2023-11-20 13:14:00
HARVARD HEALTH PUBLISHING
20.11.2023 • 13:14
You got out of bed this morning and suddenly felt a little dizzy and unsteady. That feeling quickly subsided, but now you’re worried. Is it due to a serious health problem?
Many people experience such episodes, which are generally described as dizziness. This term can include various senses. You may have a feeling of levitation or unsteadiness or a tendency to faint. Or you may feel vertigo, which is the medical term for the sensation of spinning or moving that you may have, even though you may not be moving at all.
Fortunately, most of the time these symptoms stem from a minor or easily treatable cause, says Dr. Shamai Grossman, a cardiologist and emergency medicine physician at Harvard-affiliated Beth Israel Deaconess Medical Center. They’re rarely due to a more serious problem, he says.
But even if the source of your symptoms isn’t dangerous, dizziness can still be a problem because it might lead to falls and fractures or head injuries, says Dr. Grossman. Therefore, you should be aware of the factors that may cause these episodes, as well as the warning signs of the need for immediate medical treatment of your condition.
Common triggers
Behind an episode of dizziness are usually some “usual suspects,” says Dr. Grossman.
Dehydration. When you don’t drink enough water, your blood volume can decrease and your blood pressure can drop. As a result, blood flow to the brain decreases and you may feel faint. Taking certain medications, especially diuretics, can increase your chance of becoming dehydrated.
Otological problems. An infection or other problem affecting your inner ear(s) can lead to dizziness or vertigo.
A common problem is the build-up of fluid inside the ear due to infection.
Another problem, called benign paroxysmal positional vertigo, occurs when tiny crystals of calcium carbonate (otoconia) break off from a vesicle in the inner ear and circulate in the nearby semicircular canals, floating in the fluid inside them. When your head moves, these crystals move too, interfering with the nerve signals sent to the brain and causing that spinning sensation.
Alcohol consumption. Drinking alcohol not only leads to dehydration, it also affects the composition of the fluid in the inner ear. These changes can affect your balance, cause dizziness or other symptoms.
Anemia. Lack of iron, vitamin B12 or folate sometimes causes dizziness. Anemia is characterized by a reduced number of red blood cells, which carry oxygen throughout the body. When there are not enough red blood cells circulating, you may feel tired or faint.
Hormonal changes. Some women, especially those who experience hot flashes, tend to faint due to temporary fluctuations in hormone levels during the menopausal transition.
Orthostatic hypotension. Thanks to gravity, when you stand up quickly, blood is drawn to your legs. Your body reacts by signaling your blood vessels to constrict and your heart to beat harder to restore blood supply to your upper body and head. However, in an estimated 20% of people over 65, this response is slower, resulting in a relative delay between the moment you get up and the restoration of blood flow to the brain to a normal level. Thus, you may feel a tendency to faint. Certain medications, including beta-blockers (often prescribed to treat high blood pressure), can make the problem worse. The same is true of certain underlying health problems, such as diabetes.
Possible warning signs
In rare cases, dizziness is a sign of an urgent heart or brain problem. One of these is an abnormal heart rhythm (arrhythmia), which is caused by a disruption in the electrical signals necessary for the heart to pump blood to the rest of the body, including the brain. When the heart rhythm is abnormal, you may feel faint.
Dizziness can also be caused by a problem in the cerebellum, an area at the back of the brain that contains numerous neurons and controls balance, movement and coordination of movements. Brain problems, such as having a stroke or having a tumor in that area, can cause these symptoms.
However, these are more serious conditions that usually cause multiple, longer-lasting and more frequent symptoms. For example, a stroke in the cerebellum, resulting from the presence of a clot blocking the brain’s blood supply, could cause vertigo. But this vertigo wouldn’t go away quickly or be intermittent, says Dr. Grossman. In addition to lasting longer, it would usually be accompanied by other warning signs, such as an erratic gait or problems with memory or speech. The presence of a tumor in the cerebellum could cause similar phenomena.
If your problems are due to a cardiac disorder, you may not only feel dizzy, but also feel a change in your pressure or that your heart rate is too fast.
“The hard part is identifying who has a more serious underlying problem,” says Dr. Grossman.
Therefore, take the safer route of prevention, especially if you have a history (or risk factors) of heart or cardiovascular problems.
Also seek immediate help if you experience any of the following:
– Your symptoms last longer than 15 minutes.
– Your symptoms are worrying.
– You experience neurological symptoms, such as difficulty walking, weakness or numbness in one part of the body.
How to reduce the risk of falling
Other types of dizziness are not necessarily medical emergencies, but you should let your doctor know to help determine the underlying cause of your symptoms, especially if they occur frequently. “If you’re feeling dizzy every week or more, then you should see a doctor,” says Dr. Grossman. Your doctor may also prescribe medication to treat the problem and suggest some fall prevention strategies. Some helpful tips are:
– Drink more water.
– Try alternatives to medications that could be responsible for your symptoms.
– Avoid drinking alcohol
– Get up more slowly from a sitting position.
– Wear compression stockings, which help maintain blood circulation.
“For some adults, having a relative or caregiver at home who can help them get out of bed in the morning can help keep them safe and prevent them from falling,” says Dr. Grossman. Replacing the bed with a lower one could prevent possible injury in the event of a fall.
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