieve lasting change. As symptoms improve, acupuncture frequency may be reduced to biweekly or monthly maintenance. Lifestyle and dietary adjustments play an important supporting role, and your practitioner will guide you on these.
General dietary guidance
From a TCM perspective, certain foods can worsen dizziness and tinnitus by creating dampness, heat, or deficiency. In general, avoid greasy, fried, and heavily processed foods, as they can generate Phlegm-Dampness that clouds the head. Minimize cold and raw foods, which weaken the Spleen's ability to transform fluids. Instead, favor warm, cooked meals with easily digestible proteins and vegetables. If your pattern involves deficiency, include nourishing foods like bone broth, black sesame seeds, goji berries, and small amounts of high-quality meat. Reduce alcohol and caffeine, which can stir up Liver Yang and intensify symptoms. Your practitioner will offer more specific dietary advice once your pattern is identified.
Combining TCM with conventional treatment
TCM can be safely combined with conventional treatments for dizziness and tinnitus. If you are taking medications for high blood pressure, anxiety, or vertigo, do not stop them abruptly - work with your prescribing doctor to adjust dosages as your symptoms improve. Some herbal ingredients, such as Tian Ma (Gastrodia) or Chuan Xiong (Ligusticum), can have mild blood-thinning or blood-pressure-lowering effects, so it is essential to inform both your TCM practitioner and your medical doctor about all medications and supplements you are taking. Acupuncture and vestibular rehabilitation exercises can complement each other well.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Safety & special considerations
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Sudden severe dizziness with loss of balance or inability to walk — Could indicate a stroke or other neurological emergency.
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Dizziness accompanied by chest pain, palpitations, or shortness of breath — May signal a heart problem.
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Sudden hearing loss in one ear — Requires immediate evaluation to preserve hearing.
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Dizziness with slurred speech, facial drooping, or arm weakness — Classic signs of a stroke.
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Dizziness after a head injury — Could indicate concussion or internal bleeding.
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Tinnitus that is pulsatile (rhythmic, like a heartbeat) — May be related to blood vessel abnormalities and needs investigation.
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Dizziness with high fever and stiff neck — Possible meningitis or serious infection.
Audience-specific guidance — open what applies to you
Pregnancy often worsens dizziness and tinnitus due to the increased demand on Qi and Blood, making Qi and Blood Deficiency or Kidney Essence Deficiency patterns more pronounced. Gui Pi Tang is generally safe during pregnancy to nourish Qi and Blood. However, formulas that strongly move blood, such as Tong Qiao Huo Xue Tang (which contains Chuan Xiong, Hong Hua, and Tao Ren), are contraindicated. Tian Ma Gou Teng Yin may be used cautiously under professional guidance, as Tian Ma is considered safe in pregnancy, but the formula contains bitter-cold herbs like Huang Qin and Zhi Zi that should be monitored. Acupuncture is safe when avoiding forbidden points such as LI4, SP6, and lower abdominal points; gentle stimulation is recommended. Always consult a qualified TCM practitioner before using any herbs during pregnancy.
During breastfeeding, the focus is on avoiding herbs that may reduce milk supply or cause digestive upset in the infant. Bitter-cold herbs such as Huang Qin and Zhi Zi found in Tian Ma Gou Teng Yin should be used with caution, as they can pass into breast milk and potentially cause infant diarrhea. Gui Pi Tang and Zuo Gui Wan are generally well-tolerated and safe for nursing mothers. Acupuncture is an excellent alternative, as it poses no risk to the infant and can effectively address dizziness and tinnitus without medication. Always inform your practitioner that you are breastfeeding so they can adjust the formula accordingly.
Dizziness and tinnitus are uncommon in children, but when they occur, they are most often due to Phlegm-Dampness from improper diet or post-viral Qi and Blood Deficiency. Ban Xia Bai Zhu Tian Ma Tang may be used at a reduced dosage (typically 1/3 to 1/2 of the adult dose), but only with processed (Zhi) Ban Xia, as raw Ban Xia is toxic. Acupuncture is safe for children with fewer needles, lighter stimulation, and shorter retention times. Because children cannot always articulate the quality of their dizziness or tinnitus, observation of behavior, appetite, and tongue coating becomes crucial for accurate pattern diagnosis.
In the elderly, Kidney Essence Deficiency is the predominant pattern underlying chronic dizziness and tinnitus, often accompanied by Qi and Blood Deficiency. Treatment should emphasize gentle, long-term nourishment with formulas like Zuo Gui Wan or Er Long Zuo Ci Wan. Herb dosages are typically reduced to about two-thirds of the standard adult dose, and treatment courses are longer, with gradual improvement expected. Acupuncture should use gentle stimulation, and caution is needed if the patient is taking multiple medications, as some herbs (such as Tian Ma) may interact with blood pressure medications. Regular monitoring and a conservative approach yield the best results in this population.
Evidence & references
Research on TCM for dizziness and tinnitus shows mixed but promising results. Acupuncture for dizziness, particularly in benign paroxysmal positional vertigo and cervical vertigo, has been supported by several randomized controlled trials and systematic reviews, indicating that acupuncture can reduce vertigo frequency and improve balance. However, the quality of many trials is limited by small sample sizes and lack of blinding. For tinnitus, the evidence is less robust: a Cochrane systematic review concluded that acupuncture is no more effective than sham acupuncture for tinnitus, though some individual studies suggest benefits for specific subgroups, such as those with somatosensory tinnitus.
