Feeling Dizzy? Why it Happens and What To Do
It is common to feel dizzy or unbalanced at times. You can get it from spinning around or from getting up too quickly. In some cases however, dizziness can be a symptom for something much more serious: here’s how to know the difference.
What is dizziness?
Dizziness is a feeling of lightheadedness that feels like you may be about to faint. It also brings loss of balance, difficulty walking straight and disorientation. It is usually mild and gets better without treatment. However, dizziness increases risks of falling and subsequent injuries.
You may also come across the word vertigo which is often time associated with dizziness. They are similar but vertigo refers more specifically to seeing things spinning or moving around you.
What causes dizziness?
– Heart-related problems: e.g. heart attack, heart muscle disease and irregular heartbeat. They affect the heart’s ability to pump blood out and reduce blood flow to the brain.
– Blood pressure issues: e.g. poor blood circulation and a drop in blood pressure caused by severe bleeding, dehydration or standing up suddenly. Your body will not have enough blood, especially to the brain, which can cause lightheadedness.
– Inner ear problems: e.g. vertigo including benign paroxysmal positional vertigo, Meniere’s disease, disequilibrium and ear infections. Ears regulate equilibrium and balance therefore dizziness could be an indication of a problem in that area.
– Brain conditions: e.g. stroke, brain tumour, migraines, multiple sclerosis, dementia and other brain disorders.
– Medications: dizziness is often a side effect of many medications: e.g. antihypertensives, anticonvulsants, antidepressants, sedatives, antibiotics and pain medications.
– Psychiatric disorders: e.g. stress, anxiety, panic attacks and depression.
– Other possible causes:
– Anemia or lack of iron due to reduced ability of red blood cells to carry oxygen.
– Low blood sugar, e.g. in people with diabetes or during fasts.
– Pregnancy and menstruation as a result of hormonal changes.
– Excessive activities increase sweating and fluid loss.
– Viral diseases, e.g. colds and flu. Other symptoms are also present.
– Motion sickness.
– Too much alcohol.
– Allergies.
– Carbon monoxide poisoning.
– Electrolyte and hormonal imbalances.
When to see a doctor
You must see a doctor if you:
– feel dizzy frequently.
– have worsening symptoms.
– still feel lightheaded after resting and having fluids for 2 hours.
– have difficulty breathing.
– experience chest pain.
– cannot see things clearly (blurred or double vision).
– have numbness or weakness in the face, arms or legs.
– have trouble walking.
– pass out.
– have altered consciousness.
– have difficulty speaking or hearing.
– get a fever higher than 100.4ºF (38ºC).
– keep vomiting.
– develop a new or severe headache.
How is dizziness treated?
Treatment will depend on the underlying cause. You need to see a doctor if it persists and some tests may need to be carried out first to exclude any underlying medical condition.
Treatment is not always necessary, particularly if it lasts only seconds or minutes. Chronic dizziness will go away when the underlying conditions are managed.
For example,
– Meniere’s disease: a low-salt diet and diuretics (e.g. hydrochlorothiazide) to drain fluid accumulated in Meniere’s disease.
– Migraines: pain relief medications such as paracetamol, ibuprofen, naproxen and aspirin.
– Orthostatic hypotension: e.g. fludrocortisone or pseudoephedrine to increase blood pressure.
– Anxiety: e.g. citalopram and fluoxetine.
Your doctor may give you antihistamines (e.g. dimenhydrinate and cetirizine) and anticholinergics (e.g. benztropine mesylate) if nausea also occurs . Benzodiazepines (e.g. diazepam and lorazepam) are effective in controlling spinning sensation.
Talk to your doctor or pharmacist if your dizziness is caused by medications.
You may also opt for canalith repositioning if you have benign paroxysmal positional vertigo. It can be done by your doctor or a therapist. Another therapy is called balance rehabilitation in which you will learn some exercises to help your body adjust to changes in motion.
What you can do to feel better
Below is a list of do’s and don’ts if you’re feeling dizzy:
– Sit or lie down until you no longer feel dizzy, then stand up slowly to avoid losing your balance and falling.
– Drink plenty of fluids, especially water.
– Rest in a cool place.
– Walk with a cane or hold onto handrails if necessary or possible.
– Do not bend down suddenly.
– Do not get up suddenly after sitting or lying down prolonged periods of time.
– Do not drive, use machinery, lift something heavy or anything else that could be dangerous.
Prevention
– Avoid standing up too quickly and suddenly.
– Drink plenty of fluids, particularly during hot weather or after sweaty activities.
– Eat a healthy and balanced diet regularly.
– Avoid foods and drinks that contain too much caffeine, alcohol and salt.
– Do not smoke.
– Get enough sleep every day.
– Stretch your legs after standing for a long time to help pump blood back to heart.
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Dr. Lily Wong 黃淑婷醫生 is a family practitioner at The London Medical Clinic. She is both a registered general practitioner and a pharmacist in the UK and HK. Having lived and worked as a general practitioner for many years in busy practices in London, she relocated to Hong Kong with her family a few years ago. Dr. Wong has also been appointed Honorary Assistant Professor in the Department of Family Medicine at Hong Kong University, for her teaching of medical students.
