"I get dizzy a lot — I'm wondering if it's my blood pressure." Dizziness is one of the symptoms people most often diagnose for themselves: blood pressure, anaemia, not enough sleep.

The difficulty is that the word "dizzy" covers several completely different sensations, and sorting out which one you mean is the first step of any consultation. This article is about what a practitioner asks — set out as 5 things.

I. First: these are not the same thing

Try picking whichever is closest:

• Spinning — the room turns, or you do. Often described as coming with nausea and a reluctance to move.
• Light-headed — as though you might faint, vision greying, worst in the moment you stand.
• Unsteady — not spinning; your feet feel unreliable and your sense of direction is off.
• Foggy — a dull heaviness all day, hard to concentrate, but nothing is turning.

In Western medicine these point in different directions and are handled differently. Replacing "I feel dizzy" with one of the four sentences above changes the consultation entirely.

As for how these are categorised within TCM theory, that belongs to the framework of channels and qi-blood, which is not the same as the modern medical description of the vestibular, circulatory or nervous systems.

II. The 5 things a practitioner asks about

• What you were doing — rolling over in bed, standing up from sitting, looking up to reach a high shelf, or nothing in particular.
• How long it lasts — seconds, minutes, hours, or a fogginess that runs all day.
• What comes with it — nausea, ringing in the ears, a change in hearing, palpitations, cold sweat, headache.
• What has changed recently — sleep, whether meals are regular, any dieting, whether hot weather makes it worse.
• What medication you take — prescribed, over-the-counter, and supplements. Medication is something a practitioner will always ask about — list everything you take.

III. How to describe it usefully

This table deliberately does not say what any answer "means". TCM is not a self-matching exercise — the assessment is the practitioner's, after the consultation.

IV. When to seek medical attention immediately

• Dizziness with slurred speech, weakness or numbness down one side, a drooping face, sudden vision change or double vision — call 999 immediately.
• Sudden severe unsteadiness, unable to stand or walk, together with spinning — call 999 immediately.
• Dizziness with chest pain, palpitations, breathlessness or a cold sweat — call 999 or go to the nearest emergency department. Cardiac matters are for a doctor to handle.
• Losing consciousness or fainting — seek medical attention immediately, even if you came round quickly. If the person does not come round quickly, is not breathing normally, or fainted during exercise or exertion, call 999.
• Dizziness with a sudden severe headache — call 999 or go to the nearest emergency department immediately.
• A recent head injury, particularly with vomiting, drowsiness or any change in alertness — call 999 or go to the nearest emergency department immediately.
• Dizziness with persistent vomiting that prevents eating, or clear dehydration — seek medical attention promptly.
• Sudden hearing loss together with vertigo — seek medical attention promptly.

If you have ever felt dizzy while riding or driving, avoid driving until this has been sorted out, and say so during the consultation. This is a safety matter, not a small detail.

Separately, if you have high blood pressure and are on medication for it, discuss any new dizziness with your doctor first — it may relate to the medication or to a change in blood pressure, and that is for a doctor to assess.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

V. Fitting it into life in Malaysia

• Heat and fluids — a long stretch outdoors or somewhere without air-conditioning, sweating a lot and drinking little, is a very common setting and worth describing specifically.
• How fast you get up — is it worst in the moment you rise quickly from a bed or a chair? That question sorts a lot.
• Skipped meals — lunch lost to a busy day, or the adjusted routine during the fasting month, are both worth mentioning.
• Motorcycles and commuting — the distance, the time of day and the road conditions are all everyday details a consultation asks about. (The safety warning about riding while dizzy is in section IV.)
• Reaching and housework — episodes when looking up for something on a high shelf are a specific and useful clue.

Neck and shoulder tightness often comes up alongside dizziness — see stiff, aching neck and shoulders. If dizziness and headaches arrive together, see why do I keep getting headaches?

In closing

✅ Worth remembering:

1. "Dizzy" covers four different sensations — spinning, near-fainting, unsteady, foggy. Sort that first.
2. A practitioner asks about the setting, duration, accompanying symptoms, recent changes, and your medication.
3. Medication is a common cause and a commonly skipped one — list everything you take.
4. Slurred speech or one-sided weakness, chest pain or palpitations, fainting — call 999.
5. If it has happened while riding or driving, say so, and avoid driving until it is clear.

❌ What not to do:

1. Do not settle on "it's my blood pressure" or "it's anaemia" and stop asking.
2. Do not start with TCM when a red-flag sign is present.
3. Do not stop or adjust medication a doctor prescribed on your own.

