A hum in your ears, loudest when it’s quiet?

During a busy day you may not notice it, but when things go quiet — especially at night as you get ready for bed — a constant “humming” or “hissing” sound appears in your ears and will not go away, sometimes getting in the way of sleep. You may have seen an ENT specialist and been told your hearing test is normal, yet the sound keeps bothering you. TCM has long described this, usually through “kidney essence deficiency”: the kidney opens into the ear, so when kidney essence runs low the ear is not nourished, and tinnitus is more likely. This article explains the causes, how to observe yourself, and when you should seek urgent care first.

What is tinnitus?

Tinnitus is the perception of a continuous or intermittent sound in the ears or head when there is no external source. It may be a hum, a hiss, a cicada-like buzz or something hard to describe. Loudness and pitch vary from person to person, and it is usually more noticeable in a quiet room or at night.

In TCM theory, “the kidney opens into the ear.” When kidney essence is full, hearing is sharp; when it is deficient (often seen with long-term overwork, advancing age or excessive depletion), the ear is not nourished and persistent, low-pitched humming tinnitus tends to appear, sometimes with weak lower back and knees or dizziness. Liver fire flaring upward or phlegm-fire disturbing the head can also cause tinnitus, but these usually feel more urgent and higher-pitched, which sets them apart from the chronic, low-toned tinnitus of kidney essence deficiency.

Common triggers

Age and constitution: kidney essence naturally declines with age, which is one common background factor in chronic tinnitus.

Long-term fatigue: regular late nights and overwork drain kidney essence and can make tinnitus more noticeable.

Noise exposure: long periods in noisy places or listening to headphones at high volume are important triggers from a Western medical view, and both TCM and Western medicine advise caring for your ears.

Self-check — do any of these sound like you?

Core signs: a continuous or intermittent hum in the ears or head, more noticeable in quiet surroundings or at night; usually low-pitched and persistent, worse after tiring days and sometimes eased a little by rest.

Accompanying signs (kidney essence deficiency type): weak lower back and knees, dizziness, poorer memory, frequent urination at night and slightly reduced hearing; some people also have mild trouble sleeping.

Patterns to tell apart: if the tinnitus is high-pitched and urgent, with a flushed face, a bitter taste or a short temper, it may lean toward liver fire flaring upward, which is a different constitutional pattern from kidney essence deficiency. The actual pattern should be identified by a TCM practitioner.

When to seek urgent care — safety reminder

The following are warning signs that need to be assessed first by an ENT or other specialist, and fall outside the chronic tinnitus discussed here: (1) sudden tinnitus in one ear with a sharp drop in hearing (possible sudden hearing loss — seek care as soon as possible, within 72 hours); (2) tinnitus with vertigo, nausea or vomiting (possible inner-ear disease); (3) tinnitus that beats in time with your pulse (pulsatile tinnitus, which may relate to blood vessels); (4) tinnitus with ear pain, discharge or a history of ear injury; (5) tinnitus with one-sided headache, facial numbness or other neurological symptoms. If any of these apply, please seek care promptly and do not wait or rely on TCM care alone.

TCM approaches to care

Herbal formulas: the classical direction for kidney essence deficiency tinnitus is to tonify the kidney and replenish essence. Formulas such as Er Long Zuo Ci Wan follow this approach, and a practitioner adjusts the prescription depending on whether liver fire or phlegm-dampness is also present — not every case of tinnitus suits the same formula.

Acupuncture: commonly used points include SI19 (Tinggong) and TE17 (Yifeng) to open the ear locally, and KI3 (Taixi) and BL23 (Shenshu) to support kidney essence. Actual point selection is made by a registered TCM practitioner after assessing your constitution.

Routine adjustments: because kidney essence deficiency tinnitus is closely linked to long-term strain, relying on herbs alone without adjusting your routine often limits the effect.

Daily self-care notes (supportive, not a prescription)

① Get enough rest: avoid regular late nights and overwork, which helps reduce further drain on kidney essence.

② Keep headphone volume down: cut back on long periods of loud listening so noise does not damage your hearing further.

③ Gentle acupressure: you may lightly press around Yifeng and Tinggong for everyday relief; keep the pressure gentle and stop if it feels uncomfortable.

④ Limit very salty food: excess salt may affect circulation in the inner ear, so moderate intake is advisable.

These are general wellness notes and not personal advice. If tinnitus persists or comes with any of the warning signs above, please have it checked by an ENT specialist first, then see a TCM practitioner to confirm your constitution type.

When to book a consult

If the red flags above have been ruled out and the tinnitus has lasted several weeks, or clearly affects your daily life and sleep, a consult is worth considering. Dr. Ng Hau Jun will use tongue and pulse diagnosis and an overall constitution assessment to explain whether your pattern falls under kidney essence deficiency and what care direction may help.

Oakville Wellness is in the Kam On Building in Central, convenient for Central, Admiralty and Sheung Wan, with Saturday sessions available. WhatsApp 6734 9532 to book, or see our contact page for clinic hours. You may also wish to read our internal medicine care page first.

FAQ

Q: My hearing test was normal — why can I still hear the ringing? A: A hearing test mainly measures hearing thresholds, while tinnitus is a subjective sensation. You can still have tinnitus even when the test result is normal, because the two assess different things.

Q: Will tinnitus ever go away completely? A: It varies. Some people find the sound clearly quieter or less frequent after care, but long-standing chronic tinnitus may take time and consistency to change, so it is best to discuss realistic expectations with your practitioner.

Q: Do I have to see an ENT specialist first? A: If you have had any of the urgent warning signs listed in this article, seek care promptly. If your tinnitus is chronic, linked to your constitution and the red flags have been excluded, a combined Western and TCM approach can be considered.

Q: Can younger people have kidney essence deficiency tinnitus too? A: Kidney essence deficiency is more common in older adults, but younger people who regularly stay up late or overwork can show similar constitutional patterns. Age is not an absolute indicator.

Q: How long does care take to show results? A: It varies with constitution, how long the tinnitus has lasted and how consistently you follow the plan. Mild or recent cases may respond sooner; for long-standing chronic tinnitus, completing a fuller course of care is usually advised to judge the effect.

This article is general health information and does not replace an in-person consultation; results vary between individuals. If your tinnitus is sudden, comes with a sharp drop in hearing, or with vertigo, please seek urgent care. If it is a chronic, recurring problem, Dr. Ng Hau Jun is available for a consult that starts from your overall constitution.