Dizziness

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KEY POINTS

• Dizziness can mean that you feel lightheaded, unsteady, or woozy, or it may mean you feel like your head is spinning or the room is spinning.
• The treatment depends on the cause of the dizziness and may include a diet change, new medicines, or a change in your current medicines.
• Follow the full course of treatment prescribed by your healthcare provider. If your dizziness does not allow you to continue your usual routine, rest at home. Do not try to drive, operate tools or machinery, or do other tasks, even cooking, that could endanger yourself or others if you suddenly are dizzy.

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What is dizziness?

Dizziness is a symptom, not a disease. Dizziness can mean that you feel lightheaded, unsteady, or woozy, or it may mean you feel like your head is spinning or the room is spinning. When the room is spinning, it is called vertigo. It is important for you to explain to your provider what you mean when you say you are feeling dizzy.

Lightheadedness is the unsteady or woozy feeling that you can get when you stand up too fast and there is not enough oxygen in your brain. It may feel like you are dizzy inside your head for a few seconds to minutes. Sometimes your vision seems to “goes black" for a few seconds. It may happen once in a while, or it may happen every time you stand up.

Vertigo is the feeling that you are spinning or the room is spinning. You cannot tell which way “up” is, and lose your balance. Often, even as you lie in bed, the room seems to be spinning around you. This can go on for days or weeks. This loss of balance often comes with nausea and vomiting and sometimes sweating.

What is the cause?

Most often dizziness is mild and doesn’t last long. The cause may not be known. Sometimes dizziness, often with other symptoms, is a sign of a problem. Feeling lightheaded or dizzy can be caused by:

• An infection or disease in the inner ear
• Anemia, which is a problem with your red blood cells that keeps your body from getting enough oxygen
• Being dehydrated, which means losing too much fluid from your body and not replacing it. This happens more often if you are vomiting, have diarrhea, or are sweating a lot.
• Fast, shallow breathing (hyperventilation)
• Feeling very tired, stressed, or anxious
• Fever
• Head injury or a stroke
• Heart disease or an abnormal heart rhythm
• Low blood pressure
• Low blood sugar
• Medicines

Dizziness is a common problem during pregnancy because of hormone changes and the growing baby putting pressure on blood vessels. Less common causes of dizziness are tumors or infections in the brain, or multiple sclerosis (MS).

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Your healthcare provider will ask you to describe your dizziness and how it happens in as much detail as you can. If your dizziness is caused by an ear problem, you may not need tests. If the cause of your symptoms is not clear, you may have tests or scans.

How is it treated?

The treatment depends on the cause of the dizziness. If your healthcare provider finds a problem that is causing the dizziness, you will be treated for the problem. For example:

• A low-salt diet to decrease swelling in your inner ear
• Steroid medicine to decrease swelling and inflammation that may be causing your symptoms
• Antibiotics or other medicines to treat infections that are causing your symptoms
• Medicine for motion sickness to prevent nausea, vomiting, and dizziness

If you are having dizziness because of a medicine you are taking, your healthcare provider may change the medicine or your dosage.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Try to avoid sitting or standing in one position for a long time if that causes dizziness for you. When you stand up, do it slowly. If you have been lying down, sit for a while before standing.
• Ask your healthcare provider if you should wear support stockings, which support the muscles in your legs and help prevent pooling of blood.
• Drink plenty of fluids unless your healthcare provider has asked you to limit your fluids because of heart or other problems.
• Tell your healthcare provider if you think a medicine you are taking may be making your symptoms worse. Check with your provider or pharmacist about nonprescription medicines and supplements before you start taking them.
• If you smoke, stop. If someone else in your household smokes, ask them to smoke outside. Smoking can increase dizziness.
• If your dizziness does not allow you to continue your usual routine, rest at home. Do not try to drive, operate tools or machinery, or do other tasks, even cooking, that could endanger yourself or others if you suddenly are dizzy.

Call 911 or your local emergency services right away if you have symptoms of a stroke or heart attack.

Stroke symptoms come on FAST and may include:

• Face/Head
  • Weakness, numbness, drooping, or tingling of face (may just be on one side)
  • Trouble seeing (one or both eyes)
  • Severe headache
  • Trouble thinking
  • Trouble swallowing
  • Feeling dizzy along with one or more of the symptoms listed above
• Arm/Leg
  • Weakness, numbness, or tingling in your arm or leg (may be on just one side of your body)
  • Trouble walking or moving your arm or leg
• Speech:
  • Trouble talking or understanding speech
• Time
  • Call 911 for emergency help right away if you have symptoms of a stroke.

The most common symptoms of a heart attack include:

• Chest pain or pressure, squeezing, or fullness in the center of your chest that lasts more than a few minutes, or goes away and comes back (may feel like indigestion or heartburn)
• Pain or discomfort in one or both arms or shoulders, or in your back, neck, jaw, or stomach
• Trouble breathing
• Breaking out in a cold sweat for no known reason
• If your provider has prescribed nitroglycerin for angina, pain that does not go away after taking your nitroglycerin as directed
• Along with these symptoms, you may also feel very tired, faint, dizzy, or sick to your stomach.

The sooner both strokes and heart attacks are diagnosed and treated, the better the outcome.

Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.