What is dizziness?
Dizziness is the feeling of being lightheaded, woozy, or unbalanced. It affects the sensory organs, specifically the eyes and ears, so it can sometimes cause fainting. Dizziness isn’t a disease, but rather a symptom of various disorders. Vertigo and disequilibrium may cause a feeling of dizziness, but those two terms describe different symptoms. Vertigo is characterized by a spinning sensation, like the room is moving.
Dizziness is a term used to describe a range of sensations, such as feeling faint, woozy, weak or unsteady. Dizziness that creates the false sense that you or your surroundings are spinning or moving is called vertigo. Dizziness is one of the more common reasons adults visit their doctors. Frequent dizzy spells or constant dizziness can significantly affect your life. But dizziness rarely signals a life-threatening condition. Treatment of dizziness depends on the cause and your symptoms. It’s usually effective, but the problem may recur. It may also feel like motion sickness or as if you’re leaning to one side. Disequilibrium is a loss of balance or equilibrium. True dizziness is the feeling of lightheadedness or nearly fainting. Dizziness is common and its underlying cause usually isn’t serious. Occasional dizziness is not something to worry about. However, you should call your doctor immediately if you’re experiencing repeated episodes of dizziness for no apparent reason or for a prolonged period.
Causes of dizziness
Common causes of dizziness include a migraine, medications, and alcohol. It can also be caused by a problem in the inner ear, where balance is regulated.
Dizziness is often a result of vertigo as well. The most common cause of vertigo and vertigo-related dizziness is benign positional vertigo (BPV). This causes short-term dizziness when someone changes positions quickly, such as sitting up in bed after lying down.
Dizziness and vertigo can also be triggered by Meniere’s disease. This causes fluid to build up in the ear with associated ear fullness, hearing loss, and tinnitus. Another possible cause for dizziness and vertigo is an acoustic neuroma. This is a noncancerous tumor that forms on the nerve that connects the inner ear to the brain.
Some other possible causes of dizziness include:
- sudden drop in blood pressure
- heart muscle disease
- decrease in blood volume
- anxiety disorders
- anemia (low iron)
- hypoglycemia (low blood sugar)
- ear infection
- heat stroke
- excessive exercise
- motion sickness
In rare cases, dizziness could be caused by multiple sclerosis, a stroke, a malignant tumor, or another brain disorder.
Low blood pressure as a cause of dizziness
Dizziness, lightheadedness, and the feeling of passing out is a common complaint in people who have low blood pressure. When the blood pressure is too low, not enough oxygen-rich blood is delivered to the brain, and its function can be affected. If the brain’s blood supply is decreased too much, the person may pass out (syncope). Symptoms may worsen when changing position from lying down or sitting to standing up.
In addition to feeling dizzy, associated symptoms may include:
- Nausea and vomiting
- Shortness of breath
- Chest pain
Low blood pressure may be the result of an underlying illness or disease, or it may be a normal physiologic condition. Some common reasons for low blood pressure include the following:
- Anemia (decreased red blood cell count) due to decreased production or increased destruction of red blood cells
- Bleeding that may cause anemia due to red blood cell loss
- Dehydration (loss of water in the body) often occurs with infections that cause vomiting and diarrhea. Fever also can cause a significant amount of water loss due to increased metabolic rate and excessive sweating as the body tries to cool itself.
- Heat-related illnesses associated with dehydration such as heat cramps, heat exhaustion, or heat stroke (a medical emergency)
- Side effects of certain medications used to control blood pressure and heart rate. Examples include:
- Beta blockers (propranolol [Inderal, Inderal LA], atenolol [Tenormin], metoprolol, [Lopressor, Toprol XL]), which block adrenalin receptors in the heart and may limit the ability of the heart rate to increase in response to changes of position, decreased red blood cell count, or dehydration
- Nitroglycerin and isosorbide mononitrate (Imdur), a long-acting nitroglycerin, are medications that are prescribed to dilate blood vessels in the heart to treat angina. However, these medications also cause other blood vessels in the body to dilate, decreasing blood pressure.
