Managing Persistent Dizziness and Insomnia: A Comprehensive Guide

Insomnia, dizziness

Hello, doctor: Six months ago, I had hemorrhoid surgery, and after the hemorrhoids healed, I have been troubled by dizziness for the past four months (feeling dizzy all day, especially worse in the morning).
Recently, I have also been experiencing severe insomnia for the past month.
Four months ago, I visited a family physician regarding the dizziness and was found to have anemia.
After taking iron supplements for a month and a half, my levels returned to normal (I stopped taking them afterward; should I continue taking iron for another six months?).
However, the dizziness has not improved.
I mistakenly trusted friends and family and went to an unlicensed acupuncturist, which made the dizziness worse after the treatment (I was scared because he inserted a long needle into my head).
I also took some unknown traditional Chinese medicine, but after realizing it was ineffective, I stopped.
I have sought help for "shocking" experiences as well.
Later, I consulted a neurologist, an ENT specialist, and a gastroenterologist, all of whom found no issues.
My blood tests and liver function were normal, but the dizziness persists.
A month ago, I started experiencing insomnia, and now the dizziness has worsened, along with loss of appetite and overall weakness.
Six days ago, I visited a psychosomatic specialist who prescribed some anti-anxiety medications and sleeping pills (half a pill daily), as well as medications to promote cerebral blood flow [flux (Prozac), sanyl (Euclidan), Xanax, Zoldox].
After taking them for one or two days, I felt nauseous, weak, and dizzy in the morning, so I stopped.
However, without the sleeping pills, I cannot sleep, and if I don’t sleep, I spend most of the day lying down, so I started taking the sleeping pills again.
Five days ago, I also consulted a gynecologist who prescribed aspirin EMC (BOKEY EMC) and vitamin B complex capsules, but after two days, I felt no effect.
Yesterday, I took the sleeping pills and only slept for five hours before waking up; I wonder if the sleeping pills are ineffective for me? I have also arranged for a blood FSH test, but the results are not yet available.
I am currently feeling dizzy and weak all day, with a loss of appetite, as if I am about to faint.
My children are worried seeing me with a long face all day.
I don’t know what to do now.
Should I see a specific specialist, or should I first undergo a comprehensive health check-up? P.S.
My husband and children keep telling me to exercise more.
I used to have the energy to do morning exercises, but now I feel too weak to do anything.
My children are increasingly concerned about my worsening condition.
P.S.
I retired six months ago...

Melodi, 40~49 year old female. Ask Date: 2004/08/02

Dr. Hong Chuanqi reply Family Medicine

Hello Melody, dizziness and insomnia are common issues among the elderly, but you are not that old yet, so try not to think of yourself as old.
Dizziness and insomnia often go hand in hand; they are like good friends that usually visit together.
Therefore, addressing one can effectively help with the other.
Dizziness and insomnia are typically related to changes in brain tissue, blood circulation, psychological factors, and menopausal symptoms.
Would you be willing to visit our family medicine department? Let's try it for two months and see how it goes.
Best wishes! Hong Chuanqi, 93.08.03

Reply Date: 2004/08/02

More Info

Managing persistent dizziness and insomnia can be a complex challenge, especially when multiple factors may be contributing to these symptoms. Based on your description, it seems you have been through a variety of medical evaluations and treatments, yet you continue to experience significant discomfort. Let's break down your situation and explore potential avenues for management.

Understanding Your Symptoms
1. Dizziness: Dizziness can arise from various causes, including inner ear issues, neurological conditions, medication side effects, or even psychological factors such as anxiety. Given that you experienced anemia, it’s crucial to ensure that your iron levels are stable, as low iron can contribute to feelings of dizziness. Since you mentioned that your anemia has resolved, it may be worth discussing with your healthcare provider whether you should continue iron supplementation for a longer period.

2. Insomnia: Insomnia can be multifactorial, often linked to stress, anxiety, or underlying medical conditions. The fact that you have been prescribed medications for anxiety and sleep suggests that your healthcare provider is considering psychological factors as part of your insomnia. However, the side effects you experienced from these medications, such as nausea and increased dizziness, are concerning and warrant further discussion with your doctor.

Recommendations for Management
1. Consult a Specialist: Given the complexity of your symptoms, it may be beneficial to consult a neurologist or a sleep specialist. A neurologist can help rule out any underlying neurological conditions that may be contributing to your dizziness. A sleep specialist can provide insights into your insomnia and may suggest a sleep study to evaluate your sleep patterns more closely.

2. Comprehensive Health Check: Since you mentioned considering a full-body health check, this could be a prudent step. Comprehensive blood tests, including thyroid function tests, vitamin levels (such as B12 and D), and a complete metabolic panel, can help identify any deficiencies or imbalances that may be contributing to your symptoms.

3. Medication Review: It’s essential to have a thorough review of all medications you are currently taking, including over-the-counter supplements. Sometimes, interactions between medications or side effects can exacerbate symptoms. A pharmacist or your primary care physician can assist in reviewing your medications.

4. Lifestyle Modifications: While you may feel too fatigued to engage in physical activity, gentle exercises such as walking or stretching can be beneficial. Physical activity can improve circulation and may help alleviate feelings of dizziness over time. Additionally, establishing a calming bedtime routine can help improve your sleep quality. Techniques such as mindfulness, meditation, or gentle yoga may also help reduce anxiety and promote better sleep.

5. Diet and Nutrition: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall health. Staying hydrated is also crucial. If you are experiencing a loss of appetite, consider smaller, more frequent meals that are easy to digest.

6. Mental Health Support: Given the psychological aspects of your symptoms, engaging with a mental health professional could be beneficial. Cognitive-behavioral therapy (CBT) is particularly effective for insomnia and anxiety. It can provide you with tools to manage stress and improve your sleep patterns.

Conclusion
Your situation is understandably distressing, and it’s important to approach it holistically. By consulting with specialists, reviewing your medications, making lifestyle adjustments, and seeking mental health support, you can work towards alleviating your symptoms. Remember, it’s crucial to communicate openly with your healthcare providers about what you are experiencing, including any side effects from medications, so they can tailor a treatment plan that best suits your needs. Your health and well-being are paramount, and taking proactive steps can lead you towards a more comfortable and restful state.

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