In most people, vertigo is caused by a problem of the inner ear. Inside your ear, there is a tiny organ called the vestibular labyrinth. It includes loop-shaped structures (semicircular canals) that contain fluid and fine, hair-like sensors that monitor the rotation of your head. Other structures (otolith organs) in your ear monitor linear movements of your head and your head’s position relative to gravity. These otolith organs contain crystals that make you sensitive to a movement they are located in the Vestibule, the small oval chamber in the inner ear. The utricle and saccule are two otolith organs in the inner ear. They use small stones and viscous fluid to stimulate hair cells to detect motion and orientation. The utricle detects linear accelerations and head-tilts in the horizontal plane. The saccule, on the other hand, detects the vertical movement of the head and also the linear accelerations.

For a variety of reasons, some of these crystals can become dislodged and move into one of the semicircular canals — especially while you’re lying down. This causes the semicircular canal to become sensitive to head positional changes it would normally not respond to. As a result, you feel dizzy. The sensation of movement or imbalance when you are not moving is called vertigo, and vertigo, when you change your head position, is called benign positional vertigo. There is some genetic factor to contribute to BPV: the sensor for head movement is super sensitive, which explains why some people can never enjoy riding roller coasters. If you belong to this group of people, you have to be careful to avoid all the triggers, which may stimulate your nervous system and make the sensor even more sensitive.

  1. Viral infection can cause nerve inflammation, which makes the positional sensor in a vestibular labyrinth of the inner ear hyperactive.
  2. Inner ear surgery and head injury can lead to abnormal function of your sensor.
  3. Medications: antiseizure medications, blood pressure medications, antidepressants, and even aspirin can cause vertigo.
  4. Alcohol can cause inflammation of the nerves and blood vessels. Furthermore, alcohol can dilate the blood vessels and change your blood pressure instantly.
  5. Sever cold exposure can cause dysfunction of your sensor in the inner ears.
  6. When you are dehydrated, you have insufficient blood flow to your head and poor circulation, so that your blood pressure fluctuates too much when you change position. Also, dehydration can induce histamine release.
  7. Prolonged lying on the back may cause low blood pressure, dislodge of the crystal in your inner ear or even tight muscles.
  8. Bell’s Palsy can lead to abnormal function of the nervous system.
  9. Tight neck muscles can influence blood circulation and nerve function.
  10. High Salt diet can change your balance of electrolyte leading to an imbalance of your nervous system.
  11. Quick head movement can potentially dislodge your crystals, especially when you are dehydrated, the circulation of the fluids in the inner ear can be changed. The crystal has a hard time to go back to the original place.

Symptoms of Vertigo

The most frequent symptom is dizziness, a sense that you or your surroundings are spinning or moving (vertigo). Other symptoms include lightheadedness, unsteadiness, loss of balance, blurred vision associated with the sensation of vertigo, nausea, vomiting, abnormal rhythmic eye movements (pathological nystagmus), etc.

What can you do to heal yourself?

