FEELING DIZZY: TEMPORARY LIGHTHEADEDNESS OR A WARNING SIGN?
Every once in a while, I’ll stand up too quickly after sitting at my computer and experience a brief bout of lightheadedness—or in other words, feel dizzy. I’ve found that if I sit back down or, better yet, lie down, the feeling passes in a few minutes. But I recently learned that dizziness is a common issue among seniors and can be caused by various factors, potentially increasing the risk of falls and injuries.
To shed light on the different types of dizziness, I found an insightful article from the October 1, 2024 issue of Harvard Health Watch by Executive Editor Matthew Solan, titled Unraveling Dizziness. Here are some key excerpts:
What does it mean to be “dizzy”? Here are some of the common reasons
- Dizziness can be an unsettling and scary experience. An episode may last only a few seconds or linger for several minutes or even longer. It may be an isolated incident, but in some people, episodes recur, especially during certain activities.
- But what does being “dizzy” really mean? Many people have a difficult time articulating what they experience when they say they feel dizzy because it can encompass a range of sensations. One common experience is lightheadedness; another is a spinning feeling along with unsteadiness.
Lightheadedness
- This is feeling faint, like you might pass out. It’s often due to a fall in blood pressure. If you quickly sit or lie down, the lightheadedness should pass within a couple of minutes. Here are some common reasons for this phenomenon:
- Vasovagal response.This is the most common reason for fainting. Vaso refers to blood flow and pressure, and vagal describes the action of the vagus nerve, which signals the heart to beat more slowly. Typically, when blood pressure begins to fall, the heart beats faster to compensate.
- However, with a vasovagal response, the heart rate slows while blood pressure falls, which reduces blood flow to the brain. Anyone can experience this from an emotional or physical shock. Unless you sit or lie down right away, you could lose consciousness and fall.
- Orthostatic hypotension.This usually occurs when you stand quickly. When you stand, gravity moves more of your blood toward your feet. Your body normally compensates by alerting your blood vessels to contract and your heart to pump harder and faster to re-establish the blood supply to your head. However, with orthostatic hypotension, your blood pressure falls and stays lower than it should, and your heart rate does not speed up to compensate, creating the lightheadedness. Again, this should resolve with lying down.
- Dehydration develops when you don’t consume enough fluids. Your blood volume drops, lowering your blood pressure. Unlike with the vasovagal response or orthostatic hypotension, your heart rate increases. However, it might not be enough to prevent you from feeling lightheaded.
- Hypoglycemia (low blood sugar).People with diabetes, especially those who take insulin, are very prone to hypoglycemia. And some people without diabetes are sensitive to falling blood sugar levels even if their actual blood sugar number remains in the normal range. Too much exercise, too little food or carbohydrates, a missed or delayed meal, or a combination of these factors can cause blood sugar levels to drop.
- The vast majority of medications list dizziness or lightheadedness as a possible side effect.
- Heart problems.An abnormal heart rhythm or rate that’s too slow or too fast can decrease blood flow to the brain, causing lightheadedness. If you lose consciousness or continue to feel lightheaded while lying down, call for immediate medical advice.
Spinning sensation
- This can feel like your body or the environment around you is spinning. It can cause you to become unbalanced, often with nausea and a feeling of motion sickness. The episodes might last less than a minute or as long as a day or two, and can recur. Most often they fall into the category of vertigo. For example:
- Benign paroxysmal positional vertigo (BPPV).BPPV happens when tiny calcium crystals break free from a sac deep inside the ear and travel into nearby passageways, floating in the fluid there. When your head moves, the displaced crystals also move, sending signals to the brain and causing a spinning sensation.
- Labyrinthitis or vestibular neuritis.These two terms refer to inflammation, usually from a viral infection, in the inner ear (labyrinthitis) or in the nerve in the ear that senses balance (neuritis). The vertigo symptoms can be very similar, but when there is also some hearing loss it usually indicates labyrinthitis.
Seeking solutions
- When you feel dizzy, you should first lie down or at least sit with your feet up and keep your head still. If you quickly feel better and the dizziness does not return when you get up and move, that is generally reassuring. However, if the symptoms persist or recur, it’s best to call for medical advice and arrange an appointment.
- Identifying the specific cause of ongoing or frequent dizziness can be challenging because most often there isn’t a diagnostic test to answer the question. Instead, you and your doctor can consider factors like stress, long COVID, insufficient sleep, and many other possibilities. For persistent or recurrent vertigo, your doctor can recommend an over-the-counter medication. Examples include dimenhydrinate (Dramamine) and meclizine (also available by prescription under the brand name Antivert), which help with the feeling of motion sickness. For BPPV, your doctor may move your head and body through a sequence of positions called the Epley maneuver to reposition the tiny free-floating crystals.
- Most importantly, you should always report any other associated symptoms such as new headaches, loss of appetite, weight loss, or night sweats, which might indicate a serious condition.
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