Dizziness: Light-Headedness and Vertigo
Dizziness is a word that's often used to describe two different feelings. It's important to know exactly what you mean when you say "I feel dizzy." It can help you and your doctor narrow down the list of possible problems.
- Light-headedness is a feeling that you are about to faint or "pass out." You may feel dizzy. But you don't feel as though you or your surroundings are moving. The feeling often goes away or improves when you lie down. If it gets worse, it can lead to a feeling of almost fainting or to a fainting spell (syncope). You may sometimes feel nauseated or vomit when you are light-headed.
- Vertigo is a feeling that you or your surroundings are moving when there is no actual movement. You may feel as though you are off balance, spinning, whirling, falling, or tilting. You may feel very nauseated or vomit. You may have trouble walking or standing. And you may lose your balance and fall.
Dizziness can occur in people of any age. But it's more common among older adults. A fear of dizziness can cause older adults to limit their physical and social activities. Dizziness can also lead to falls and other injuries.
It's common to feel light-headed from time to time. Brief bouts of light-headedness aren't usually caused by a serious problem. Light-headedness often is caused by a quick drop in blood pressure and blood flow to your head. This can occur when you get up too quickly from a seated or lying position (orthostatic hypotension). Light-headedness that lasts may mean that you have a more serious problem that needs to be checked.
Light-headedness has many causes. They include:
- Illnesses such as influenza (flu) or colds.
- Vomiting, diarrhea, fevers, and other illnesses that cause dehydration.
- Very deep or rapid breathing (hyperventilation).
- Anxiety and stress.
- The use of tobacco, alcohol, cannabis, or other drugs.
- Medications that cause drowsiness, like opioids, sleeping aids, and muscle relaxers.
A more serious cause of light-headedness is bleeding. Most of the time, the location of the bleeding and the need to seek medical care are clear. But sometimes bleeding isn't obvious (occult bleeding). You may have small amounts of bleeding in your digestive tract over days or weeks without noticing the bleeding. When this happens, light-headedness and fatigue may be the first signs that you are losing blood. Heavy menstrual bleeding also can cause this type of light-headedness.
Sometimes the cause of light-headedness is an abnormal heart rhythm (arrhythmia). This can cause fainting spells (syncope). Unexplained fainting spells need to be checked by a doctor. You can check your heart rate by taking your pulse.
Many prescription and non-prescription medicines can cause light-headedness or vertigo.
Vertigo occurs when there is conflict between the signals sent to the brain by the different systems of the body that sense balance and position. Your brain uses input from four sensory systems to maintain your sense of balance and orientation to your surroundings.
- Vision gives you information about your position and motion in relationship to the rest of the world. This is an important part of the balance mechanism. It often overrides information from the other balance-sensing systems.
- Sensory nerves in your joints allow your brain to keep track of the position of your legs, arms, and torso. Your body can then make tiny changes in posture that help you keep your balance.
- Skin pressure sensation gives you information about your body's position and motion in relationship to gravity.
- A portion of the inner ear, called the labyrinth, which includes the semicircular canals, contains specialized cells that detect motion and changes in position. Injury to or problems of the inner ear can send false signals to the brain. They can tell the brain that the balance mechanism of the inner ear (labyrinth) detects motion. If these false signals conflict with signals from the other balance and positioning centres of the body, vertigo may occur.
Common causes of vertigo include:
- Inner ear disorders. Examples are benign paroxysmal positional vertigo (BPPV), Ménière's disease, vestibular neuritis, and labyrinthitis.
- Injury to the ear or head.
- Migraine headaches. They are painful, debilitating headaches that often occur with vertigo, nausea, vomiting, and sensitivity to light, noise, and smell.
- Decreased blood flow through the arteries that supply blood to the base of the brain (vertebrobasilar insufficiency).
Less common causes of vertigo include:
- A non-cancerous growth in the space behind the eardrum (cholesteatoma).
- Brain tumours and cancer that has travelled from another part of the body (metastatic).
- Problems in the brain, such as a stroke or a transient ischemic attack (TIA).
Alcohol and many prescription and non-prescription medicines can cause light-headedness or vertigo. These problems may develop from:
- Taking too much of a medicine (overmedicating).
- Alcohol and medicine interactions.
