When Heat Rises to Your Face and Your Chest Feels Tight, but the Tests Are Normal

"Heat rushes up. My face burns, but my hands and feet are cold."

There are people who say this. The chest feels tight, the pit of the stomach feels blocked, irritation flares up over nothing, and it grows worse when you lie down to sleep.

The endoscopy, the ECG, the thyroid test — all normal.

A normal test means the organs have not been damaged. It does not tell you where the blood is going right now, or how much of it.

I see this state as the top and bottom of the body having fallen out of alignment.

The top is hot, the bottom is cold

When I examine such a person, there is a characteristic.

The face and chest feel hot, while the hands, feet, and lower abdomen are cold. The upper part is red and the lower part is pale. The person says, "I guess I have a hot constitution," yet the feet are like ice.

It is not that there is too much heat. The heat is gathered above and does not descend.

The body has a mechanism that decides where to send the blood. The autonomic nervous system does that work. You can think of it as a hand that opens and closes. When that hand stays tilted to one side for a long time, the top and the bottom start acting separately. In the place where Korean medicine has long seen the top as hot and the bottom as cold, this distribution was likely present as well.

The body's warmth is meant to circulate. What has risen upward must return downward, and what has been warmed below must rise upward. When this circulation is cut off, the top overheats and the bottom cools. Then, above, come flushing, tightness, insomnia, and irritation; below, come coldness, indigestion, and loose stools — together.

That these two groups of symptoms come together is the important clue. Look at only one, and it splits into "too much heat" or "the body is cold," but when the two are present together, the story changes.

Why does circulation get cut off?

It cannot be cut down to a single cause. But in these patients, I see several things overlapping.

The center of gravity of the autonomic nervous system is tilted upward. When a state of tension persists for a long time, the body pools its resources toward the heart and brain and pushes the digestive organs and the hands and feet to the back. Then the upper part becomes overaroused and the lower part cools. (When you often feel dizzy and your head is foggy, but the tests are normal)

The diaphragm has hardened. When that muscle dividing the top and the bottom does not move properly, the breath grows shallow and the pressure rhythm inside the abdomen disappears. When I press on the abdomen of people whose pit of the stomach is always tight, that spot is hard. (Breathing is not the act of taking in air)

There is low-grade inflammation and stagnation in the digestive tract. The tightness at the pit of the stomach is not only a matter of the mind. In fact, at that spot, stomach acid, bile, peristalsis, and mucosal defense are often out of alignment.

Sleep has broken down. And the heat sensation disturbs sleep, and the unslept body becomes more sensitive the next day. The loop closes.

So "putting out the heat" alone is not enough

These people are usually already doing something. They eat cold things and seek out things said to cool the heat.

But if you put out only the heat above, below grows colder still. When below grows colder, circulation turns even less, and in the end the heat gathers upward again. The reason it feels cool for a moment and then comes back is here, in my view.

What I look at is reconnecting the circulation that has been cut off.

While calming the overheating above, at the same time you must open the path that descends below. Release the hardened pit of the stomach so the breath descends all the way down, get the stagnant digestive tract moving again, and let the body settle downward at night.

The reason I use herbal medicine is here too. This misalignment does not resolve with medicine that pushes in only one direction. It must act a little on many branches at the same time, creating the conditions for the top and bottom to travel back and forth again. Once the conditions return, the body restores circulation on its own. (What herbal medicine actually does)

About the word "menopause"

Women often hear, for these symptoms, "It's menopause, so just endure it."

That hormonal change forms the background of these symptoms is true.

But I think "menopause" is not the end of the explanation. Even among those who go through the same age and the same hormonal change, some struggle greatly and some pass through it. That difference comes from whether that body has the reserve to withstand that change.

I do not try to replace hormones. I look at the body's conditions for enduring that change. Sleep, digestion, circulation, tension. When these hold you up, the same wave shakes you less.

Cases where you must go to a hospital first

Among chest tightness, there are some you must never wait on.

If the chest hurts with a squeezing or crushing pain and cold sweat comes with it, or the sensation radiates to the jaw or the left arm, it is the heart. Call 119 immediately. And if you suddenly become short of breath while one leg swells, if a sense of heat comes along with weight loss, trembling hands, and a fast pulse, or if there is abnormal bleeding after menopause, get tested first.

This article is about the problem that remains after these things have been ruled out.

I do not remove the heat, I get it moving

Many people have explained themselves with the words "a hot constitution."

But if your feet are cold, that is not too much heat. It is heat that has lost its way.

And there is also something you can do today. Use your calves. Walking, rising onto your toes. When the calf muscles move, blood comes up from below, and that in itself nudges the distribution.

That said, if only one hand or foot is cold, or the color changes, or sensation grows dull, that is a different story. In that case the blood vessels need to be looked at.

I do not try to eliminate the heat. I do the work of making the heat circulate through the body again. That is how I see this symptom.

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References

• As oestrogen falls the body's temperature set point shifts, and the autonomic nerves that open and close the skin's vessels are involved — Korea Disease Control and Prevention Agency
• Discomfort at the pit of the stomach can persist even when tests find nothing wrong — Asan Medical Center
• When calf muscles contract they squeeze the veins and push blood from below back toward the heart — Scientific Reports, 2017

Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)