Why am I so dizzy?

Q: I have been having daily dizzy spells for the past three months. I initially assumed that it was due to fatigue and poor nutrition so I took a few days off and made lots of positive changes to my diet. This didn’t help. A friend of mine told me that anaemia can cause dizzy spells so I started taking some blood boosting supplements that I bought over the counter. These haven’t improved my situation. My wife suggested that I go for a medical check-up, but I am not sure which specialist I should see. Kindly advise.

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I agree with your wife – you need a full physical check-up. However, you do not need to go to a specialist for this check-up. You need to start off with a visit to a general practitioner (GP). He/she should be able to get to the bottom of your dizzy spells and refer you to a specialist if need be. There are several possible causes for your dizziness.

Blood pressure problems

If your blood pressure drops unexpectedly, you are bound to feel dizzy. In some cases, the dizziness occurs when you change positions, for example, from sitting/lying down to standing.

Ear infections

What most of us don’t know is that the ear is also crucial for maintaining balance. Any problems in the inner section of your ear can lead to periods when you feel a little unsteady on your feet.

Infections in the inner part of the ear including labyrinthitis and conditions like Ménière’s disease (excessive build-up of fluid in your inner ear) can affect balance leading to a form of dizziness known as vertigo.

Vertigo is the false sense that your surroundings are spinning or moving. Ear conditions can also be associated with fluctuating hearing loss, ringing in the ear and the feeling of a plugged ear.

Benign paroxysmal vertigo

This condition causes an intense but false sense that you’re spinning around. These episodes are triggered by a rapid change in head position, such as when you turn over or sit up in bed.

Diabetes and low blood sugar

If you have recurrent episodes of low blood sugar, you are bound to have episodes of weakness and dizzy spells. Low blood sugar spells occur in diabetics on treatment or in non-diabetics with poor eating habits or an underlying health problem that affects sugar metabolism —for example chronic pancreatitis.

Poor blood circulation

If your heart is not pumping enough blood to your brain, you are bound to get dizzy. Conditions that affect your heart muscle (cardiomyopathy), irregular heart beat and even heart attacks can affect your heart’s ability to efficiently pump blood to your brain.

Dehydration

If your fluid intake is very poor or if you are losing fluid through diarrhoea or vomiting, you could find yourself getting dizzy. This is marked during hot weather where overheating is a problem.

Neurological (brain) conditions

People who have had previous injury to the head, stroke and multiple sclerosis (MS) will sometimes report loss of balance as a symptom.

Remember, you can sometimes get a stroke without the classic features of complete paralysis of one side of the body. Occasionally, the stroke symptoms can be subtle. A tumour (growth) in the section of the brain that controls balance can lead to dizzy spells.

Migraines

People who experience migraines may have episodes of dizziness in the period before or after a classic migraine attack. These episodes can last minutes to hours and may be associated with headache as well as light and noise sensitivity.

Anaemia

You have previously used blood boosting supplements. These are only effective if your dizziness is due to anaemia (a medical condition in which your haemoglobin levels are low.

Haemoglobin is an active molecule in your blood cells). Anaemia occurs if you have low iron levels, low vitamin B levels or if you have been sick for a long period. Other signs and symptoms that may occur along with dizziness if you have anaemia include fatigue, weakness and pale skin.

Medications

Dizziness can be a side effect of certain medications such as anti-hypertensives, anti-seizure drugs, antidepressants and sedatives. If you are on any long-term medication, carry them for your doctor to review, they could be the cause of your dizzy spells.

Stress, anxiety

Stress and anxiety can manifest in many ways. One possible manifestation is fatigue and dizzy spells. This can be frustrating to deal with as diagnosis is often difficult and most of the time it is missed.

Alcohol, drug abuse

When alcohol is taken in moderation, there are few adverse effects. However, when abused alcohol can damage the brain, heart and liver. This can lead to symptoms such as tremors, dizziness, dementia and even heart failure.

Prepare for your visit

• Carry any medication you are using.

• Have a diary documenting when and how frequent your dizzy spells occur.

•Document any new symptoms that have developed in the past few months (even if you think that they are unrelated to your dizzy spells).

• Find out from your relatives about any related health problems in your immediate family.