Dizziness is symptom that can be very specific or very hard to describe. For medical professionals, dizziness is a general term that refers to everything from a spinning sensation to a foggy head to losing your balance when you walk.
We can define dizziness more specifically in these following ways:
- VertigoThis is the sensation of motion that should not be there (usually because you are stationary).It’s usually described as a feeling that you’re spinning or that the room is spinning, or that you’re being pulled in a specific direction.
- Central instability at restThis is the sensation of rocking or swaying even though you’re still.
- LightheadednessThis is a vague sensation commonly described as having a floating head or feeling ungrounded.It’s usually persistent, and can often come with anxiety, being overheated or feeling as if you’re about to faint.
- ImbalanceThis is the feeling of losing your stability when you change position quickly or while you are walking.It’s the body’s inability to maintain a stable and oriented position.This can be a result of issues with the inner ear, vision, muscles, joints or the nervous system – all of which contribute to balance.
Differentiating between these terms is crucial for diagnosis and treatment, as each can point to different underlying causes and may require different treatment approaches. For example, vertigo might be treated with manoeuvres to reposition crystals in the inner ear, while imbalance might be addressed with physical therapy to improve strength and stability.
Lightheadedness may be alleviated by addressing the root cause, such as dehydration or anxiety. Understanding the specific nature of dizziness a person experiences helps healthcare providers to identify the appropriate intervention and manage the condition effectively.
In this column, we will delve into the multifaceted nature of postural dizziness, exploring its causes and the signs that indicate when it is essential to seek professional medical assistance.
Insufficient blood flow
The experience of dizziness when standing up, scientifically referred to as orthostatic hypotension, occurs due to a rapid drop in blood pressure, which reduces cerebral perfusion (i.e. the flow of blood through the brain). Although this can happen to anyone, repeated instances or severe spells of dizziness warrant a closer examination of one’s health.
When you stand up quickly, gravity pulls blood toward your lower body. Your circulatory system usually compensates by narrowing blood vessels and increasing your heart rate. However, if these responses are sluggish or inadequate, blood pressure drops sharply, leading to dizziness.
This process can be disturbed by factors such as dehydration, which diminishes blood volume, making it harder for the body to maintain blood pressure. Drinking ample fluids, therefore, is a preventative strategy. You can also take measures such as rising slowly, which allows the body’s regulatory mechanisms time to kick in, in order to minimise the risk of dizziness.
This is especially important in the morning when the body’s processes are kickstarting after hours of rest. Positional changes should be incremental: first, sitting up, pausing, then standing, while ensuring steady breathing throughout.
External causes
The environment plays a role too. High temperatures can lead to vasodilation (i.e. expansion of the blood vessels), further dropping blood pressure, hence the importance of staying cool and hydrated. Similarly, alcohol consumption can lead to dehydration and vasodilation, increasing the likelihood of orthostatic hypotension.
Responsible drinking habits and ensuring one’s stomach isn’t empty when consuming alcohol can mitigate these effects. While regular physical activity is beneficial for overall cardiovascular (heart) health, intense or prolonged exercise can lead to a temporary pooling of blood in the extremities, leading to dizziness upon stopping.
Implementing a proper cooldown period, hydrating throughout the workout, and gradually transitioning to resting postures can help alleviate these symptoms. Certain medications, such as anti-hypertensives, diuretics and some psychiatric drugs, have side effects that can cause or exacerbate orthostatic hypotension.
It’s crucial for individuals on such medications to be aware of these potential side effects and to consult with healthcare providers if they experience recurrent dizziness. Beyond these common causes, there are more complex medical conditions such as postural tachycardia syndrome (POTS), cardiovascular issues and neurological disorders that have orthostatic hypotension as a symptom.
These conditions necessitate thorough medical evaluation and tailored treatment plans. Tracking the frequency, duration and severity of dizzy spells can be instrumental in aiding healthcare professionals to diagnose and address these conditions effectively.
Symptoms such as fainting, frequent falls or palpitations, together with dizziness are significant red flags. These symptoms could be indicative of serious underlying conditions like arrhythmias, neurological disorders or severe dehydration.
In such cases, it’s imperative to seek immediate medical attention. Tests such as blood pressure monitoring and tilt table tests may be conducted to assess the cause and extent of orthostatic hypotension.
Know when to seek help
Preventing dizziness involves both lifestyle adjustments and proactive measures. Adequate hydration is paramount, as is a balanced diet rich in nutrients that support vascular health. Regular, moderate-intensity exercise can strengthen the cardiovascular system, improving its response to postural changes.
Additionally, managing stress, which can affect the autonomic nervous system, is also important for preventing dizziness. For individuals who experience persistent dizziness, it is essential not to dismiss it as merely an inconvenience.
Continuous or severe spells could compromise one’s quality of life, leading to anxiety about standing up, restricting movement and increasing the risk of falls. Seeking medical advice in such scenarios is not just about treatment, but also about regaining confidence in one’s mobility and ensuring safety.
In conclusion, while dizziness upon standing is often benign, understanding its potential causes and knowing when to seek medical advice is critical. By implementing strategic lifestyle changes, individuals can often manage or prevent the uncomfortable and potentially risky spins associated with standing up.
However, when dizziness is persistent, severe or accompanied by other concerning symptoms, it is a clear signal to seek medical evaluation. Through such vigilance and appropriate care, one can maintain not just balance in posture, but also in health.
By Datuk Dr Nor Ashikin Mokhtar
Published in Star Newspaper, 27 Nov 2023
