What Causes Dizziness?

Dizziness is a symptom that can be used to define many different sensations, including lightheadedness, fatigue, weakness, nausea, spinning, and whirling.

There are four specific types of dizziness: vertigo, disequilibrium (feeling unbalanced or as if you’re about to fall), presyncope (the feeling that you are about to faint), and lightheadedness. 

Several things can cause dizziness, and, in many cases, the sensation is temporary.

But, in other cases, dizziness can be a sign of an underlying and sometimes serious condition.

In this article, we’ll cover some of the most common causes of dizziness and how your provider will work with you to diagnose the underlying cause.

We’ll also cover which treatment options are available and which additional symptoms warrant immediate medical attention. 

Causes

There are many different factors and conditions that can cause dizziness.

Dizziness is a term that can describe a range of feelings and symptoms.

Therefore, if you reach out to a healthcare provider to help diagnose the cause and treat you, it’s important to get specific about what type of dizziness you’re feeling and whether or not there are any additional symptoms.

Vertigo

Vertigo is usually a symptom of vestibular dysfunction (disturbance of the body’s balance system) as well as a form of dizziness.

It is three times more common among people with vaginas than people with penises and can be associated with other conditions, including depression, migraine, and heart disease.

People who experience vertigo often describe having the sensation of motion or rotational motion.

Other symptoms include: 

• Feeling disoriented or unsteady
• Nausea
• Vomiting
• Staggering gait
• Loss of coordination

Though vertigo is often caused by a dysfunction of the vestibular system, there are other possible causes, including benign paroxysmal positional vertigo (BPPV), Ménière disease, inflammation, stroke, atherosclerosis (hardening of the arteries), psychological disorders, anxiety, and certain anticonvulsant medications.

Ear infection

Infections of the inner ear can also cause dizziness (specifically vertigo).

Two conditions called acute labyrinthitis and vestibular neuritis can cause vertigo and are often caused by viral infection.

Many viruses can cause these inner ear infections, including:

• Herpes virus
• Influenza
• Measles
• Mumps
• Rubella
• Polio
• Hepatitis
• Epstein-Barr
• Varicella

In cases of vertigo caused by an ear infection, you can experience additional ear-related symptoms, such as:

• Sudden hearing loss
• Ringing in your ears (tinnitus)

Other symptoms that can accompany ear infection-related dizziness include:

• Inability to focus
• Periods of uncontrolled, back-and-forth eye movements (nystagmus)

For most people, symptoms go away on their own after several weeks. But if your symptoms persist, reach out to a healthcare provider for help. 

Low blood pressure

A sudden drop in blood pressure can also cause some forms of dizziness.

Specifically, orthostatic hypotension (a form of low blood pressure that occurs when a person transitions from sitting or lying down to standing) is the most common cause of presyncope.

Presyncope is a form of dizziness marked by a feeling of faintness or impending fainting.

Anyone can experience orthostatic hypotension, but it occurs most frequently in the elderly and in people with a history of heart attack or stroke.  

Dehydration

Dehydration can also cause dizziness, especially the forms – lightheadedness and presyncope (the feeling that you are about to faint).

Anyone can become dehydrated when they don’t drink enough fluids.

Dehydration can also occur when the body loses too much fluid, which can happen as a result of:

• Sweating excessively (especially in hot climates)
• Urinating frequently (a side effect of certain medications and illnesses)
• Diarrhea
• Vomiting
• Fever

Additional symptoms of dehydration can include:

• Dry mouth
• Feeling very thirsty
• Urinating or sweating less than usual
• Dark-colored urine
• Dry skin
• Fatigue

In many cases, dehydration can be treated at home by drinking plenty of fluids. However, in rare cases, the condition can be life-threatening.

If you’re fainting, feeling confused, or have a rapid heartbeat, seek immediate medical attention. 

Heart problems

Certain heart conditions that cause poor blood circulation can also cause dizziness.

These conditions include:

• Cardiomyopathy: Cardiomyopathy is an acquired or developed disease that affects the heart muscle. Unfortunately, the condition often goes undiagnosed, and there may be as many as 1 in 500 adults in the US who have the condition. Not all people with cardiomyopathy experience symptoms, but dizziness (particularly lightheadedness and presyncope) can occur.

