Non-Specific Dizziness: Insights from Traditional Chinese Medicine

Nonspecific dizziness

Hello doctor, I started experiencing dizziness in early February.
During this time, I had two episodes of blood rushing to my head, but I did not experience vertigo.
On March 30, I visited a doctor due to this dizziness.
The doctor said it was because I was overweight (116 kg) and prescribed a glucose-lowering agent (for diabetes patients, although I do not have diabetes) to help with weight loss.
On April 5, I returned for a follow-up due to discomfort near my heart, and an ECG showed normal results, but my blood pressure was measured at 155/101.
The doctor asked if I wanted to try blood pressure medication.
On the day I took it (at 5 PM), I felt dizzy.
By Thursday morning (April 7), I started experiencing numbness in my head, followed by numbness and coldness in my hands and feet, along with dizziness.
A friend called an ambulance, and after examination at the hospital, it was determined to be a side effect.
On Friday (April 8), I returned for a follow-up, and the doctor advised me to stop the blood pressure medication, with my last dose taken on Thursday at 5 PM.
On Saturday (April 9), I stopped taking the glucose-lowering agent, and then I began to feel heavy dizziness in the back of my head.
On the nights of April 10 and 11, I couldn't sleep and felt pulsations in the back of my head.
Starting April 12, I began to sleep better (sitting up), but in the mornings, I still felt heaviness in the back of my head and occasional dizziness.
The doctor said it was due to mental stress, and sometimes my scalp would feel numb and tight.
Now I also feel like I have a cold; every night at 10 PM, I feel fatigued and dizzy.
Until now, I still feel heaviness in the back of my head, and I have been sleeping sitting up every day.
By mid-May, I started sleeping lying down.
I took the glucose-lowering agent for about eleven days and lost five kilograms in two weeks.
After stopping the medication, I weighed 102 kg by the end of April, and then I returned to normal weight loss.
As of now (July 6), I have reached a plateau at 95 kg.
During this time, I consulted three traditional Chinese medicine practitioners.
Two of them said I have cervicogenic dizziness and liver qi imbalance with insufficient blood and qi, but one practitioner said that when the ambulance came on April 7, I had a minor stroke.
At that time, I only had numbness in my hands and feet, numbness in the back of my head, and dizziness.
I was on the phone with my friends and supervisor, and she asked if my left side was numb (it wasn't at that moment, but after she mentioned it, I started to feel numbness in my left hand and foot after sitting for a while, which resolved the next day).
She said I had damp-heat in early February.
Due to the ambulance incident, I underwent blood tests, urine tests, liver and kidney ultrasounds, autoimmune tests, EEG, brain ultrasounds, autonomic nervous system tests, and 24-hour ECG, all of which were normal.
I had CT scans of my head and neck, which showed only minor bone spurs in my neck without nerve compression.
On June 21, I had an MRI, which revealed mild narrowing of the blood vessels in my right brain.
The neurologist said this would not cause dizziness, while the family medicine doctor suggested it might be tension-type dizziness or dizziness due to tight neck muscles.
Another doctor mentioned it could be caused by sleep apnea.
Most doctors have indicated it is tension-type dizziness.
My current symptoms include slight weakness in my hands and feet, orthostatic hypotension, heaviness in the back of my head, occasional pain in the back of my head and neck, headaches on the top of my head, tightness on both sides of my head, scalp numbness during emotional stress, numbness in my left hand, facial numbness, and numbness in my left foot after sitting for a long time.
Sometimes I experience palpitations, and low-frequency sounds can cause slight palpitations.
I am currently seeing a new traditional Chinese medicine practitioner who palpated my neck and shoulders and said my neck and shoulder muscles are very tight, and my head is also very tense.
I have undergone acupuncture twice, and yesterday (July 6) I went for my third session.
I told him that the heaviness in the back of my head still feels present.
He palpated again and confirmed that my neck and shoulders are still very tight.
After performing a massage on the occipital region and both sides of my head, it was quite painful.
He also mentioned that there are lymph nodes below my ears.
Afterward, the sensation from the acupuncture was very strong.
When I returned home, I felt some pain in the occipital area due to the strong pressure from the massage.
In the afternoon, I felt unwell and went to sleep.
Today (July 7), when I got up, I noticed that the heaviness in my head was more intense when standing and walking than before.
Is this a phenomenon of dizziness? I wonder how many sessions of acupuncture it will take to be effective.
Is my dizziness caused by tight neck muscles?

