By Dr Eugene Brink
It is normal to sometimes feel dizzy or lightheaded, but when it becomes a chronic occurrence it is time to seek and remedy its cause.
“Don’t ignore it. Even if the light-headedness does not have a serious cause, it could lead to serious injuries from a fall. And at the worst, the cause may itself be life-threatening,” says Dr Shamai Grossman, an associate professor of emergency medicine at Harvard Medical School.
There are a surprising number of easily treatable causes of faintness:
- Low blood sugar and blood pressure
These are two of the most common ones. Dr Debora Weatherspoon writes at Healthline.com that your body needs sugar, or glucose, for energy. When the sugar level in your blood drops, you may feel dizzy and tired.
“Low blood sugar is often a side effect of insulin and other drugs used to treat diabetes. These drugs lower blood sugar, but if the dose isn’t right your blood sugar can drop too much. You can also get hypoglycaemia if you don’t have diabetes. It can occur if you haven’t eaten in a while or if you drink alcohol without eating,” she says.
She recommends a fast-acting source of carbohydrates, such as a glass of orange juice or sucking on a hard sweet to relieve this. “Follow that up with a more nourishing meal to raise your blood sugar levels. If you often get hypoglycaemia, you might need to adjust your diabetes medicine. Or you could eat smaller, more frequent meals throughout the day.”
The autonomic nervous system helps the body regulate the shift in blood pressure when we stand up. “As we get older, this system may deteriorate, causing a temporary drop in blood pressure when we stand – known as orthostatic hypotension – resulting in lightheadedness. This may be a long-term problem, but there are medications to treat it, such as midodrine (ProAmatine) and fludrocortisone (Florinef), so this too warrants a trip to your doctor.”
Possible causes of dehydration are being overheated, not eating or drinking enough, or being sick. “A glass of water may be enough to make you feel better, but if you haven’t been eating or drinking much for days, it will take more than that to rehydrate your body,” says Grossman.
This might call for an intravenous infusion of fluid and a doctor can confirm whether you require electrolytes like potassium or salt.
- Chronic conditions
Apart from hypoglycaemia, other chronic deficiencies and illnesses may leave you feeling lightheaded. Chronic fatigue syndrome (CFS) is such an example. “As indicated in the name, fatigue is the main symptom of CFS, and it can be so severe that it creates difficulty in performing everyday tasks,” writes Amanda Barrell at MedicalNewsToday.
Another one is iron-deficiency anaemia (IDA). “Iron helps to carry oxygen around the body, maintaining healthy cells and tissues. A lack of iron can lead to iron-deficiency anaemia (IDA), which may cause dizziness and fatigue.”
Supplements could help, but consult your doctor if you suspect that you have any of these afflictions.
Barrell says certain medication could cause dizziness and light-headedness. These include:
- antidepressants like fluoxetine (Prozac) and trazodone (Desyrel)
- antiseizure drugs such as divalproex (Depakote), gabapentin (Neurontin, Active-PAC with gabapentin), and pregabalin (Lyrica)
- blood-pressure-lowering drugs, such as ACE inhibitors, beta-blockers, and diuretics
- muscle relaxants such as cyclobenzaprine (Fexmid, Flexeril) and metaxalone (Skelaxin)
- sleeping pills such as diphenhydramine (Benadryl, Unisom, Sominex), temazepam (Restoril), eszopiclone (Lunesta), and zolpidem (Ambien)
So common, but often overlooked. “People who get migraines can experience dizziness and vertigo, even when they don’t have a headache. The vertigo can last for a few minutes to a few hours. Avoiding migraine triggers like alcohol, caffeine, and dairy foods is one way to prevent these headaches,” says Weatherspoon.
Amanda Barrell, 26 February 2018, “Why do I feel both tired and dizzy?”, https://www.medicalnewstoday.com/articles/321045.
Deborah Weatherspoon, 24 February 2017, “What causes dizziness and fatigue? 9 possible causes”, https://www.healthline.com/health/dizziness-and-fatigue.
Harvard Medical School, 13 December 2019, “Lightheaded? Top 5 reasons you might feel woozy”, https://www.health.harvard.edu/diseases-and-conditions/lightheaded-top-5-reasons-you-might-feel-woozy.