  1. The positional exercises of Brandt and Daroff: Sit on the edge of the bed near the middle, with legs hanging down. Turn head 45° to right side. Quickly lie down on left side, with head still turned, and touch the bed with the portion of the head behind the ear. Maintain this position and every subsequent position for about thirty seconds. Stand up again for thirty seconds. Quickly lie down to right side after turning head 45° toward the left side. Stand up again. Do 6-10 repetitions, 3 times per day. These exercises may desensitize certain sensors in your inner ear and move the crystals back to their original place.
  2. Drink a lot of water to avoid dehydration.
  3. Have your allergies treated: When you have allergies, your sensor for head position can function abnormally due to swelling or inflammation. You can drink one teaspoon of apple cidar vinegar 3 times a day to improve your digestion and reduce your allergies. Otherwise, see your primary care physician.
  4. Get plenty of rest to rejuvenate your adrenal gland in order to reduce the inflammation of the inner ear. The adrenal gland produces cortisol to fight inflammation and allergy, and maintain our blood pressure and blood sugar level. If you adrenal gland is weak due to the high stress, your blood pressure and blood sugar tend to fluctuate too much, which can lead to vertigo. Your nerves and blood vessels are prone to inflammation. Adrenal fatigue can cause allergies, autoimmune disease and also vertigo.
  5. Balance your hormones: Estrogen and progesterone imbalance can cause vertigo. One of my patients had vertigo for a long time. When going to sleep, she would lie on her stomach or lie on her back without a pillow, because her positional sensor was too sensitive any other way. When she got pregnant, her dizziness got worse. The hormone changes sensitized the nerves in her inner ear. Also, high progesterone during pregnancy may have caused swelling in her inner ear. When her allergies got worse, her dizziness also got worse due to increased histamine levels. If, after not having dizziness, she did not sleep well for a couple of nights or became overly stressed for a period of time, her dizziness came back. Insufficient sleep may cause imbalance of the nervous system, and a low cortisol level can also cause swelling of the nerves.
  6. Drink plenty of water to avoid dehydration.
  7. Here is a case to explain how important water is to your health. An 80-year-old, very healthy, man came to my clinic. He had been very healthy and still played tennis two hours every day. He suddenly developed vertigo and went through all the medical tests without any positive findings. When he came to see me, I did a physical exam and found out that his neck was very stiff. I asked him if he drank a lot of water. He said to me that he drank some, not too convincingly. I suggested that he stretch his neck muscles and drink plenty of water. Since he played tennis for two to four hours every day, he might be dehydrated chronically if nobody reminded him to drink water, which happens a lot with men that I have treated for some reasons. These two factors contributed to his lack of blood flow to his inner ear and dysfunction of the vestibular labyrinth (the sensor for head positional changes).
  8. Have your allergies treated: When you have allergies, your sensor for a head position can function abnormally due to swelling or inflammation. You can drink one teaspoon of apple cider vinegar 3 times a day to improve your digestion and reduce your allergies.
  9. Get plenty of rest to rejuvenate your adrenal gland in order to reduce the inflammation of the inner ear. The adrenal gland produces cortisol to fight inflammation and allergy and maintain blood pressure and blood sugar level.
  10. Stretch your neck before you go to sleep.
  11. If you eat a high salt diet, please make sure you eat orange or banana to balance your potassium and sodium. When your kidney discharges the extra salt, you also lose potassium that can cause the imbalance of the electrolyte.

Why this healthy 65 years old lady suddenly develop vertigo?

Lisa Wang was born in Boston and has had a happy marriage for over 50 years. She has been a teacher in Wellesley for over 30 years and really enjoys her work. She has a very strict routine: going bed before 10 pm, sleeps for 8 hours, never eats sweets or any processed food. She has had a very healthy weight for all her lifetime.

When she came to Boston Chinese Acupuncture Clinic for her vertigo, she was 65 years old and otherwise a healthy lady. She looked at least 15 years younger than her real age, even though she had a lot of stress from her children. She was able to manage well with her lovely husband.

She lives in Dover, MA and tends to feel cold most of the wintertime because she has always been on the thin side. When she turned 63 years old, she started drinking red wine. She passed having menopause without hot flashes and night sweats a few years ago. The red wine helps her thin body produce more heat. She feels happier with her daily walking and other routines.

Two years after she started wine drinking to warm up her body, she developed severe vertigo. She cannot drive because when she turns her head to left or right, her vertigo started. Stress can make her vertigo worse. She tried PT, massage and homoeopathic remedies but nothing works. She finally decided to try acupuncture and Chinese herbs for her vertigo. When her husband drove her to Boston Chinese Acupuncture Clinic in Needham, her acupuncturist was very surprised that she did not ask for the heat in the room, as other thinner people do during the Boston bitter wintertime. Her face looks slightly red, and her tongue looks red on the tip and edge. Her liver pulse is thin and wiry even though her liver function is normal. She does not eat much meat or other heat-producing food such as spicy food.

Her Acupuncturist combined acupuncture and Chinese herbs to help restore the balance function of her vestibular. The vertigo was better after 10 acupuncture treatments, but she still feels unsteady when she turns her head too fast. Finally, her acupuncturist asks her to stop drinking the red wine, wear warmer clothes and take Chinese herbs to keep her thyroid function stronger during the wintertime.

Her vertigo went away completely after 3 months of the acupuncture and Chinese Herbs.

