When Should You Worry About Dizziness?

Symptoms of dizziness may be described as: 

• Lightheadedness or actual fainting
• Weakness 
• Nausea
• Confusion
• Fatigue/tiredness
• Clumsiness
• Feeling off balance
• Feeling a sensation of movement, spinning, rocking, or whirling, of themselves or the room (possible vertigo)

Dizziness may be accompanied by other symptoms such as:

• Headache or head pressure
• Chest pain or tightness
• Vomiting

Dizziness can be caused by a wide variety of conditions, including: 

• Heart disease or blood pressure problems
  • Heart attack
  • Irregular heart rhythms (arrhythmia)
  • Fast or slow heart rate
  • Weakened or diseased heart muscle (cardiomyopathy)
  • Extremely high blood pressure (hypertension)
  • Low blood pressure (hypotension)
  • Toxins or drugs that affect the rate or force of the contractions of the heart
• Brain diseases or conditions
  • Headache
  • Migraines
  • Loss or decrease of blood supply to the brain, such as fainting 
  • Stroke
  • Tumor
  • Dementia 
• Medications
  • Antidepressants
  • Blood pressure medications
  • Diuretics
  • Pain relievers
  • Sedatives
  • Tranquilizers
  • Some antibiotics
• Metabolic disorders
  • Low blood oxygen (hypoxia)
  • Low blood sugar (hypoglycemia)
  • Dehydration
• Other illnesses
  • Internal bleeding or hemorrhage
  • Low red blood cell count (anemia)
  • Prolonged bed rest
  • Endocrine diseases such as those of the thyroid, adrenal glands, and pituitary gland 
  • Allergies
  • Low blood pressure after eating (postprandial hypotension)
• Psychiatric conditions
  • Anxiety/stress
  • Depression
  • Panic disorder
  • Breathing too fast or too deeply (hyperventilation), which may be caused by anxiety
  • Physical symptoms caused by mental illness (somatization) 
• Aging
  • Low blood pressure on standing (orthostatic hypotension)
  • Hardening of the arteries (atherosclerosis)
  • Nerve damage or disease (neuropathy)
  • Diminished ability to exercise/deconditioning
  • Weakness
  • Menopause
  • Poor eyesight 
  • Loss of coordination
  • Dementia
  • Hearing loss or ringing in the ears (tinnitus)
• Pregnancy
  • Dizziness is most common in the first trimester, but can occur any time during pregnancy 
  • Rising hormones cause blood vessels to dilate, which increases blood flow to the baby 
  • Low blood sugar levels due to the body’s metabolism changes

The cause of dizziness is diagnosed with a patient history and physical examination along with tests based on the patient’s history and physical exam to determine the cause, such as:

• Blood tests
• Electrocardiogram (ECG) 
• Computerized tomography (CT) scan 
• Cardiac stress test 

Treatment for dizziness depends on the cause. Dizziness can be a symptom of many different underlying conditions and each condition must be treated differently. 

Treatment for some conditions that cause dizziness may include:

• Medications to treat the underlying condition
• If dizziness is caused by medications, it may be treated by stopping or modifying the dosage or regimen (never stop taking a prescribed medication without first talking to your doctor)
• Intravenous (IV) fluids to treat dehydration
• Emergency blood transfusion
• Fever reducers 
• Medications to treat infections
• Oxygen for shortness of breath or hyperventilation
• Epley maneuver for vertigo
• Medications such as meclizine (Antivert) or benzodiazepines such as diazepam (Valium) or lorazepam (Ativan) may be given to control the spinning feeling (vertigo) associated with dizziness
• Surgery 

Home treatments for mild cases of dizziness include:

• Drink adequate fluids
• Eat regular meals
• Eat a healthy diet
• Exercise regularly
• Get plenty of rest
• Lay down 
• Stand up slowly
• Don’t smoke