Although dizziness isn't unusual, finding the cause for it can be difficult.

By Nancy Wartik
Updated October 20, 2020
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At some point, everyone is bound to feel a bit of dizziness. It's a common symptom but can be confusing. According to a study done by Mayo Clinic, about 2.6 million Americans visit an emergency room or their doctor's office because of dizziness. Women usually have dizzy symptoms more often than men, and the condition often worsens as men and women get older. Sometimes, dizziness can be caused simply by standing up too quickly, starting a new medication or another minor reason. But other times, it's the result of something more serious. Here's what the experts say can cause chronic dizziness and, most importantly, what you can do about it.

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What Should I Do if I Feel Dizzy?

Occasional dizziness strikes isn't usually a big deal. "Everyone can get it, particularly if your blood pressure is on the low side," says Dr. Robert Baloh, director of the Neuro-Otology Program at the Ronald Reagan UCLA Medical Center. "When you jump up after sitting for a long time, your heart has to pump a lot of blood uphill. There can be a momentary decrease in blood flow to your brain as a result."

If you're dizzy and are sick with a cold or the flu, your illness is the most likely explanation. If not, consider, for starters, what you've eaten, or haven't that day. "People have two doughnuts for breakfast, drink a cup of coffee and can't understand why they're light-headed afterward," says Richard Gans, Ph.D., executive director of the American Institute of Balance, in Largo, Florida. "It's because their blood sugar levels are crashing after the sudden spike." Think about your fluid intake as well: If you're dehydrated, your blood pressure can fall, which may leave you dazed.

Taking a new medication is a common culprit, too. Dizziness is the first- or second-listed side effect for many drugs. "We ask patients when the dizziness started and often it turns out to be after they changed prescriptions or began taking an over-the-counter drug, or even a supplement," says Gans. "They just didn't put the two together." Even a change in eyeglass prescription can throw you off balance.

Call Your Doctor

Suppose unexplained dizziness lasts longer than a few minutes or recurs regularly over a few hours or days. In that case, you should get in touch with your doctor, says Dr. David Zee, a neurology professor who runs the Vestibular/Eye Movement Testing Laboratory at Johns Hopkins University School of Medicine. Although unlikely, there's a small chance you're having heart trouble, a stroke or a transient ischemic attack (a kind of mini-stroke).

Dizziness can also be an early symptom of an underlying illness. Thyroid disorders, multiple sclerosis, diabetes, hypertension, anemia, panic attacks, and even depression all can trigger dizziness. Migraines may cause it, too, even if you don't actually have a headache.

Dizziness sometimes signals problems with the body's vestibular, or inner-ear, system, which controls balance and can affect your vision as well. Vestibular problems may occur after a brain injury, be caused by a virus or simply come on as you get older.

The first place to start is with your family doctor, who can usually diagnose the less-serious causes of dizziness. "Primary-care doctors see a lot of dizziness and can treat most of it pretty well," Zee says. To help your doctor, be specific when you're describing your symptoms. "People use the term 'dizzy' to mean all kinds of things," says Zee. "For some, it's feeling like they might faint. For others, it's feeling off-balance or feeling a spinning sensation. Some people even say they feel dizzy when they're anxious, afraid or upset."

Consider a Specialist

In some cases, your general practitioner may not be able to figure out what's wrong. Don't give up. "Chronic dizziness can be at least as bad as chronic pain in terms of what it does to people physically and psychologically," says Dr. Philip Sloane, a family, and geriatric medicine practitioner at the University of North Carolina at Chapel Hill who has done clinical work and research on dizziness. "It can be extremely fatiguing and frustrating, like trying to work in your office when there's a guy with a jackhammer upstairs."

Be persistent about getting help, says Helen Cohen, Ed.D., associate director of the Center for Balance Disorders at the Baylor College of Medicine. "If the treatment plan your doctor gave you hasn't worked after a couple of weeks, call back and ask, 'How long should I wait?'" she says. "If you feel like your doctor isn't helping, ask for a referral." You can also contact the nearest teaching hospital to determine if there's a dizziness or balance disorders center there.

Educate Yourself

Be aware that some specialists might not be up-to-date on diagnostic tests for dizziness. And most doctors don't have the sophisticated equipment, infrared goggles, revolving chairs, electrode tests and more that options that dizziness specialists like Cohen use to help identify specific disorders. "I've had people tell me they've been to five, six, seven physicians before they were referred to me," she says.

Doctors sometimes aren't aware of treatment options for the chronically dizzy, either. For example, there's a technique that effectively cures one of the most common causes of dizziness, benign paroxysmal positional vertigo (BPPV), in up to 95% of patients. The procedure, known as canalith repositioning, is a simple hands-on maneuver that's been around for nearly 30 years.

There isn't always such an easy answer to chronic dizziness, unfortunately. There is a rare disorder called mal de debarquement syndrome, a French term basically meaning you're stuck feeling as if you just stepped off a boat. It usually subsides on its own, though in some patients, it can persist.

Dealing with chronic dizziness doesn't necessarily mean eliminating it entirely, but there's almost always something that will improve it. And when dizziness is due to a damaged vestibular system, there's a type of therapy called vestibular rehabilitation that can help the brain relearn how to keep the body in balance. Using the same principles that allow ice-skaters to execute beautiful spins without becoming dizzy eventually, vestibular rehab exercises can make symptoms largely disappear.

Don't Give Up

While there are often limitations to how well dizziness is diagnosed and treated, it can really pay to pursue your options. Talk to your doctor if you're feeling chronic dizziness, and follow up if symptoms continue. You can also contact the Vestibular Disorders Association at (800-837-8428 or vestibular.org); the American Academy of Otolaryngology-Head and Neck Surgery (703-836-4444, entnet.org) for referrals to otologists and neurotologists who can treat balance disorders; and Dizzytimes.com for an online dizziness support group

Comments (2)

Anonymous
November 29, 2018
If unexplained dizziness lasts longer than a few minutes or recurs regularly over the course of a few hours or days, you should get in touch with your doctor.
Anonymous
November 29, 2018
I am an active 68 year old female that woke up dizzy yesterday. I checked blood pressue. Did the first BVVP listed on my Google search. Epley Maneuver that has helped me before years ago. It helped some but then I looked down and I was dizzy again. I rested mostly in bed. Later in the day I was less dizzy but it was still there. I tried the second listed BVVP. The Semont-Toupet maneuver. This maneuver worked! I was very cautious. Afraid the symptoms will come back. Still this morning feel stress that my head hurts a little and that the dizziness will return. Any info would be appreciated! Thank you, Marie B Pridgen