Dizziness is a symptom that can be caused by labyrinthitis, a sudden drop in blood pressure, hypoglycemia, neurological diseases, (like Alzheimer's or a stroke), or as a result of a medication side effect. occur due to a side effect of medications.

Depending on its underlying cause, dizziness can be intense or constant, and may be accompanied by other symptoms, like nausea, vomiting, vertigo, loss of balance, hearing loss, ringing in the ears, confusion or fainting.

It is important to consult your doctor if you experience dizziness frequently to determine what is causing it. This will help to guide the most appropriate treatment. However, very intense or prolonged dizziness that lasts for over an hour or presents with more symptoms should be urgently assessed in the emergency room.

What causes dizziness?

The main causes of dizziness are:

1. Labyrinthitis

Labyrinthitis is characterized by inflammation of the labyrinth in the ear, which is a part of the inner ear responsible for hearing and balance. Swelling in this area can cause dizziness and other symptoms such as vertigo, a loss of balance, hearing loss, nausea or general malaise.

Labyrinthitis is more commonly noted in older adults, but it can happen at any age. It can be caused by viral or bacterial respiratory infections, diabetes, high blood pressure or even emotional factors like stress, anxiety or depression.

What to do: You should consult an ENT specialist to confirm the diagnosis and initiate treatment, which can be done with prescription anti-vertigo, anti-emetic or antibiotic medications. You should also avoid stress, reduce your sugar and caffaine intake and avoid smoking, as these can worsen dizziness.

2. Benign paroxysmal positional vertigo

Benign paroxysmal positional vertigo (BPPV) is a disorder caused by the displacement of calcium carbonate crystals within the canals of the inner ear. This can lead to dizziness when moving the head or turning over in bed, getting up or lying down.

BPPV can be caused by head trauma, labyrinthitis, Ménière's disease, migraines or previous inner ear surgery.

What to do: Treatment for benign paroxysmal positional vertigo (BPPV) is guided by an otorhinolaryngologist and involves performing specific maneuvers to reposition the calcium carbonate crystals inside the inner ear.

In some cases, the doctor may prescribe medications to relieve associated symptoms, such as meclizine, ondansetron or metoclopramide.

3. Meniere's disease

Ménière's syndrome is a rare disease caused by the accumulation of fluid within the canals of the inner ear. It can cause symptoms such as dizziness, frequent vertigo, hearing loss or ringing in the ear.

This fluid accumulation can occur due to anatomical abnormalities in the ear, allergies, viral infections, blows to the head, frequent migraines and an exaggerated immune system response.

What to do: Treatment for Ménière's disease is guided by an otorhinolaryngologist who may prescribe medications, physiotherapy or even surgery in more severe cases.

4. Vestibular neuritis

Vestibular neuritis is a viral infection that affects the vestibular nerve. This nerve is responsible for transmitting information relating to movement and balance from the inner ear to the brain.

When this nerve becomes inflamed, it can result in intense and constant dizziness, loss of balance, vertigo, nausea and vomiting.

What to do: Treatment for vestibular neuritis is guided by an otorhinolaryngologist, family doctor or neurologist, who may prescribe the use of anti-vertigo medications to relieve dizziness and vertigo, anti-emetics for nausea and vomiting, or physiotherapy.

5. Migraine

A migraine is a type of intense, pulsating headache that can cause episodes of dizziness. It is usually accompanied by other symptoms such as sensitivity to light, tearing, the appearance of spots in your field of vision or nausea.

Migraines can be triggered by hormonal changes, stress, strong smells, flickering lights or even food allergies.

What to do: it is important to rest and to opt for quiet, low-light environments when experiencing migraines. Check out other natural remedies for migraines that you can use to help relieve dizziness and other symptoms.

If you experience migraines frequently, you should consult a neurologist to identify the underlying cause and to initiate treatment with medication.

6. Anxiety

Mental disorders, like depression and anxiety, can cause dizziness. This symptom usually occurs alongside anxiety attacks, and causes symptoms like shortness of breath, shaking, and tingling in the feet, hands and mouth. Learn more about the symptoms of an anxiety attack and how they can present.

This type of dizziness can come on suddenly, and emerge in times of major stress.

What to do: Anxiety can be treated through modalities like psychotherapy, and if necessary, with prescription anxiety medication, like antidepressants or anxiolytics.

