Tinnitus
Overview
Tinnitus is the perception of sound—ringing, buzzing, or rushing—without an external source, often with hearing loss, dizziness, insomnia, or irritability. Chinese medicine distinguishes excess from deficiency: excess results from emotion transforming to fire, exuberant gallbladder-liver fire, or phlegm-fire disturbing the ear upward; deficiency arises from kidney essence insufficiency with inadequate sea of marrow, or spleen-stomach weakness with qi and blood failing to rise and nourish the ear.
Pattern differentiation (clinical patterns)
Exuberant Liver-Gallbladder Fire
Sudden loud tinnitus like rushing or wind-thunder not reduced by pressure, headache, red face, bitter mouth, dry throat, irritability, constipation, dark urine, red tongue with yellow coating, wiry rapid pulse.
Clear liver and drain fire; open constraint and the orifices.
Kidney Essence Deficiency
Gradual faint cicada-like tinnitus worse at night with hearing loss, dizziness, weak lower back/knees, and seminal emission, red tongue with scant coating, fine weak pulse.
Tonify the kidney and boost essence; nourish yin and subdue yang.
Connections
Daily care & prevention
Avoid prolonged noise and high-volume earphones; keep regular sleep, reduce caffeine, alcohol, and nicotine, and manage blood pressure, glucose, and stress. Bedtime masking (white noise) can reduce focus on the sound. Massage around the ear (Tinggong/Tinghui), Yifeng (TE17), Taixi (KI3), and Taichong (LR3), with ear exercises. Sudden one-sided tinnitus with hearing loss needs prompt evaluation (treatment window around 72 hours).
When to seek medical care
Seek urgent care for sudden one-sided tinnitus with hearing loss (sudden deafness), stroke signs such as limb weakness or slurred speech, pulsatile (heartbeat-synchronous) tinnitus, or tinnitus after head injury.