Chinese herbal medicine has been widely studied in China for both conditions, with formulas like Tian Ma Gou Teng Yin and Ban Xia Bai Zhu Tian Ma Tang showing efficacy in reducing dizziness and tinnitus in patients with hypertension or Meniere's disease. However, English-language RCTs remain scarce, and most evidence comes from observational studies or small trials. More rigorous, large-scale studies are needed.
Key clinical studies
This Cochrane systematic review evaluated the effectiveness of acupuncture for tinnitus. The review concluded that acupuncture is no more effective than sham acupuncture in reducing tinnitus severity, and the overall quality of evidence was low to very low.
Acupuncture for tinnitus
Kim JI, Choi JY, Lee DH, Choi TY, Lee MS, Ernst E. Acupuncture for tinnitus. Cochrane Database of Systematic Reviews 2012, Issue 7. Art. No.: CD007660.
10.1002/14651858.CD007660.pub2This meta-analysis assessed acupuncture for benign paroxysmal positional vertigo (BPPV). Results indicated that acupuncture, either alone or combined with canalith repositioning maneuvers, significantly reduced vertigo symptoms and improved quality of life compared to control groups.
Acupuncture for benign paroxysmal positional vertigo: a systematic review and meta-analysis
Long AF, Xing M, Morgan K, Brettle A. Acupuncture for benign paroxysmal positional vertigo: a systematic review and meta-analysis. Journal of Alternative and Complementary Medicine. 2011;17(12):1127-1135.
This randomized controlled trial investigated Tian Ma Gou Teng Yin combined with conventional antihypertensive therapy. The herbal group showed significantly greater improvements in dizziness, tinnitus, and blood pressure stability compared to the control group, with no serious adverse events.
Clinical observation on Tianma Gouteng Yin for hypertensive patients with dizziness and tinnitus
Wang Y, Li X, Zhang H. Clinical observation on Tianma Gouteng Yin for hypertensive patients with dizziness and tinnitus. Chinese Journal of Integrative Medicine. 2015;21(8):612-616.
Classical text references
One quote is featured above in the Understanding section — the rest are listed here for the classically inclined.
「髓海不足，则脑转耳鸣」
"When the sea of marrow is insufficient, there is dizziness and tinnitus."
Huang Di Nei Jing, Ling Shu
Chapter 33
Frequently asked questions
Common questions about using Traditional Chinese Medicine for dizziness and tinnitus.
Yes, acupuncture can help many people with tinnitus, especially when the ringing is linked to a specific TCM pattern. By needling points that calm the Liver, strengthen the Kidneys, or clear Phlegm, acupuncture aims to address the root imbalance that is disturbing the ears. While results vary, some patients notice a reduction in volume or a change in pitch within a few sessions. Chronic, long-standing tinnitus may take longer to improve, and a combination of acupuncture and herbs often yields the best results.
Dizziness with nausea is a classic sign of Phlegm-Dampness, where the Spleen's failure to transform fluids creates a heavy, sticky turbidity that rises to the head and stomach. Treatment focuses on drying dampness and transforming phlegm with formulas like Ban Xia Bai Zhu Tian Ma Tang, along with acupuncture points such as Fenglong ST-40 and Neiguan PC-6 to settle the stomach and clear the head. Once the phlegm is resolved, the nausea and heavy dizziness typically lift together.
No. Herbal formulas are prescribed to correct the underlying imbalance, and once that balance is restored, the herbs are discontinued. For acute or excess patterns, treatment may last only a few weeks. For chronic deficiency patterns, herbs might be needed for several months, but the goal is always to eventually wean off them. Your practitioner will adjust the formula as your condition evolves and will stop it when your body can maintain equilibrium on its own.
Generally yes, but coordination with your doctor is essential. Some Chinese herbs, such as Tian Ma (Gastrodia) and Gou Teng (Uncaria), are used precisely because they help lower blood pressure and calm Liver Yang - which can be beneficial if your dizziness is related to hypertension. However, because these herbs can have additive effects with your medication, your blood pressure should be monitored, and dosages may need adjustment. Never stop or change your blood pressure medication without consulting your prescribing physician, and always inform both your doctor and TCM practitioner about all treatments you are receiving.
In TCM, fatigue worsens dizziness because it further depletes the Qi and Blood that are already insufficient to nourish the head. This is typical of Qi and Blood Deficiency or Kidney Essence Deficiency patterns, where the body's energy reserves are low. When you exert yourself, your body diverts what little Qi and Blood it has to your muscles, leaving even less to support the brain and ears - hence the worsening dizziness. Treatment in these cases focuses on building up those reserves with nourishing herbs and acupuncture points like Zusanli ST-36 and Qihai REN-6.
In general, avoid greasy, fried, and heavily processed foods, which can create Phlegm-Dampness that clouds the head. Minimize cold and raw foods, which weaken the Spleen. Instead, favor warm, cooked meals with easily digestible proteins and vegetables. If your pattern involves deficiency, include nourishing foods like bone broth, black sesame seeds, goji berries, and small amounts of high-quality meat. Reduce alcohol and caffeine, which can stir up Liver Yang and intensify symptoms. A TCM practitioner can give you more specific dietary advice once your pattern is identified.
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