Dry Eyes, Dry Mouth, and Dizziness: Your Symptoms

Dry eyes, dry mouth, and dizziness?

Hello, Doctor! Initially, I experienced discomfort in my eyes, which was then accompanied by dizziness, specifically a sensation of feeling heavy-headed and light-footed.
Yesterday, I even felt dizzy to the point of having a seizure-like sensation.
Now, I often feel dry mouth and notice an increase in the coating on my tongue, especially in the morning when I wake up, my throat feels very dry and uncomfortable.
I went to the hospital for a fundus examination and visual field test, and the results indicated dry eye syndrome, but nothing else was problematic.
Later, I suspected Sjögren's syndrome and visited a rheumatologist for blood tests, which only showed elevated allergy levels.
Due to time constraints, I have not yet undergone salivary gland biopsy and related tests.
I also went to a neurologist for a wakefulness EEG, and the results were normal as well.
I would like to ask if I need to see an otolaryngologist to check my inner ear balance? Dizziness is currently my most challenging issue and has even caused problems at work.

Awei, 20~29 year old female. Ask Date: 2018/10/25

Dr. Gao Jiankai reply Internal Medicine

Hello Ah Wei, thank you for your question.
I apologize for the delayed response due to some internet issues.
I think it would be a good idea to consult an otolaryngologist.
Dryness syndrome is indeed less commonly associated with dizziness, but certain conditions in neurology or otolaryngology can present with symptoms like dry mouth and dry tongue.
Therefore, it is important to seek the opinions of a neurologist or an otolaryngologist.
The Allergy, Immunology, and Rheumatology Department at Changhua Hospital, Ministry of Health and Welfare, is concerned about you.

Reply Date: 2018/10/25

More Info

It sounds like you are experiencing a complex set of symptoms that are causing you significant distress. Your symptoms of dry eyes, dry mouth, dizziness, and the sensation of heaviness in your head could be indicative of several underlying conditions, and it’s important to approach this systematically.

Firstly, the combination of dry eyes and dry mouth raises the possibility of Sjögren's syndrome, an autoimmune disorder that primarily affects moisture-producing glands. This condition can lead to symptoms such as dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca). The fact that you have already undergone some tests, including blood tests for allergies and a visual field test for your eyes, is a good start. However, further evaluation, such as a salivary gland biopsy, may be necessary to confirm or rule out Sjögren's syndrome.

Your dizziness, particularly the "head heavy, feet light" sensation, can be attributed to several factors. It could be related to vestibular issues, which involve the inner ear and balance. Since you mentioned considering a visit to an ENT (ear, nose, and throat) specialist, this could be a wise decision. They can assess your inner ear function and determine if there are any balance-related issues contributing to your dizziness. Conditions such as vestibular neuritis or Meniere's disease could potentially explain your symptoms.

Additionally, it’s worth noting that anxiety and stress can exacerbate physical symptoms, including dizziness and feelings of disorientation. If you find that your symptoms are worsening with stress or anxiety, it might be beneficial to explore mental health support, such as counseling or therapy, to help manage these feelings.

You mentioned that you have had a normal EEG (electroencephalogram), which is reassuring as it rules out seizure activity. However, if your dizziness persists or worsens, further neurological evaluation may be warranted. Conditions such as migraines can also present with dizziness and may not always be accompanied by a headache.

In summary, I recommend the following steps:
1. Visit an ENT Specialist: This will help rule out any inner ear issues that could be causing your dizziness.

2. Follow Up on Autoimmune Testing: If you suspect Sjögren's syndrome, ensure that you follow through with the necessary tests, including a salivary gland biopsy.

3. Consider Mental Health Support: If anxiety is a factor, seeking help from a mental health professional could provide you with coping strategies and support.

4. Monitor Symptoms: Keep a detailed log of your symptoms, including when they occur, their severity, and any potential triggers. This information can be invaluable for your healthcare providers.

It’s understandable to feel overwhelmed by these symptoms, especially when they interfere with your daily life and work. Remember that you are not alone in this, and there are healthcare professionals who can help you navigate these challenges. Don’t hesitate to reach out for support, both medically and emotionally.

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