Check-out some herbs for anxiety that you can take to help relieve mild symptoms at home.

7. Pregnancy

Dizziness during pregnancy is a very common symptom at the beginning of pregnancy. It is often related to normal hormonal changes and increased blood flow in the woman's body. Dizziness during pregnancy can also occur due to dehydration, hypoglycemia or anemia.

What to do: Prenatal care should be initiated once pregnancy is confirmed. The family doctor or OB will monitor the woman and baby regularly throughout pregnancy with blood work and ultrasounds, especially if dizziness is present. If blood tests confirm anemia, the doctor may prescribe iron and folic acid supplements.

Women are also encouraged to drink plenty of water to keep the body hydrated and to adhere to diabetes treatment as necessary to prevent episodes of hypoglycemia.

8. Sudden drop in blood pressure

A sudden drop in blood pressure can lead to dizziness, weakness, confusion or even fainting.

This type of dizziness is most common to occur when changing positions, like getting up from a chair to stand, however it can also be noted with pregnancy, heart disease (like arrhythmias or heart failure), or the use of medication.

What to do: Treatment for orthostatic hypotension varies depending the underlying cause. The doctor may prescribe medications to treat specific heart problems, or change doses of current medications that are contributing to drops in blood pressure. To prevent dizziness, be sure to get up slowly from a sitting or lying position.

9. Neurological diseases

Some neurological diseases, such as Parkinson's disease, strokes, brain tumors or Alzheimer's can cause dizziness and loss of balance.

A blow to the head can also cause temporary or permanent damage to the region of the brain that regulates balance, leading to chronic dizziness or vertigo.

What to do: Treatment for neurological diseases should be guided by a neurologist who can recommend specific medications for the underlyinh disease. If you suspect a stroke, you should proceed to the nearest emergency room immediately, as it is a medical emergency that requires immediate treatment. Read more about stroke symptoms that warrant urgent medical attentions.

10. Low blood sugar

Low blood sugar, also referred to as hypoglycemia, is a significant reduction in blood glucose levels. It causes symptoms such as dizziness, tremors, weakness, cold sweat, pale skin, blurry vision, heart palpitations, chest pain, anxiety, confusion, difficulty speaking or drowsiness.

Hypoglycemia generally occurs in diabetics with inadequate medical care with insulin or other diabetes medication, but it can also arise from prolonged periods without eating, consuming alcohol or exercising intensely.

What to do: eating in small quantities every 2 to 3 hours can help to prevent hypoglycemia. However, if symptoms appear, you should ingest about 15 g of simple carbohydrates that are easily absorbed, like a glass of natural orange juice, a soda, hard candy or chocolate.

Diabetics should also follow-up regularly with an endocrinologist blood sugar tests and evaluate the dosing of diabetes medication.

11. Medication side effects

Medications can cause dizziness as a side effect, and can commonly occur with such as diazepam, clonazepam, phenobarbital, phenytoin or metoclopramide.

Furthermore, some medications can cause a drop in blood pressure,like diuretics, nitrate, methyldopa, clonidine, levodopa and amitriptyline. This can lead to dizziness, especially in the elderly.

What to do: You should consult the prescriber of the medication, so that this side effect can be assessed. If necessary, the doctor can change the dose or change the medication.

12. Iron deficiency anemia

Iron deficiency anemia can cause dizziness and occurs due to a decrease in the production of red blood cells. These cells are responsible for bringing oxygen to the body's tissues, and a low red blood cell count can lead to low oxygen levels.

Low oxygen can result in dizziness, drowsiness, excessive fatigue, paleness or shortness of breath.

What to do: Treatment for iron deficiency normally includes the use of iron supplements, in addition to the consumption of iron rich foods in iron such as lentils, parsley, beans and red meat.

When to see a doctor

It is important to consult your family doctor if you experience dizziness frequently or it appears with other symptoms, such as:

Blurry vision
Headache
Palpitations
Cold sweat
Pallor
Excessive fatigue
Tremors
Shortness of breath
Chest pain
Nausea and vomiting
Intense cramps
Swelling in the body
Drowsiness

If dizziness appears suddenly and is associated with any of the symptoms above, and does not improve within 20 minutes, you should proceed to the nearest hospital immediately for assessment and treatment.