- Diuretics that can cause dehydration
- ACE inhibitors that slow the heart rate
- Medications for erectile dysfunction (sildenafil [Viagra, Revatio], tadalafil [Cialis], and vardenafil [Levitra, Staxyn ODT], avanafil [Stendra]) that can dilate blood vessels
- Alcohol use
Symptoms of dizziness
People experiencing dizziness may feel various sensations, including:
- lightheadedness or feeling faint
- a false sense of spinning
- loss of balance
- feeling of floating or swimming
Sometimes, dizziness is accompanied by nausea, vomiting, or fainting. Seek emergency medical help if you have these symptoms for extended periods.
Factors that may increase your risk of getting dizzy include:
- Age. Older adults are more likely to have medical conditions that cause dizziness, especially a sense of imbalance. They’re also more likely to take medications that can cause dizziness.
- A past episode of dizziness. If you’ve experienced dizziness before, you’re more likely to get dizzy in the future.
Dizziness can increase your risk of falling and injuring yourself. Experiencing dizziness while driving a car or operating heavy machinery can increase the likelihood of an accident. You may also experience long-term consequences if an existing health condition that may be causing your dizziness goes untreated.
When to call a doctor about dizziness
You should call your doctor if you continue to have repeated bouts of dizziness. You should also notify your doctor immediately if you experience sudden dizziness along with:
- a head injury
- a headache
- a neck ache
- a high fever
- blurred vision
- hearing loss
- difficulty speaking
- numbness or tingling
- droopiness of the eye or mouth
- loss of consciousness
- chest pain
- ongoing vomiting
These symptoms could indicate a serious health problem, so it’s important to seek medical attention as soon as possible.
How Is Dizziness Diagnosed?
Rapid evaluation and treatment may be necessary if doctors suspect a serious cause of dizziness.
The doctor will ask detailed questions and take a history to define the type of dizzy feeling. The patient’s description of the dizzy feeling may be the most important detail. The patient will be given a detailed physical exam to further define likely causes.
Tests ordered will be based on the diseases suggested by the patient’s history and results of the physical exam.
- In the emergency department, the patient may be placed on a heart monitor, electrocardiogram (ECG) may be performed, and blood studies may be ordered. Sometimes specialized tests such as a CT scan or a cardiac stress test may be ordered.
- Rarely, the patient may have to have surgery to treat internal bleeding or hemorrhage, if this is the cause for the symptoms.
- The patient may be hospitalized or sent to a physician specialist depending on the possible causes.
- The doctor may find no specific cause for the dizziness, but will attempt to exclude other serious diseases.
Treatments for dizziness
Treatment for dizziness focuses on the underlying cause. In most cases, home remedies and medical treatments can control the cause of dizziness. For example:
- Inner-ear issues may be managed with medications and at-home exercises that can help control balance.
- BPV can be resolved with maneuvers that can help alleviate symptoms. Surgery is an option for patients whose BPV is not otherwise controlled.
- Meniere’s disease is treated with a healthful low-salt diet, occasional injections, or ear surgery.
- Migraines are treated with medications and lifestyle changes, such as learning to identify and avoid migraine triggers.
- Medication and anxiety-reducing techniques can help with anxiety disorders.
- Drinking plenty of fluids can help when dizziness is caused by excessive exercise, heat, or dehydration.
Are There Natural or Home Remedies for Dizziness?
If a person is feeling dizzy, it may be a symptom of a condition or disease that is something more dangerous and should always be discussed with a doctor to determine the possible reasons for the dizziness. Medical treatment for dizziness depends on the cause and should be evaluated by a medical professional.
At home, it is recommended for the patient to do the following some home remedies for mild cases of dizziness include:
- Get plenty to drink, have regular meals, and get plenty of rest.
- Have the person who is dizzy lay down.
- Stand up slowly, as this may help dizziness associated with position changes.
- Reassurance can help an anxious person who feels dizzy.
- Make your home safe for a chronically dizzy person.
- Banisters, a walker or cane, and tub mats are safety measures that may help avoid injury to the patient.
- Secure rugs and carpeting to avoid falls.
- A doctor can recommend resources for a professional home-safety consultant visit.