- Misusing a medicine or alcohol use disorder.
- Drug intoxication or the effects of withdrawal.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, or natural health products can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Vertigo is the feeling that you or your surroundings are moving when there is no actual movement. It may feel like spinning, whirling, or tilting. Vertigo may make you sick to your stomach, and you may have trouble standing, walking, or keeping your balance.
Symptoms of a heart attack may include:
- Chest pain or pressure, or a strange feeling in the chest.
- Shortness of breath.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
- Light-headedness or sudden weakness.
- A fast or irregular heartbeat.
For men and women, the most common symptom is chest pain or pressure. But women are somewhat more likely than men to have other symptoms like shortness of breath, tiredness, nausea, and back or jaw pain.
Symptoms of serious illness may include:
- A severe headache.
- A stiff neck.
- Mental changes, such as feeling confused or much less alert.
- Extreme fatigue (to the point where it's hard for you to function).
- Shaking chills.
Heartbeat changes can include:
- A faster or slower heartbeat than is normal for you. This would include a pulse rate of more than 120 beats per minute (when you are not exercising) or less than 60 beats per minute (unless that is normal for you).
- A heart rate that does not have a steady pattern.
- Skipped beats.
- Extra beats.
Neurological symptoms—which may be signs of a problem with the nervous system—can affect many body functions. Symptoms may include:
- Numbness, weakness, or lack of movement in your face, arm, or leg, especially on only one side of your body.
- Trouble seeing in one or both eyes.
- Trouble speaking.
- Confusion or trouble understanding simple statements.
- Problems with balance or coordination (for example, falling down or dropping things).
Many prescription and non-prescription medicines can make you feel light-headed or affect your balance. A few examples are:
- Blood pressure medicines.
- Medicines used to treat depression or anxiety.
- Pain medicines.
- Medicines used to treat cancer (chemotherapy).
Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.
Adults and older children often have several symptoms of shock. These include:
- Passing out (losing consciousness).
- Feeling very dizzy or light-headed, like you may pass out.
- Feeling very weak or having trouble standing.
- Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care in the next hour.
- You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Call 9-1-1 Now
Based on your answers, you need emergency care.
Call 9-1-1 or other emergency services now.
After you call 9-1-1, the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.
Sometimes people don't want to call 9-1-1. They may think that their symptoms aren't serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 9-1-1 for medical transport to the hospital.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Call 9-1-1 Now
Based on your answers, you need emergency care.
Call 9-1-1 or other emergency services now.
Sometimes people don't want to call 9-1-1. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 9-1-1 for medical transport to the hospital.
Light-headedness usually isn't a cause for concern unless it is severe, doesn't go away, or occurs with other symptoms such as an irregular heartbeat or fainting. Light-headedness can lead to falls and other injuries. Protect yourself from injury if you feel light-headed. Here are some things you can do.
- Lie down for a minute or two.
This will allow more blood to flow to your brain. After lying down, sit up slowly. Stay sitting for 1 to 2 minutes before you slowly stand up.
- Get some rest.
It's not unusual to be light-headed during some viral illnesses, such as a cold or influenza (flu). Resting will help prevent attacks of light-headedness.
- Be safe with activities.
Don't drive a motor vehicle, operate equipment, or climb on a ladder while you are dizzy.
- Be careful with substances.
Don't use substances that can affect your circulation. These include caffeine, tobacco, alcohol, cannabis, or other drugs.
- Stay hydrated.
Dehydration can cause or increase light-headedness. It can happen when you have an illness that causes diarrhea, vomiting, or a fever.
- Drink more fluids, especially water.
- Other fluids are also helpful, such as fruit juice mixed to half-strength with water, rehydration drinks, weak tea with sugar, clear broth, and gelatin dessert.
- If you have kidney or heart disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
- Protect yourself if you have vertigo.
- Don't lie flat on your back. Prop yourself up slightly to relieve the spinning sensation.
- Move slowly to avoid the risk of falling.
When to call for help during self-care
Call a doctor if any of the following occur during self-care at home:
- New or worse nausea or vomiting.
- Symptoms occur more often or are more severe.
Preparing For Your Appointment
You can help your doctor diagnose and treat your condition by being prepared for your appointment.
Current as of: August 25, 2022
Author: Healthwise Staff
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
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