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by U.S.A. Medical Doctor & Herbalist.



A model of chronic Dizziness including Vertigo: EXERTIONAL DIZZINESS and Dizziness Threshold. How natural herbal remedies differentiates dizziness into different disease categories and can treat them.

First, Biomedical medicine classifies dizziness into 4 categories. All 4 major pathogenetic mechanisms/categories often coexist in the same individual.   

1) Light Headedness, Unsteadiness inside the head, or wooziness, not clearly defined by pathogenesis, represents the majority of chronic dizziness, including " psychogenic " dizziness and idiopathic dizziness. Often, light headedness is the dominant background out of which emerge sudden and self limited breakthrough episodes of true vertigo with nystagmus and the spinning environment.

2) Presyncope with feelings of passing out due to hypoperfusion of brain from sudden low blood pressure from slow autonomic nervous system response ( orthostatic hypotension,, ), or cardiac response ( arrthymias,, ), or metabolic disturbances ( hypoglycemia,,). These are diagnosed often. 

3) Vertigo with spinning of the surroundings due to " inner ear disorders " ( Benign positional vertigo, Meniere's disease, vestibular neuonitis, and central vertigo from stroke,,). Dizziness is not the same as vertigo. Pure Vertigo is only one subcategory of dizziness. Vertigo is caused mainly by disorders of the 8th cranial nerve ( the inner ear including the semicircular canal and the microcirculation supplying the nerve ) or brainstem, where as dizziness likely involves the whole brain circuitry including the vestibular nerve track, just like fatigue or headache. " Dizziness " and " vertigo ", meaning different nuances, can coexist. 

4) Dyseqilibrium with unsteadiness from drugs, cerebellar disorder, or neuropathy with muscular weakness. This category is usually obvious.  

5 % of elders over age 75 suffer from disabling chronic dizziness with periodic vertigos. Mostly they are told that they have inner ear disorder. Not so. But the majority of chronic dizziness belong to category 1) lightheadedness, unsteadiness, and spinning sensations inside one's head. Vertigos with rotary sensations of the surroundings usually come and go, but even when it subsides, there is underlying persistent unsteadiness inside one's head. However, the diagnosis of benign paroxysmal positional vertigo ( BPPV ) is given despite the absence of nystagmus. If the criterion of nystagmus is adhered to, then BPPV  is not a clinically important  cause of dizziness ( < 10 % ) and does not account for background unsteadiness inside the head. So called Meniere's disease is not common ( although 100 % serious for the sufferers ) being found in 0.2% of USA population and 0.02 % of Japanese. But, 2 % of USA population mistakenly think that they have meniere's disease, likely partly due to labeling of patients with " disease names " by medical doctors.    

According to  the thinkings of natural herbal remedies for dizziness, all types of dizziness including vertigo occurs 1) when the brain is malnourished from deficiency of bioenergies, 2) when pathogenetic factors block the nourishments from reaching the brain (  mental phlegms, blood stasis, uprising liver yang or heat ) or 3) by a combination of 2 above mechanisms. Biomedically translated, chronic dizziness is a symptom of chronic, recurrent insufficency of bioenergy to all parts of brain including the vestibular nerve and brainstem, caused by evolutionarily imperfect autoregulation of cerebral blood flow which occur at the level of microcirculation of arterioles. Chronic dizziness is analogous to chronic exertional angina caused by insufficient blood flow to the heart muscles. This model of demand and supply of brain explains well why often dizziness flares up after strenuous mental exertion. This also is why to control chronic dizziness, one needs to reduce the demands by mentally resting, while natural herbal remedies for dizziness work on the supply side by 1)nourishing the brain with Qi and Blood, 2) getting rid of pathogenetic factors blocking the supply, and by  improving the responsiveness of autoregulation of cerebral blood flow. There is a Dizziness THRESHOLD for chronically dizzy people, and natural herbal formulas will elevate this threshold over time ( one may read on theories of mathematics for 6 hours instead of 2 hours before dizziness or vertigo appears). 

What are then the etiological factors that cause the deficiency of bioenergies and/ or blockage of bioenergies reaching the brain? ( Traditional languages of herbalism operate on a model which cannot be fully understood by biomedical languge. The traditional organs do not correspond to anatomic entities but rather networks of functional systems. To give a flavor of traditional diagnosis, a simplified basic tongue diagnosis will also be included. Tongue appearance changes according to disturbed homeostasis of bioenergies.). The most common etiologies are as follows.