👉 If you would like to set out your dizziness properly for a practitioner, you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it with you. In-person consultations are coming soon.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

「医师，我常常头晕，不知道是不是血压的问题。」头晕是最常被自己猜测原因的症状之一——猜血压、猜贫血、猜睡不够。

问题是，「头晕」这两个字底下装着好几种完全不同的感觉，而分清楚是哪一种，是问诊的第一步。这篇讲的是医师在问诊时会了解哪些事，整理成 5 件事。

一、先分清楚：这几种「晕」不是同一件事

请试着从下面挑一个最接近的：

• 天旋地转：周围的东西在转，或自己在转，常被描述为想吐、不敢动。
• 头重脚轻：像快要昏过去，眼前发黑，站起来那一下最明显。
• 走路不稳：不是转，是脚步飘、方向感不对。
• 头昏沉：整天像蒙着一层，注意力不集中，但没有转的感觉。

这四种在西医里分属不同的方向，处理方式也不一样。把「我头晕」换成上面其中一句，问诊的效率完全不同。

至于这些在中医理论里怎么归类，属于经络与气血的理论框架，与现代医学对前庭、循环或神经系统的描述不是同一回事。

二、医师会了解的 5 件事

• 发作的情境：躺着翻身时、从坐到站时、抬头拿高处东西时，还是没有特定动作。
• 持续多久：几秒、几分钟、几小时，还是一整天都昏沉。
• 伴随的情况：想吐、耳鸣、听力变化、心悸、冒冷汗、头痛。
• 最近的变化：睡眠、进食是否规律、有没有节食、天气热时是否更明显。
• 正在服用的药物：包括医生开立的、自己买的、保健品。药物是医师一定会问的一项，请把所有正在吃的都讲出来。

三、一张表看懂：怎么描述才有用

这张表刻意不写「哪一个答案代表什么」。中医不做自我对号入座——分辨是医师问诊后的判断。

四、这些情况请立刻就医

• 头晕伴随说话不清、单侧手脚无力或麻痹、嘴角歪斜、视线突然改变或看东西有双影——请立刻拨打 999。
• 突然严重的走路不稳、站不住或无法行走，并伴随天旋地转——请立刻拨打 999。
• 头晕伴随胸痛、心悸、气促或冒冷汗——请立刻拨打 999 或前往最近的急诊部。心脏方面的情况需要由医生处理。
• 突然失去意识、昏倒——请立刻就医，即使很快就醒过来。若昏倒后没有很快醒过来、呼吸不正常，或是在运动或用力时昏倒，请立刻拨打 999。
• 头晕伴随突然发作的剧烈头痛——请立刻拨打 999 或前往最近的急诊部。
• 最近头部受过伤，尤其伴随呕吐、嗜睡或意识改变——请立刻拨打 999 或前往最近的急诊部。
• 头晕伴随持续呕吐无法进食，或明显脱水——请尽快就医。
• 突然的听力下降合并眩晕——请尽快就医。

如果您曾经在骑车或开车时头晕，请在情况厘清前避免驾驶，并在问诊时主动说明。 这是安全问题，不是小事。

另外，若您有高血压并正在服药，出现新的头晕请先与医生讨论——这可能与药物或血压变化有关，属于须由医生评估的范围。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

五、大马生活里怎么安排

• 热与水分：在户外或没有冷气的空间待久了、流汗多又喝得少，是很常见的情境，值得具体说明。
• 起床与起身的速度：从床上或椅子上快速站起来时最明显吗？这一题很有分辨力。
• 有没有跳过一餐：忙起来省掉午餐、斋戒月的作息调整，都值得讲。
• 摩托与通勤：骑车通勤的路程、时段与路况，都是问诊会问到的生活细节（骑车时头晕的安全提醒见第四节）。
• 爬高与家务：抬头拿高处的东西时发作，是一个具体的线索。

肩颈紧绷与头晕常被一起提起，可参考：肩颈僵硬酸痛。若头晕与头痛常一起出现，可参考：经常头痛，中医怎么看。

结语

✅ 记住这几点：

1. 「头晕」有四种不同的感觉：转、快昏倒、走不稳、昏沉——先分清楚。
2. 医师会了解发作情境、持续多久、伴随情况、最近的变化、正在服用的药物。
3. 药物是常见但常被略过的原因，请把所有正在吃的都讲出来。
4. 伴随说话不清或单侧无力、伴随胸痛心悸、昏倒——立刻拨 999。
5. 骑车开车时晕过，一定要说，并在厘清前避免驾驶。

❌ 不要这样做：

1. 不要自己先认定是「血压」或「贫血」就不再追问。
2. 不要在出现红旗信号时先找中医调理。
3. 不要自行停用或调整医生开立的药物。

👉 如果您想把头晕的情况完整说给医师听，欢迎透过汉方中医的线上问诊，由依 2016 年 T&CM 法令注册的医师为您评估。亲诊服务即将推出。

无论身在何处，与持证中医师对坐。

汉方现代中医