Internal Medicine Doctors of
Mill Basin & Bergen Beach, Brooklyn

Medical Issues Regarding Dizziness (Lightheadedness)

Posted by admin on July 12th, 2013

“Experiencing dizziness or lightheadedness can be an unsettling experience. Symptoms can range from mild to severe. Causes of dizziness can also range from the non-serious to life-threatening. For this reason, if you are experiencing episodes of dizziness, you should come in to the office to be examined. It’s important to rule out serious causes for your dizziness. In addition, whether there is a serious cause for your dizziness or not, I may be able to prescribe treatment to ease your symptoms”.

-Dr. Zimilevich, MD

 What is dizziness?

Dizziness can be hard to describe. Many people describe dizziness as an unpleasant sensation that makes them feel as though they might fall. People who are dizzy may feel off balance and may grasp at stable objects, such as a table or a wall,  to maintain their balance. Lightheadedness can be similar to dizziness. Vision may be affected, with the vision fading or “graying out”. Vertigo, on the other hand, is the sensation that you are whirling or spinning around (or your surroundings are), usually in one direction. Vertigo is often associated with disorders affecting the inner ear.

It can be difficult for a physician to differentiate between dizziness, lightheadedness and vertigo, which is why I have lumped them all together here.

Potential causes of dizziness

As mentioned, there can be numerous reasons why you might feel dizzy or lightheaded. Some of the more serious reasons include:

• abnormal blood pressure– blood pressure that is very low or extremely high may cause dizziness or even fainting.
• cardiac arrhythmias- if the heart beats too slowly or too quickly, you may feel dizzy or lightheaded. You may even faint.
• stroke- if you experience a stroke, you may experience dizziness or lightheadedness as one of the symptoms. Other symptoms may include altered mental status or confusion, slurred speech, altered gait or difficulty feeling or moving one side of the face or body.
• emotions/hyperventilation- when you are very upset, you may find yourself breathing very rapidly and deeply. This can cause dizziness, as well as numbness and tingling in your face, hands and feet.
• standing up too quickly/prolonged standing- if you rise too quickly, your blood pressure may drop; likewise, if you stand in one position too long (as soldiers are sometimes forced to do) you may feel dizzy or faint.
• medications- there are numerous medications that may make you dizzy, including sedatives, narcotics, tranquilizers, blood pressure medications, diuretics and others
• dehydration- if you have been ill and have been vomiting or experiencing diarrhea for a prolonged period of time, you may feel weak and lightheaded, especially when upright due to low fluid volume and decreased blood pressure
• low blood sugar (hypoglycemia)- if you are diabetic and take your insulin without eating properly, or take your diabetes medications improperly, you may experience a rapid drop in blood glucose levels, which may cause you to feel dizzy or lightheaded.
• inadequate oxygenation- if you are not getting enough oxygen due to heart disease, lung disease or for another reason, you may feel dizzy and weak.
• deconditioning- if you are in poor physical condition (i.e. due to prolonged illness) and attempt activity that is beyond what your body can handle, you may feel weak and dizzy
• acute blood loss- if you are bleeding internally or externally and lose enough blood, you will feel dizzy and lightheaded. Chronic blood loss may also cause you to feel weak and dizzy, but you may tolerate the blood loss for longer before experiencing symptoms if the loss is very slow over a prolonged period of time.
• infection- if you have a viral, bacterial or other infection, it may cause you to feel dizzy and weak
• cancer- many cancers will cause dizziness and weakness, which may be the presenting symptoms in some types of cancer (i.e. cancers affecting the blood)

When should I be concerned about dizziness?

If you experience any of the following, you should definitely make an appointment to come in and see me as soon as possible:

• new or severe episode of dizziness or lightheadedness
• sudden dizziness that you can’t attribute to a cause
• any change in your pattern of dizziness
• worsening of dizziness
• dizziness associated with a new medication
• dizziness associated with preexisting serious illness, such as heart or lung disease (Note: if you are also experiencing chest pain or shortness of breath, go to the nearest emergency room)
• dizziness that results in you losing consciousness or falling
• dizziness associated with weakness, gait disturbance (inability to walk straight), facial drooping or slurred speech, as these may be symptoms of a stroke (Note: if you think you or a loved one is having a stroke, call an ambulance and go to the nearest emergency room) 

What should I expect when I come in to see you?

First of all, you should expect that it may take a little detective work before I can tell you what is causing your dizziness! In some cases, it is possible that we won’t be able to find a cause for your dizziness, but we can rule out serious and/or life-threatening ones.

I’ll first need to know  all about the problem- when it began, what you were doing when it started, how often it has occurred, whether you lost consciousness and what you think may have caused the dizziness. Next, I will want to know all about your medical history, including any illnesses and medications you are taking (including over-the-counter and herbal remedies).

Next, I’ll need to examine you. This may require you to disrobe and put on a gown so that I have better access for examination. I’ll let you know if this is necessary. I may examine multiple areas, or I may perform a focused examination of one particular body system if I have a hunch regarding what might be causing your dizziness.

I may order diagnostic testing, which might include blood work, a heart tracing (ECG), an x-ray or another test. If I think you need to have diagnostic testing done, I promise to tell you why I think you need it and what I might be looking for.

What treatment might I receive?

Treatment will be based on what I find when I examine you and, possibly, on the results of any diagnostic testing. Treatment will depend on what I think is causing your dizziness. I will be sure to discuss your treatment with you, making sure that you understand the treatment and what needs to be done to help you feel better.

If you are experiencing dizziness, lightheadedness or vertigo, you should make an appointment to come in to the clinic. Although your dizziness may not be caused by a serious medical condition, it is important to rule out the more serious causes. Make your appointment today.

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