Get to the bottom of those dizzy spells

Dizziness is one of the most common complaints one encounters as a doctor. Unfortunately, most people often ignore the dizziness until it affects their daily function.

Although a single episode of dizziness should not be a cause for alarm, repeated episodes warrant a medical check-up. Possible causes of dizziness include:

Problems in the brain

Dizziness can be a sign of an oncoming stroke. It can also occur after a stroke or if you have a tumour in the brain. With most stroke, you end up with weakness or paralysis on one side of your body. However, there are members of the stroke family who do not give this classic presentation.

These usually present with confusion, slurred speech, slight weakness and dizziness. It lasts a few minutes before all symptoms clear up and you are back to normal. These types of ‘mini strokes’ can be a sign of an impending full blown stroke.

Abnormal heart function

Under normal healthy conditions, the heart beats in a regular predictable pattern. However, sometimes the rhythm can be disturbed leading to palpitations (awareness of one’s heartbeat) and even dizzy spells.

This can occur if the salts in your body are not well-balanced, if you have an abnormality in the structure of your heart, hormonal imbalance, after a heart attack or due to medication and illicit drug use. It can also occur after the heart is damaged by many years of living with high blood pressure.

Blood pressure changes

Very low blood pressure levels can lead also to dizzy spells and are often considered a medical emergency. Often low blood pressure can occur if you are bleeding, vomiting excessively, passing large amounts of loose stool or if your dosage of high blood pressure medication is inappropriate.

In some people, there is a sudden drop in blood pressure when they stand up suddenly (especially after lying down). This tends to be more common among the elderly. Very high blood pressure levels can also make you feel a little woozy.

Abnormally high blood pressures occur in patients known to be hypertensive but are not taking their medication as prescribed (skipping doses). It can also occur in pregnancy where it can be associated with miscarriages and seizures (fits).
Blood sugar (glucose) control.

Low blood sugar levels can lead to sudden episodes of weakness, dizziness and even loss of consciousness. Blood sugar levels become low if you skip meals or eat inappropriately small quantities (in relation to your activity level). Levels also become low in diabetics who take their medication without eating.

Low blood sugar levels make it difficult to concentrate and make your activity level go down. They are particularly dangerous in diabetics who have been known to go into coma as a result of very low sugar levels.

Blood-related issues

People with low levels of either iron or vitamin B may end up with low haemoglobin (Hb) levels. This is medically-known as anaemia. Haemoglobin is the active part of blood. Often people with anaemia also tend to notice that they have pale palms.

In addition to dietary factors (low iron and vitamin intake), anemia can also occur in women who have heavy periods, people who bleed a lot after an accident and after surgery to the stomach or intestines. It can also occur in people with severe stomach ulcers and in cancers of the stomach/intestines.

Ear problems

We all know that the ear is responsible for hearing. What most of us don’t know is that the ear is also crucial for maintaining balance. Any problems in the inner section of your ear can lead to periods when you feel a little unsteady on your feet.

Mental health issues

People with anxiety are known to have episodes of awareness of their heart beat (palpitations), excessive sweating, hyperventilating and general discomfort. They can also sometimes have unusual symptoms such as dizzy spells.

Medication

Although the general principle behind drug subscription is to give good effects and treat medical conditions, some medication has also been known to give disturbing side-effects. Most drugs list dizziness as a possible side-effect.

That said, certain drugs are more likely offenders. These include anti-hypertensives (high blood pressure medication), sedatives, anti-depressants and some antibiotics.

What to do if you have dizzy spells

Medical attention

First you need to visit your doctor and explain to them what is wrong. You need not start with a specialist as you first need a basic check-up which will determine the best treatment for you. This can be done by a general practitioner (GP) or physician.
He/she can then refer you to various specialists depending on their findings.

The exception here is women with heavy monthly periods who need to seek the services of a gynaecologist.

Make lifestyle changes

Avoid excessive caffeine, alcohol and tobacco. These may make your dizziness worse and agents such as tobacco have been linked to heart problems and strokes.

You also need to eat a healthy diet rich in protein (to give you iron and vitamin B). Vegetables (especially dark green ones) can also be a good source of iron. Ensure you always keep yourself well hydrated.

Driving

Avoid driving and operating heavy machinery. In addition, care should be taken in the kitchen and other areas where there are sources of fire.

Caring for the elderly

An elderly person with dizziness is particularly vulnerable to falls with resultant fractures (especially hip and arm) and bleeding into their brain if they hit their head. For this reason, such a person should always have a caregiver nearby and changes need to be made to the house to ‘fall proof’ it.

This includes removing any small rugs/carpets, using special adherent mats in the bathroom and putting rubber coverings on sharp corners of objects such as tables and counters.

This article was first published in the Business Daily.