Lisa stopped both acupuncture and herbs after her vertigo was completely gone. However, when she has high stress or eats restaurant food with high salt, sugar and pepper, she needs to take herbs for a few days and vertigo will go away. She has a very sensitive nervous system to detect salt, sugar and spices. Chinese herbs help her restore the balance whenever the physical and mental stress occurred to her.

Questions for the practitioners:

  1. Why do dehydration and spicy food lead to vertigo?
    a. Low blood pressure
    b. Histamine release
    c. Poor circulation
    d. All of the above
  2. Why can histamine make your vertigo worse?
    a. Histamine can cause hypersensitivity of nervous system
    b. Histamine can lead to swelling of the sensor in the vestibular system
    c. Histamine can lead to inflammation of the nerves and blood vessels.
    d. All of the above.
  3. Which Medications can lead to Vertigo( BPV)?
    a. Anti-seizure medications
    b. Blood pressure medications
    c. Anti dépression medications
    d. All of the above
  4. Why can tight muscles cause dizziness?
    a. Tight muscles can influence blood circulation
    b. Tight muscles can irritate the nerves leading to vertigo
    c. Tight muscles can induce histamine release
    d. A and B
  5. Why can prolonged supine position cause Vertigo( BPV)?
    a. It may cause very low blood pressure
    b. It may lead to histamine release
    c. It may cause dehydration
    d. It may stimulate the sympathetic nervous system
  6. Why can extreme cold and surgery cause dizziness?
    a. Extreme cold can cause poor circulation to your inner ear sensor
    b. Surgery can cause damage of the nerves in the inner ear
    c. Surgery can damage the blood flow to the vestibuar sensor
    d. All of the above
  7. Where is the little sensor for a head position located?
    a. Cochlear
    b. Vestibule
    c. Middle ear
    d. A, B, and C
  8. What are the two main structures of Otolith organs?
    a. Utricle
    b. Saccule
    c. Vestibul
    d. a and b
  9. Which of the following detects the vertical movement?
    a. Vestibule
    b. Utricle
    c. Saccule
    d. None of the above
  10. What is the maneuver patients can do to put the crystal back to its position in order to stop vertigo( BPV)?
    a. Brandt and Daroff
    b. Meditation
    c. Chi Gong
    d. None of the above
  11. Why can dehydration lead to vertigo ( BPV)?
    a. Histamine release
    b. Low blood pressure
    c. Poor circulation
    d. b and c
  12. In the case study, what is the main factor leading to vertigo for Lisa?
    a. Alcohol
    b. Cold
    c. Heat
    d. Insomnia
  13. Why can adrenal fatigue cause vertigo (BPV)?
    a. The fluctuation of the blood pressure
    b. Low blood sugar
    c. Inflammation
    d. All of the above
  14. Why can hormone imbalance cause vertigo or dizziness?
    a. Hypersensitive sensor in the inner ear
    b. Dehydration
    c. Neck tightness
    d. Poor circulation
  15. What Chinese herbs can we use to treat vertigo (BPV) with Phlegm condition?
    a. Ban Xia
    b. Sheng Bai Zhu
    c. Shi Chang Pu
    d. All of the above herbs
  16. Which herbs can we use to treat vertigo (BPV) with Liver Yang rinsing?
    a. Mu li
    b. Gui Ban
    c. Long Gu
    d. A, B and C
  17. Which herbs can help improve the digestion, thus help build the stronger gut lining?
    a. Fu Ling
    b. Dang Gui
    c. Chuan Xong
    d. Lian Qiao
  18. Which Chinese herb can help clear up liver and heart fire to prevent vertigo (BPV)?
    a. Zhi Zi
    b. Dan Zhu Ye
    c. Mu Dan PI
    d. A, B, and C
  19. What are the main symptoms for Vertigo (BPV) caused by phlegm condition?
    a. Tendency to have cysts or lipomas,
    b. Nasal congestion,
    c. Post-nasal drip
    d. All of the above symptoms
  20. What are the main symptoms for Vertigo (BPV) with liver and heart fire?
    a. Dizziness that gets worse when you get angry or stressed
    b. Red face with high blood pressure, dry skin,
    c. Tend to be thirsty
    d. All of the above symptoms

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