TOP 10 CAUSES OF DIZZINESS
By Sanaz Majd, MD
Most people have experienced dizziness at some point. But, unfortunately, it is one of the most vague and non-specific symptoms to understand, for both patients and doctors. It’s a challenge to discern because of the following main reasons:
• The symptom itself can be interpreted in various ways and is often a challenge to describe—its meaning can vary from “lightheadedness,” to a sensation of the “room spinning,” to simply just general weakness, to a sensation of almost passing out. All of these descriptions can point to different causes.
• Dizziness can be linked to numerous organ systems—the heart, lung, brain, blood, or nervous system. It’s a non-tangible symptom that can be caused by many possibilities.
For most patients, dizziness is not serious, is short-lived, and typically self-resolves. And although episodes are often brief and self-limiting, they can sometimes interfere with functioning when severe enough. It may be a challenge to walk across the room or to go about daily activities.
So let’s shed some light on this rather mysterious symptom and talk about the 10 top causes of dizziness; the first 6 are the most common and the last 4 less so. Although this list is by no means comprehensive, most people suffering from dizziness do so because of one or more of the following reasons.
MOST COMMON CAUSES
Medication Side Effects
To just name a few, medications to treat prostate issues, urinary incontinence, anti-hypertensives, diuretics, gabapentin, and anti-depressants (especially when discontinued abruptly) can cause dizziness.
Dehydration
Whether hiking up Mount Everest or simply sun-bathing in the backyard, heat exposure, lack of sufficient fluid intake, and loss of fluids via sweat or urine can dehydrate the body. Blood pressures can drop and cause dizziness; the key describing feature from patients is often a sensation of lightheadedness for several seconds upon sitting up or standing up. This is because the blood pressure needs to quickly change in order to keep up with gravity.
So be sure to drink plenty of fluids in hot weather, during exercise, and when consuming caffeine or alcoholic beverages (which are diuretics that increase urination and, hence, excretion of water).
Electrolyte Imbalances
Imbalances in potassium or sodium levels in our body (out of whack from our diet, medication side effects, with diarrhea/vomiting, or other medical conditions) can also cause dizziness. A simple blood test can detect this one.
Anemia
Young menstruating women with heavy periods are one of the most common groups of people with anemia. However, those who slowly release microscopic amounts of blood in the stool (from a bleeding stomach ulcer or problems with the colon, for example), or those have other types of anemia besides just blood loss, can also experience dizziness. Anemia is easily screened via a blood test.
Anxiety/Stress
Patients who tend to hyperventilate as a result of anxiety and/or chronic stress can develop a non-specific dizziness. Hyperventilating even to a very mild degree over time can, believe it or not, do this.
Benign Positional Vertigo
A person’s center of balance is located in the inner ear on both sides in what is referred to as the “vestibular system.” Tiny crystals that reside there can shift in the inner ear and patients whose vestibular system is not equal in both sides may experience a sensation of movement. People particularly describe the dizziness as a sensation of the “room spinning,” which can often be triggered and/or worsened by head movement. Vertigo is benign, but can be a challenge to have to deal with on a daily basis. It typically self-resolves within a few weeks or less.
Note that viruses can also attack the inner ear and wreak havoc on the sense of balance, as can any other inner ear problems (such as inflammation, extra fluid buildup from allergies, etc.).
LESS COMMON CAUSES
Low Blood Sugar
This one pertains mostly to those who are diabetic on insulin or to those who take certain drugs that drop blood glucose levels. Low blood sugar can certainly send us off balance, but dizziness often accompanies other more prominent symptoms such as shakiness.
Meniere’s Disease
Not as common of a cause, but you may have heard about this one while searching the internet. Meniere’s Disease includes a triad of symptoms: dizziness due to vertigo, hearing loss, and tinnitus (ringing in your ears).
Heart Problems
Heart arrhythmias, heart valve deformities, or other problems with the heart can also cause dizziness. This type of dizziness is sometimes described as the sensation of “almost passing out,” or actually passing out. It’s also more of a concern with older patients, those who have risk factors for heart disease, and those with prior cardiac issues.
Nervous System Issues
Some strokes or disorders of the nervous system can also potentially cause dizziness, but they often are accompanied by other disturbing neurologic symptoms, such as vision loss, problems with speech, motor or sensory deficits, etc.
WHEN TO WORRY ABOUT DIZZINESS
As you can see, serious causes of dizziness are the least common, however, they are not to be missed. For most people, dizziness can be annoying to deal with, but is typically benign and self-resolving. If the dizziness is persistent, severe, or accompanied by other more concerning symptoms, a medical evaluation is vital. These red flags often include (but are not limited to):
• Other neurologic symptoms (vision loss, problems with speech, motor or sensory deficits, etc.)
• Unstable vitals (blood pressure, heart rate, etc.)
• Cardiac symptoms (chest pain, heart palpitations, etc.)
• Passing out/feeling of almost passing out
Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
Sanaz Majd, MD, is a board-certified Family Medicine physician and host of the Majd MD YouTube channel, reviewing the most popular medical topics: www.youtube.com/MajdMD. You can also follow her on Facebook or Instagram: @SMajdMD.
