Dizziness Got You Down?
By MigraineFreeLiving Staff
There’s no doubt about it. Dizziness can be disabling. Whether it is dizziness from a stroke, from dehydration, heart failure, or some rare condition like semicircular canal dehiscence, being unable to get from A to B can make you M A D.
The trouble doctors have with dizziness is that it can be caused by so many things! 🤯An infection in the inner ear, pressure changes in the head, too many High Noons at the beach…
When should I be concerned?
Because dizziness can be mild or perfectly benign, or it can indicate a life-threatening neurologic injury, be mindful of the following symptoms:
Sudden, unprovoked dizziness
Dizziness associated with new double vision or loss of vision, new weakness, new numbness, hearing loss
Dizziness leading to difficulty with balance or walking
Progressively worsening dizziness
(Note this list is not comprehensive. Please discuss any symptoms with your doctor.)
Some doctors will differentiate dizziness and “vertigo”--which is the illusion of self-motion or motion of the world in its absence. The thought here is that vertigo is often tied to a disorder of the inner ear or brain. In my experience, this distinction is NOT helpful. I tell my residents this all the time. Many people with dizziness due to atrial fibrillation or heart conditions will feel like they are swaying in place, or people with severe neuropathy will feel like the world is moving beneath their feet. Dizziness is dizziness. Rather than focusing on symptoms being related to vertigo or not, it’s important to hone in on other symptoms or descriptions of the dizziness when “localizing the lesion” as neurologists tend to do.
Dizziness with nausea and vomiting can suggest dysfunction of the inner ear or the cerebellum (part of the brain which coordinates balance and movement)
Dizziness that occurs suddenly with head rotation (e.g., rolling over in bed) and is most severe for 1-2 minutes can suggest BPPV
Dizziness that leads to fainting can be related to a heart condition or low blood pressure
What can I do at home?
If dizziness worsens when you stand, which is a common trigger for dizziness, it can be related to medications which slow your heart rate or lower your blood pressure. For anyone on medications like this, it’s generally good practice to check your heart rate and blood pressure regularly.
Like might be done in the doctor’s office, checking your blood pressure and pulse while laying flat (after a few minutes), then sitting upright (after 5 min), then standing (after 5 min), can tell you if your dizziness is related to orthostatic hypotension. Again, this may be related to certain medications, but it can also be due to dehydration, low salt levels in the blood, heart conditions, or disorders affecting the nerves which regulate blood pressure control. It’s a good idea to report these to your doctor, but half of people with orthostatic hypotension will have NORMAL vital signs. So be sure to ask your doctor if more formal testing may be helpful.
If you’re dehydrated, or your blood pressure is low, or particularly if you exercise a lot (like I do), you might want to keep a close eye on your electrolyte input. And here’s some bad news, GATORADE DOES NOT HAVE ELECTROLYTES! It is sugar water. 👇
If you need electrolyte repletion, from excess sweat or insensible losses from high temperatures specifically, electrolyte supplements like LMNT or Liquid IV include the most balanced electrolyte content. They can be a little $$$ and if you take too much it can affect your blood pressure and kidney function, so be sure to mention these as nutritional supplements during your doctor’s visits.
Finally, if you are suffering from orthostatic hypotension, this can be due to blood pooling in the legs. Compression stockings are highly beneficial for individuals with orthostasis. As always, talk to your doctor about any new or worsening symptoms.