Chronic Dizziness: When to Seek Medical Help

Chronic dizziness

I have low blood pressure and anemia, which often causes me to feel dizzy.
Although I usually don't have major issues in my daily life, recently I've experienced severe dizziness at times, and there have been a few occasions when I couldn't stand up properly.
Once, my blood pressure was measured at 90/60 and my heart rate was 51.
Sometimes, when I feel better and don't experience dizziness, I suddenly see a flicker in front of my eyes, making it difficult to focus (but my awareness is clear and my vision isn't blurry), accompanied by feelings of nausea.
I would like to know which specialist I should consult for these symptoms.

Andrey, 20~29 year old female. Ask Date: 2017/06/21

Dr. Chen Taicheng reply Family Medicine

Anemia (iron deficiency anemia is common in women due to menstruation) and low blood pressure can both cause dizziness.
If it is iron deficiency anemia, iron supplementation may help, or it is necessary to determine if menstrual flow is excessive (consult a gynecologist); low blood pressure generally does not require medication, and dietary adjustments (such as increasing salt intake) or hydration can help raise blood pressure.

When experiencing sudden darkness in vision, consider what you were doing at that moment.
For example, prolonged standing or sitting, or dehydration can lead to poor blood circulation, resulting in low blood pressure and symptoms similar to fainting (such as temporary vision loss and inability to stand).
Rapid changes in position, such as standing up suddenly from a lying or sitting position, can also cause orthostatic hypotension, leading to similar symptoms.

Other factors such as anemia (often due to menstrual blood loss in women, which can cause low blood pressure), bradycardia, arrhythmias, hypoglycemia, emotional stress, overheating, and overcrowding can also produce similar symptoms.
Less common causes include pulmonary diseases, minor strokes, carotid artery sclerosis, or seizures.

It is advisable to seek further evaluation and treatment for anemia and blood pressure issues from a family medicine or internal medicine specialist.
Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital Family Medicine Department is concerned about you.

Reply Date: 2017/06/21

More Info

Chronic dizziness can be a challenging symptom to navigate, especially when it is accompanied by other health issues such as low blood pressure and anemia. Given your history of low blood pressure (90/60 mmHg) and a heart rate of 51 beats per minute, it is crucial to understand the potential underlying causes of your dizziness and when to seek medical help.

Firstly, dizziness can stem from various sources, including cardiovascular issues, neurological conditions, vestibular disorders, or even metabolic imbalances. In your case, the combination of low blood pressure and anemia could be contributing factors. Low blood pressure can lead to inadequate blood flow to the brain, resulting in dizziness or fainting spells. Anemia, characterized by a deficiency of red blood cells or hemoglobin, can also cause fatigue, weakness, and dizziness due to insufficient oxygen delivery to tissues.

The episodes of severe dizziness where you find it difficult to stand, along with the sensation of your vision shaking and difficulty focusing, warrant further investigation. These symptoms could indicate a more serious condition, such as orthostatic hypotension (a drop in blood pressure upon standing), arrhythmias (irregular heartbeats), or even neurological issues that may require immediate attention.

When considering which medical specialty to consult, it would be advisable to start with a primary care physician or a general practitioner. They can perform an initial evaluation, including a thorough history and physical examination, and may order blood tests to check for anemia and other potential issues. Depending on their findings, they may refer you to a cardiologist for heart-related concerns or a neurologist if they suspect a neurological cause for your symptoms.

In addition to seeking medical help, it is essential to monitor your symptoms closely. Keep a diary of your dizziness episodes, noting the frequency, duration, and any associated symptoms such as nausea or changes in vision. This information can be invaluable for your healthcare provider in determining the underlying cause and appropriate treatment.

In the meantime, consider lifestyle modifications that may help manage your symptoms. Staying hydrated, eating small, frequent meals, and avoiding sudden changes in position can help mitigate dizziness. If you experience episodes of dizziness, sitting or lying down until the sensation passes can prevent falls and injuries.

In summary, chronic dizziness, especially when accompanied by low blood pressure and anemia, should not be ignored. It is essential to seek medical evaluation to determine the underlying cause and receive appropriate treatment. Starting with a primary care physician is a good first step, and they can guide you through the necessary referrals to specialists if needed. Your health and safety are paramount, so do not hesitate to seek help, especially if your symptoms worsen or become more frequent.

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