What you can do about dizziness
Follow these tips if you have recurrent bouts of dizziness:
- Sit or lie down immediately when you feel dizzy and rest until the dizziness goes away. This can prevent the possibility of losing your balance, which may lead to falling and serious injury.
- Use a cane or walker for stability, if necessary.
- Always use handrails when walking up or down the stairs.
- Do activities that improve balance, such as yoga and Tai Chi.
- Avoid moving or switching positions suddenly.
- Avoid driving a car or operating heavy machinery if you frequently experience dizziness without warning.
- Avoid caffeine, alcohol, and tobacco. Using these substances may trigger dizziness or make it worse.
- Drink at least eight glass of water a day, get seven hours or more of sleep, and avoid stressful situations.
- Eat a healthful diet that consists of vegetables, fruits, and lean proteins to help prevent dizziness.
- If you suspect your dizziness is being caused by a medication, talk to your doctor about lowering the dose or switching to another medication.
- Take an over-the-counter medication, such as meclizine (Antivert) or an antihistamine, if you experience nausea along with dizziness. These medications may cause drowsiness, so don’t use them when you need to be active or productive.
- Rest in a cool place and drink water if your dizziness is being caused by overheating or dehydration.
Always talk to your doctor if you’re concerned about the frequency or severity of your dizziness.
Outlook for dizziness
Most cases of dizziness clear up on their own once the underlying cause is treated. In rare cases, dizziness can be a sign of a more serious health problem.
Dizziness may result in complications when it causes fainting or a loss of balance. This can be especially dangerous when a person is driving or operating heavy machinery. Use caution if you feel an episode of dizziness coming on. If you become dizzy, stop driving immediately or find a safe place to steady yourself until it passes.
What About Dizziness During Pregnancy?
Dizziness is a common symptom during pregnancy. One of the reasons women feel dizziness during pregnancy is due to rising hormones that cause blood vessels to dilate, which increases blood flow to the baby, but also can result in lower blood pressure and temporary dizziness.
Other causes of dizziness during pregnancy include low blood sugar levels as the body’s metabolism changes. Women who are anemic or who have varicose veins may experience dizziness more often.
Dizziness can occur in any trimester. It is most common in the first trimester, but during the second trimester, the expanding uterus puts pressure on blood vessels and can cause dizziness. In the third trimester, when you lie on your back the weight of the baby presses on your vena cava (a large vein that carries blood from your lower body to your heart) which can result in dizziness.
Contact your doctor if you experience dizziness during pregnancy, especially if the dizziness is constant or persistent, or if it is accompanied by pain in your abdomen or vaginal bleeding, blurred vision, headaches, or heart palpitations.
Dizziness Caused by Aging
- Reduced capacity for exercise or activity, weakness, and deconditioning
- Reduced ability for the blood circulation to compensate for quickly assuming an upright position (orthostatic hypotension)
- Hardening of the arteries (arteriosclerosis)
- Neuropathy (a progressive dysfunction of the nerves that is caused by different illnesses, especially diabetes)
- Poor eyesight and coordination
- Hearing loss or ringing in the ears (tinnitus)
An anxiety or panic attack happens when you’re faced with extreme stress and your body goes into fight-or-flight mode. The cause is emotional, but the symptoms are physical.
Along with dizziness and nausea, a panic attack can cause symptoms like:
- Fast heartbeat
- Shortness of breath
- Tightness in your chest
- Feeling hot or cold
The panic attack should stop on its own. If you often get these attacks, talk therapy and medication may help.
An anxiety attack can feel like a heart attack. Sometimes it’s hard to tell the difference.
Call your doctor or 911 if you:
- Suddenly feel anxious for no reason
- Still have symptoms after a few minutes
- Also have chest pain or can’t catch your breath
Dizziness Caused by Other Diseases or Conditions
- Internal bleeding or hemorrhage
- Anemia (low red blood cell count)
- Prolonged bed rest, causing weakness and loss of ability to compensate for assuming an upright position infections
- Endocrine diseases in which hormone-producing organs such as the thyroid, adrenal glands, and pituitary gland affect hydration, salt balance, and function of other organs
- Allergies may cause wheezing and low blood pressure, or can trigger sinusitis, which can result in dizziness
- Postprandial hypotension (low blood pressure after eating)
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