Dizziness: Possible Causes Beyond Viral Infections

Dizziness, feeling of heaviness in the head, and lightness in the legs?

Hello, doctor.
I've been feeling a bit dizzy these past few days.
It's not severe, and I feel dizzy whether I'm standing or sitting, but I don't feel anything when lying down.
I visited a clinic, and the doctor said it's due to a viral infection and prescribed me cold medicine.
However, aside from the dizziness and a slightly elevated temperature on the first day, I have no other cold symptoms, and my rapid tests have all been negative.
The dizziness tends to worsen in the evening compared to during the day, but I don't feel nauseous.
I would like to know if there could be other reasons for my dizziness.

Niming, 10~19 year old female. Ask Date: 2022/10/04

Dr. Hong Yuanbin reply Internal Medicine

Hello, there are indeed many factors that can cause dizziness.
Based on your situation, the following possible factors may apply: 1.
Staying up late or irregular sleep patterns 2.
Excessive stress 3.
Anemia 4.
Side effects of cold medications 5.
Inner ear imbalance.
It is recommended to get plenty of rest, maintain a regular schedule, and drink plenty of water.
If dizziness persists, you may need to consult a neurologist or an otolaryngologist at a larger hospital.
Thank you for your inquiry.

Reply Date: 2022/10/04

More Info

Dizziness can be a perplexing symptom, and while viral infections are a common cause, there are numerous other potential reasons for experiencing dizziness. It’s essential to consider a broad range of possibilities, especially since you mentioned that your symptoms do not align with typical cold symptoms and that your rapid tests for viral infections have returned negative.

Firstly, it’s important to understand the different types of dizziness. Dizziness can be categorized into vertigo (a sensation of spinning), presyncope (feeling faint or lightheaded), and disequilibrium (a loss of balance). Each type can have different underlying causes.

1. Vestibular Disorders: Conditions affecting the inner ear, such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or Meniere's disease, can lead to dizziness. These conditions often present with episodes of vertigo, which may be triggered by changes in head position or may be accompanied by hearing changes.

2. Neurological Issues: Dizziness can also be a sign of neurological conditions. Migraines can cause dizziness, even in the absence of a headache. Other neurological disorders, such as multiple sclerosis or transient ischemic attacks (TIAs), can also present with dizziness.

3. Cardiovascular Factors: Dizziness can result from issues related to blood flow. Orthostatic hypotension, which is a sudden drop in blood pressure when standing up, can cause lightheadedness or dizziness. Other cardiovascular conditions, such as arrhythmias or heart failure, can also lead to dizziness due to inadequate blood flow to the brain.

4. Anemia: Low levels of hemoglobin can lead to insufficient oxygen delivery to the brain, resulting in dizziness. If you have symptoms like fatigue or pallor, it may be worth checking your blood counts.

5. Dehydration and Electrolyte Imbalance: Insufficient fluid intake or loss of fluids (due to sweating, vomiting, or diarrhea) can lead to dehydration, which can cause dizziness. Similarly, imbalances in electrolytes such as sodium and potassium can affect your body’s ability to maintain proper fluid balance and nerve function.

6. Medication Side Effects: Some medications can cause dizziness as a side effect. If you have started any new medications recently, it’s worth discussing this with your healthcare provider.

7. Psychological Factors: Anxiety and stress can manifest physically, leading to symptoms like dizziness. If you are experiencing increased stress or anxiety, this could be contributing to your symptoms.

Given that your dizziness worsens at night and you do not experience nausea, it may be beneficial to keep a symptom diary. Note when the dizziness occurs, its severity, any associated symptoms, and potential triggers. This information can be invaluable for your healthcare provider in determining the underlying cause.

In conclusion, while viral infections are a common cause of dizziness, many other factors could be at play. It’s crucial to follow up with your healthcare provider for a thorough evaluation, which may include blood tests, imaging studies, or referrals to specialists such as an ear, nose, and throat (ENT) doctor or a neurologist. Understanding the full context of your symptoms will help in diagnosing the cause of your dizziness and determining the appropriate treatment.

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