Many parts of your body -- including your eyes, brain, inner ear, and nerves in your feet and spine -- work together to keep you balanced. When a part of that system is off, you can feel dizzy. It can be a sign of something serious, and it can be dangerous if it makes you fall.
Your doctor will look at all your symptoms and overall health to figure out what's going on and how to treat it.
Get medical attention immediately if you're dizzy and you faint, fall, or can't walk or have any of the following:
- Chest pain
- Different or really bad headache
- Head injury
- High fever
- Irregular heart rate
- Shortness of breath
- Stiff neck
- Sudden change in speech, vision, or hearing
- Weakness or numbness in your face
- Weakness in your leg or arm
Is It Vertigo?
Does it feel like you're spinning or the room is moving around you? That's a classic sign of a particular type of dizziness called vertigo. It's more than feeling off-kilter and usually gets worse when you move your head. This is a symptom that there is an issue in the inner ear or part of the brainstem governing balance. The most common kind is benign paroxysmal positional vertigo, or BPPV.
Your inner ear is a complicated system of canals filled with fluid. These let your brain know how your head is moving. With BPPV, tiny bits of calcium in part of your inner ear get loose and move to places they don't belong. The system doesn't work the way it should and sends your brain the wrong signals.
It's often caused by the natural breakdown of cells that happens with age. A head injury can cause it, too.
You'll feel it briefly when you tilt or turn your head, and especially when you roll over in bed or sit up. BPPV isn't serious and usually goes away on its own. If not -- or you'd like to help it along -- it can be treated with special head exercises ("particle repositioning exercises") called the Epley maneuver to get the pieces of calcium back in place. Most people feel better after one to three treatments.
There are other causes of vertigo both in and outside the brain. You can have Meniere disease (described below), labyrinthitis (described below), a tumor called an acoustic neuroma or side effects from some antibiotics. In the brain, it can be caused by a vestibular migraine, multiple sclerosis, malformations of brain structures or a stroke from lack of blood flow or bleed (hemorrhage) in the cerebellum.
Is It an Infection?
Inflammation of the nerves in your ears also can cause vertigo. It can be either vestibular neuritis or labyrinthitis. Vestibular neuritis refers to inflammation of your vestibular nerve only while labyrinthitis involved both your vestibular nerve and your cochlear nerve. Both conditions are caused by an infection. Usually, a virus is to blame. But bacteria from a middle ear infection or meningitis can make their way into your inner ear as well.
In this case, dizziness usually comes on suddenly. Your ears may ring, and it may be hard to hear. You also may be nauseated and have a fever and ear pain. Symptoms can last several weeks.
If it's caused by a virus and can't be treated with antibiotics, medication can help make you feel better as the infection runs its course.
Is It Meniere's Disease?
This condition brings on intense periods of vertigo that can last hours. You may feel fullness or pressure in one ear. Other symptoms include ringing in your ears, hearing loss, and nausea. You may feel exhausted after the attack passes.
People with Meniere's disease have too much fluid in their inner ear. Doctors don't know what causes it, and there's no cure for it. It's usually treated with diet changes (a low-salt diet) and medicine to control the dizziness.
Is It Your Circulation?
Dizziness can be a sign of a problem with your blood flow. Your brain needs a steady supply of oxygen-rich blood. Otherwise, you can become lightheaded and even faint.
Some causes of low blood flow to the brain include blood clots, clogged arteries, heart failure, and an irregular heartbeat. For many older people, standing suddenly can cause a sharp drop in blood pressure.
It's important to get medical help immediately if you're dizzy and faint or lose consciousness.
Is It Your Medication?
Several drugs list dizziness as a possible side effect. Check with your doctor if you take:
- Antibiotics, including gentamicin and streptomycin
- Anti-seizure medications
- Blood pressure medicine
Is It Dehydration?
Many people don't drink enough fluids to replace the liquid they lose every day when they sweat, breathe, and pee. It's particularly a problem for older people and people with diabetes.
When you're severely dehydrated, your blood pressure can drop, your brain may not get enough oxygen, and you'll feel dizzy. Other symptoms of dehydration include thirstiness, tiredness, and dark urine.
To help with dehydration, drink plenty of water or diluted fruit juice, and limit coffee, tea, and soda.
Is It Low Blood Sugar?
People with diabetes need to check the amount of sugar (glucose) in their blood often. You can get dizzy if it drops too low. That also can cause hunger, shakiness, sweating, and confusion. Some people without diabetes also have trouble with low blood sugar, but that's rare.
A quick fix is to eat or drink something with sugar, like juice or a hard candy.
Is It Something Else?
Dizziness can be a sign of many other illnesses, including:
- Migraines, even if you don't feel pain
- Stress or anxiety
- Nervous-system problems like peripheral neuropathy and multiple sclerosis
- Tumor in the brain or inner ear
You may have other symptoms besides dizziness with any of these conditions. If your dizziness won’t go away or impacts your ability to function, make sure to discuss it with your doctor to find out the cause and treat it.