• Heart attack: It is also called a myocardial infarction. A heart attack occurs when a part of the heart muscle doesn’t get enough blood. There are several signs of a heart attack, including chest pain, pain or discomfort in the neck, jaw, or back, shortness of breath, and dizziness—specifically lightheadedness and presyncope.

• Heart arrhythmia: Also called an irregular heartbeat, arrhythmia can be caused by a heart attack, smoking, congenital heart defects, and stress. Lightheadedness is one of the major symptoms along with shortness of breath, chest pain, and sweating. 

• Transient ischemic attack (TIA, or stroke): Dizziness or vertigo is the most common symptom of a posterior circulation transient ischemic attack, or stroke when there is a temporary blockage of blood flow to the brain.

Blood loss

A significantly decreased amount of blood in the body, also called hypovolemia, can cause orthostatic hypotension, the most common cause of presyncope dizziness.

Hypovolemia can happen as a result of excessive use of diuretics, vasodilators, and certain drugs as well as dehydration and bed rest.

Certain medications

Dizziness can also occur as a side effect of certain medications, including:

• Anti-seizure drugs
• Antidepressants
• Sedatives
• Tranquilizers
• Blood pressuring lowering medications

Diagnosis

The diagnosis of dizziness will vary depending on the type of symptoms you have.

For example, your provider may perform specific diagnostic tests for complaints of vertigo and different tests if you’re experiencing symptoms of lightheadedness. 

However, in most cases, your provider will begin the process of diagnosis with a discussion of your symptoms, health history, and physical exam.

Physical exam

During a physical examination for dizziness, your provider may check how you walk and maintain your balance.

Additional tests may also be recommended, depending on your symptoms.

Additional diagnostic tests may include:

• Eye movement testing, to check how your eyes track a moving object
• Head movement testing, to check for signs of vertigo
• Posturography, to assess which parts of the balance system you’re relying on and which may be causing you difficulty
• Rotary chair testing

Blood work

Additionally, your provider may recommend blood work. Certain blood tests can check for infection and assess your heart and blood vessel health.

Treatment 

There are many possible causes of dizziness and many different treatment options.

Treatment will vary depending on the type of dizziness you have, and its underlying cause, which is why consulting with a medical provider is essential to determining the right course of treatment for your symptoms.

Home remedies

Dizziness caused by dehydration can be treated at home by drinking adequate fluids and rest.

Some symptoms of vertigo can also be managed at home with rest.

People with Ménière disease may be especially sensitive to a high salt diet, caffeine, and alcohol, so lifestyle adjustments that focus on avoiding these triggers can also help to provide relief from symptoms. 

Walking with a cane for stability and removing trip-hazards in your home will also help for people with disequilibrium and who are at risk of falling.

Medications

Certain medications can also help to treat dizziness and its underlying causes. Medications that your provider may recommend include:

• Water pills (diuretics)
• Antihistamines
• Anticholinergics
• Anti-anxiety medications (like diazepam and alprazolam)
• Migraine medications

When To See a Medical Provider

It’s important to reach out to your healthcare provider if you’re experiencing severe or prolonged dizziness that doesn’t go away on its own.

Additional symptoms that warrant medical attention include:

• Sudden, severe headache
• Chest pain
• Difficulty breathing
• Numbness or paralysis of arms or legs
• Fainting
• Rapid or irregular heartbeat
• Confusion or slurred speech
• Stumbling or difficulty walking
• Ongoing vomiting
• Seizures
• A sudden change in vision or hearing
• Facial numbness or weakness

Speaking with a healthcare provider can help you identify the underlying cause of your dizziness and which treatment options are right for you.

How K Health Can Help

Did you know you can get affordable primary care with the K Health app? Download K Health to check your symptoms, explore conditions and treatments, and, if needed, text with a clinician in minutes.

Depending on your symptoms, your doctor will recommend treatment options or refer you to another specialist. K Health’s AI-powered app is based on 20 years of clinical data.