Dizziness or light-headedness is a common problem amongst adults. It is seldom a major medical or life-threatening problem, and mainly a nuisance value. But there are a few significant conditions that may cause light-headedness, and which deserve attention.
The first important issue is to distinguish between light-headedness or dizziness alone, or that accompanied by a sensation of the room turning, which is more indicative of vertigo, and points to an ear problem. Light-headedness without vertigo is usually due to a temporary inadequate blood flow to the brain and is transient. Lying down and/or drinking a glass of water/cooldrink should quickly help this
Medication side effects: the biggest culprit here is blood pressure medication, which may include diuretics (water pills). Your doctor may have to adjust the dosage or even change you to a different medication. Some medications used to treat an enlarged prostate are known to cause a significant drop in blood pressure.
Postural hypotension: this is a sudden temporary drop in blood pressure that may happen when standing up suddenly. Blood vessels relax or constrict to regulate blood pressure and keep it steady when changing posture. This is controlled by the autonomic nervous system, which – like so much else – can deteriorate as we age. This is seldom serious, and most people adapt by e.g. getting up slowly, or making sure that there is something to hold on to for the few seconds it takes for the blood vessels to respond to the new position and adjust blood pressure. Most often this is due to medication used to lower BP, so your doctor may have to adjust dosage or change medications. Short term, caffeine, salt and fluid intake will help, but in more serious or long-term cases there may be a hormonal problem requiring investigation and treatment.
Dehydration: this can happen easily if you have a fever, or are not drinking enough for any reason. During extreme sports and protracted diarrhoea for example, you lose not only essential water but also electrolytes like sodium and potassium. Drinking just water will not fix this, so proper replacement fluid is needed. There are many types available at pharmacies. If oral intake of these does not help, then you may need to go to your nearest casualty for intravenous fluids.
Low blood sugar: This is far less common than thought, and happens mainly to diabetics or to those on a severely restricted diet. Spells of low blood sugar are usually accompanied by nausea and a drenching – but ice cold – sweat. This is easily corrected with sugar in some easily absorbed form, like a sweet, or a sugary drink. Blood sugar problems, especially if they occur often, warrant investigation, so you should see your doctor for this.
Heart problems/stroke: These are two serious conditions that may present with episodes of dizziness, and which warrant URGENT medical attention. If chest pain, nausea, sweating, jaw pain or arm pain accompany the dizziness, then it may be due to a heart attack. Weakness or paralysis of the face, headache, slurred speech, numbness, difficulty walking or visual disturbances may indicate a stroke. Treatment given within an hour of onset of the stroke symptoms gives the person the best chance of recovery with minimal permanent defects.
It is important to remember that in the elderly and in diabetics, symptoms may be minimal so if in any doubt, get the person to an emergency room as soon as possible.