Alvin, 40~49 year old female. Ask Date: 2016/07/08

Dr. Yan Sumei reply Traditional Chinese Medicine

Dear Alvin,
Feeling dizzy and heavy-headed is truly distressing.
Your MRI findings indicate mild narrowing of the blood vessels in the right hemisphere of the brain.
When you experience emotional stress, you also report numbness in your scalp, left hand, and both cheeks, as well as numbness in your left foot after sitting for a long time.
This suggests that the narrowing of the cerebral vessels is indeed having an impact.
Conditions such as cerebral vessel narrowing, emotional tension, a busy work schedule, and high blood pressure can all contribute to feelings of dizziness and heaviness.
In addition to consulting with a physician, I recommend making adjustments to your diet and lifestyle: eat lighter meals, engage in regular exercise, relax your mind, get plenty of rest, and avoid staying up late.
If massage therapy causes discomfort, it would be best to skip it next time.
Wishing you health and peace!
Sincerely,
Yen Su-Mei
Department of Traditional Chinese Medicine
Nantou Hospital

Reply Date: 2016/07/08

More Info

Understanding non-specific dizziness can be quite complex, especially when considering the insights from Traditional Chinese Medicine (TCM). Your symptoms, including persistent dizziness, feelings of heaviness in the head, and episodes of numbness, suggest a multifaceted issue that may involve both physical and emotional components.

From a TCM perspective, dizziness can be attributed to several factors, including Qi (energy) deficiency, blood deficiency, phlegm-dampness, and liver Qi stagnation. Your description of feeling heavy in the back of your head, along with the tightness in your neck and shoulders, aligns with the TCM concept of "Qi stagnation" and "blood stasis." This stagnation can lead to insufficient blood flow to the head, resulting in dizziness and discomfort.

The fact that multiple doctors have suggested different diagnoses, including tension-type headaches and possible cervical issues, indicates that your condition may not have a singular cause. The tightness in your neck and shoulders could indeed contribute to your dizziness, as muscle tension can affect blood flow and nerve function. Additionally, emotional stress and anxiety can exacerbate physical symptoms, leading to a cycle of discomfort.

In TCM, treatment often focuses on restoring balance and promoting the smooth flow of Qi and blood. Acupuncture is a common modality used to alleviate symptoms by targeting specific points that correspond to the meridians associated with your symptoms. The fact that you have already undergone acupuncture and have experienced some relief suggests that this approach may be beneficial for you. However, the effectiveness of acupuncture can vary from person to person, and it may take several sessions to achieve significant improvement.

Your current TCM practitioner has identified tightness in your neck and shoulders, which is crucial information. Releasing this tension through acupuncture and possibly additional therapies, such as Tui Na (Chinese therapeutic massage), may help alleviate your symptoms. The pain you experienced during the massage indicates that there is indeed significant tension that needs to be addressed. It's essential to communicate openly with your practitioner about your comfort levels and any discomfort you experience during treatment.

In addition to acupuncture and massage, herbal medicine may also play a role in your treatment. Formulas that nourish the blood, calm the mind, and promote Qi circulation could be beneficial. For example, formulas like "Xue Fu Zhu Yu Tang" (Blood Mansion Drive Out Stasis Decoction) may help invigorate blood flow and alleviate symptoms associated with stagnation. However, it's crucial to work with a qualified TCM practitioner who can tailor the herbal treatment to your specific condition.

Lifestyle modifications can also support your recovery. Incorporating gentle exercises like Tai Chi or Qi Gong can help improve circulation and reduce muscle tension. Additionally, practicing stress-reduction techniques such as mindfulness meditation or deep-breathing exercises may help manage anxiety and promote relaxation.

In summary, your symptoms of dizziness and heaviness in the head may be related to a combination of physical tension and emotional stress. TCM offers various approaches, including acupuncture, herbal medicine, and lifestyle modifications, to address these issues. It may take time and consistent treatment to see significant improvements, so patience and open communication with your healthcare providers are essential. If your symptoms persist or worsen, further evaluation may be necessary to rule out any underlying conditions.

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