1) Unbalanced Diet:

Chronic excessive intake of greasy foods or dairy products weaken the transfomative function of " spleen ", and create dampness and phlegms, which can be observed on the tongue as thick white or yellow sticky/ greasy coating. The tongue body becomes swollen with dampness. Phlegm/ dampness can block the nourishing bioenergy from permeating the brain, and dizziness sometimes with muzziness or even vertigos ensue. When the spleen is impaired a long term, then the Qi ( the dynamic energy carried along the neurovascular channels) become depleted, and malnourishes the brain with the production of wooziness or unsteadiness inside the head.

2)Emotional strain:

Chronic anger, frustrations, sadness, worries, and frights lead to stagnation of Qi and loss of control of the flow of qi by the " liver ". Qi stagnation leads to intermittent blokage of nourishment of brain and intermittent dizziness often fluctuating with the emotional changes. If qi stagnation is prolonged, friction like heat and even fire arise. Heat can then be seen on the tongue along the sides and the tip as distinct redness. If heat enters the blood vessels, red prickles can occur on the tongue. Heat induced dizziness often come with reddish face, a sense of heat coming up, and pulsatile temporal arteries.


Chronic overwork without rest depletes "liver blood", and even substantial body energy called "kidney yin". Blood deficiency, rather common in premenopausal women, produces pale and shrinking tongue and often mild dizziness sometimes with the change of head posture. With further overwork and kidney yin deficiency, deficient heat is created. ( Deficient heat is a form of heat created when there are overdriving biochemical reactions and inefficient energy generation. An example is that of cellular heat generation by inefficient overloaded mitochondria where phosphorylation to produce ATP, cellular currency of energy, is partially decoupled from the electron transport chain. )The tongue body now becomes red and shrunk and the tongue coating become scant and easily peeled off. Dizziness tend to be more persistent with hollowing feeling and associated with dry mouth at night, hot flashes, hot palm and soles, and night sweating. "Yin " and "Yang" are interdependent, and deficiency of one eventually causes symptomatic deficiency of the other. With " kidney yang deficiency" ( often coexistent with kidney yin defeciency ), the warming body energy become reduced, dizziness associated with cold back and limbs, cold sensations with goose bumps may appear. The tongue may become pale and swollen, either with wetness or dryness. 

The above are simplified summary of the etiologies, pathogenetic mechanisms, tongue appearances in different types of dizziness. Each type of dizziness can be well managed with natural herbal remedies for dizziness prepared as formulas. It is also important to have balanced diet, stable emotional life, and timely peaceful rests. 

A chronic dizziness formula will gradually/ steadily, but surely improve unsteadiness inside the head, prevent sudden vertigos, and even heal the symptom. 2 bottles recomended for an initial try out. The dose will vary, depending upon the duration and severity of the symptom, the individual sensitivities, and weight. There are 5 major formulas for chronic dizziness. In most elders, Dizziness tend to be chronic recurring problems with periodic flare ups. Even with these flare ups, the chronic dizziness formula will work. The most commonly used and quite effective formulas are Dizzy&Hot or Dizzy&Cold.                                                                                                                                                                                                   

Dizzy&Hot for those with warm feet, soles, feeling heated, and sometimes sweating at night. Dizzy&Cold for those with cold feet and hands, and feeling cold easily.

Dizzy& Hot&cold (음양부족현기증) for those with combined heat and cold sensations.

Dizzy & Blurry for those with blurry vision, tingling extremities as in women with recent heavy periods.      

Dizzy& Weary for those with no major alterations of temperature sensitivities but with energy deficiencies  ( often younger women before menopause).

Dizziness is  a common symptom for which biomedicine has little to offer except meclizzine ( antivert) which is mildly effective for vertigo, but does not get to " the roots" of dizziness, which took years to develop. 


As for ACUTE or Flare up of Dizziness and Vertigo, One can use Dizzy/Vertigo, or Dizzy & Nausea. Use Dizzy/Vertigo if one also has some headache and  high blood pressure with it. Use Dizzy& Nausea if one has also nausea, digestive problems, and sputum production with the episode.           


A herbal remedy for Acute dizziness without nausea is Dizzy/Vertigo  which  in Decoction  cured our chihuahua's vertigo with severe nystagmus.