Managing Tinnitus and Anxiety: Insights from Traditional Chinese Medicine

Tinnitus, palpitations, and feelings of fullness or discomfort in the chest and stomach?

Hello, Doctor Gao.
I have been experiencing tinnitus for over six months.
In addition to the tinnitus, I also feel a constant tingling sensation in the area of my spine in the back.
I visited an ENT specialist in December last year, and the doctor said that all my tests came back normal, but I still have unexplained tinnitus.
During the winter, when the weather is cool or cold, the tinnitus sometimes fluctuates in volume; however, during hot weather like now, the tinnitus is quite loud and persistent, occurring 24/7.
Even with a fan or air conditioning running, I can still hear the tinnitus.
My tinnitus is unilateral, affecting my left ear, and it sometimes accompanies a pulsating sound in my head.
The tinnitus sounds like a mix of electrical noise and static, similar to a poorly tuned radio, with sharp and piercing tones.
I have undergone several tests arranged by the ENT doctor, including middle ear analysis, auditory transmission, and pure tone audiometry.
At the end of December last year, another traditional Chinese medicine (TCM) doctor suggested that I see a neurologist to rule out any underlying organ issues that might not respond well to TCM treatment.
The doctor explained that tinnitus could be related to the auditory nerve, which is a branch of the cranial nerves.
Any pathology or compression affecting the nerve could lead to symptoms.
Various neurological symptoms can be evaluated by a neurologist.
I started experiencing tinnitus after the National Day holiday in October last year.
Two months later, during the winter, I began to feel unwell, experiencing overall fatigue, tiredness, and once had a headache, fever, and muscle weakness, along with a loss of appetite.
Before the Lunar New Year this year, I contracted shingles.
However, last month, during the hot weather in April, my overall fatigue and tiredness began to improve gradually, while the tinnitus became increasingly louder.
When I first experienced tinnitus, I consulted a TCM doctor who suggested that my tinnitus was due to weakened cranial nerves.
The TCM doctor prescribed herbal medicine for five days, but after finishing the medication, I did not return for further treatment because I did not believe that weakened cranial nerves could cause tinnitus.
I then visited another TCM clinic, where the director recommended that I return to the ENT department for further examination.
The results showed that everything was normal, and the ENT doctor initially wanted to prescribe medication, but I declined, as I prefer not to take Western medicine due to its side effects.
The doctor suggested that poor cerebral blood circulation might be the cause of my tinnitus and indicated that he would prescribe medications for the auditory nerve, sedatives, or B vitamins to nourish the nerves, hoping that the tinnitus would gradually decrease.
I told the doctor that I would prefer to continue with TCM.
Do I need to undergo any other tests to identify the underlying issues? I saw a post in a Facebook group about abdominal breathing, where someone mentioned that they started experiencing tinnitus and pulsating sounds a year and a half ago.
After practicing abdominal breathing for six months, they reported improvement, with only 7-8 days a month without the pulsating sounds.
I started practicing abdominal breathing last night before bed, but this morning, I suddenly felt discomfort, including a racing heartbeat and a tight sensation between my stomach and heart.
After breakfast, I felt even more uncomfortable and bloated, with some pain.
It wasn't until the afternoon that I began to feel some relief.

Doctor Gao, why is this happening? Could there be an issue with my practice of abdominal breathing? Typically, abdominal breathing is considered a helpful technique, so I am puzzled by this reaction.
I want to persist with daily abdominal breathing for 3-6 months to see if my tinnitus and pulsating sounds improve, and whether the volume of these sounds gradually diminishes or disappears altogether.

Buju Ming Anonymouser, 20~29 year old female. Ask Date: 2024/05/10

Dr. Gao Peiyi reply Traditional Chinese Medicine

It is likely just caused by nervous anxiety and is unrelated to diaphragmatic breathing.

Reply Date: 2024/05/10

More Info

Managing tinnitus and anxiety can be particularly challenging, especially when traditional medical evaluations yield normal results, as you've experienced. Your symptoms, including persistent tinnitus, feelings of fatigue, and anxiety, suggest a complex interplay of physical and psychological factors. Traditional Chinese Medicine (TCM) offers a holistic approach that may help alleviate some of your symptoms.

In TCM, tinnitus is often viewed as a manifestation of underlying imbalances in the body, particularly involving the kidneys, liver, and heart. The kidneys are believed to house the essence that supports hearing, while the liver is associated with the smooth flow of Qi (energy) and blood. Anxiety, on the other hand, can be seen as a disturbance of the heart and spirit (Shen). Therefore, addressing both tinnitus and anxiety simultaneously is crucial.

Herbal Formulas: You mentioned that a previous TCM practitioner prescribed herbs for "brain nerve weakness." While this may not have resonated with you, it's essential to consider that TCM practitioners often tailor treatments based on individual diagnoses. Formulas like "Tian Wang Bu Xin Dan" (Heavenly Emperor's Heart-Supplementing Pill) can nourish the heart and calm the spirit, which may help with anxiety. Additionally, "Gui Pi Tang" (Restore the Spleen Decoction) can strengthen the spleen and improve blood production, potentially addressing fatigue and memory issues.

Acupuncture: Acupuncture can also be beneficial for both tinnitus and anxiety. Specific points may be targeted to improve circulation, reduce stress, and promote relaxation. For instance, points like Shenmen (HT7) and Anmian can help calm the mind and alleviate anxiety. Regular sessions may lead to gradual improvements in your symptoms.

Lifestyle Modifications: Incorporating practices such as mindfulness meditation, yoga, or tai chi can also be beneficial. These practices help manage stress and anxiety, which may, in turn, reduce the perception of tinnitus. You mentioned trying abdominal breathing; while it is generally a calming technique, it's essential to ensure that you're practicing it correctly. If you're experiencing discomfort, it might be helpful to consult with a qualified instructor or therapist who can guide you through the process.

Diet and Nutrition: In TCM, diet plays a significant role in maintaining health. Consuming foods that nourish the kidneys and liver, such as black beans, walnuts, and leafy greens, may support your overall well-being. Staying hydrated and reducing caffeine and alcohol intake can also help manage anxiety and improve sleep quality.

Further Evaluation: Given the complexity of your symptoms, it may be worthwhile to seek further evaluation from a neurologist or an ear, nose, and throat (ENT) specialist. They can rule out any underlying neurological issues or other conditions that may contribute to your tinnitus. Additionally, a thorough assessment of your mental health by a psychologist or psychiatrist could provide insights into managing anxiety more effectively.

In conclusion, managing tinnitus and anxiety through TCM involves a multifaceted approach that includes herbal remedies, acupuncture, lifestyle changes, and possibly further medical evaluation. While it may take time to see significant improvements, a consistent and holistic approach can lead to better management of your symptoms. Remember to communicate openly with your healthcare providers about your experiences and preferences, as this will help them tailor their recommendations to your needs.

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