Decoding Dizziness

Learn about some of the most common causes, and what you can do.
Author: Donna Behen

Everyone’s experienced a bout of dizziness at least once in their life—usually it’s as a child after running around in circles or riding an amusement park Tilt-A-Whirl. But for some adults, that unsettling feeling of being disoriented, lightheaded and off-balance is a more common occurrence, and it can have many different causes.

For example, severe dehydration can often cause dizziness, as can migraine headaches. Dizziness is also a common side effect of certain prescription drugs.

Dizziness in people with bleeding disorders can be especially dangerous, since falls increase the risk of fractures, bleeds and other serious injuries, so it’s important to tell your doctor if you’re having this symptom. Your doctor can determine the cause and get you appropriate treatment.

Here are some of the medical conditions that can cause dizziness and lightheadedness, and how they’re treated:

Benign Paroxysmal Positional Vertigo (BPPV)

When someone has vertigo—a severe form of dizziness in which it feels like you or everything around you is spinning—the cause is often a vestibular (inner ear) disorder known as benign paroxysmal positional vertigo (BPPV).

BPPV is one of the most common types of vertigo, and it happens when a change in head position, such as rolling over or getting out of bed, gives you a sudden spinning sensation. What’s happening is that tiny crystals in your inner ear become dislodged and shift out of place, which causes the sensation of vertigo. The condition occurs most often in people 50 and older and is more common in women than in men.

Doctors treat BPPV by performing a series of head movements known as the Epley maneuver, which can shift the inner ear crystals back into place.

Meniere’s Disease

Another vestibular disorder that can cause episodes of vertigo is Meniere’s disease. The disorder, which usually affects just one ear, can also cause hearing loss and tinnitus (ringing in the ear). It can affect people of any age but is most likely to appear between the ages of 40 and 60.

The cause of Meniere’s disease is unknown, but it’s thought to be related to an increased volume of fluid in the inner ear. There’s no cure, but doctors can prescribe medications to take during an episode of vertigo, which will lessen the severity of an attack. If Meniere’s disease is causing balance issues, vestibular rehabilitation therapy can help.

Low Blood Pressure

Another common cause of dizziness is low blood pressure, or hypotension. Some people have low blood pressure all the time, and it’s normal for them and causes no symptoms. But low blood pressure that’s due to a health issue such as dehydration, pregnancy, diabetes or heart problems can cause dizziness as well as confusion, blurry vision and headaches.

Some people experience dizziness and lightheadedness due to orthostatic hypotension, which is caused by a sudden change in body position, such as going from lying down to standing up. This type of low blood pressure usually lasts for just a few seconds.

Low blood pressure can also be a side effect of taking medications to control high blood pressure, and taking certain over-the-counter medications in combination with hypertension drugs may also trigger low blood pressure.

Iron-Deficiency Anemia

Women and girls with bleeding disorders are at increased risk for iron-deficiency anemia, due to blood loss from heavy or prolonged menstrual bleeding. In addition to dizziness, anemia can cause fatigue, weakness, headaches and nausea.

If blood tests confirm that you are anemic, doctors usually prescribe iron supplements. If you can’t tolerate iron supplements or if your anemia persists after a month or two of taking iron supplements, you may need to be given iron intravenously.

Women are sometimes also prescribed hormone treatments or medication to control heavy menstrual bleeding so that they’re less likely to become anemic in the future.