Dizziness: Causes, Symptoms, and Treatment Options

Dizziness in the morning and evening?

Dear Dr.
Yeh,
I have recently been troubled by dizziness, which has significantly affected my daily life.
The main symptoms are as follows, and I would appreciate your assistance in interpreting them:
1.
First occurrence (March 2): While climbing stairs, I suddenly experienced a wave of dizziness accompanied by rapid breathing (30+/min), vomiting, pale complexion, increased heart rate (150+/min), and cold extremities.
After resting for 20-30 minutes, I returned to normal and did not seek medical attention.
2.
Second occurrence (March 3): While walking, I suddenly felt dizzy, with increased heart rate and rapid breathing.
After resting for 10 minutes, I returned to normal and did not seek medical attention.
3.
Third occurrence (March 4): While sitting quietly, I turned my head and suddenly felt dizzy, with increased heart rate and rapid breathing.
After resting for 30 minutes, I did not return to normal (still experiencing dizziness and palpitations) and sought medical attention (family medicine).
An ECG (normal) and routine blood tests (normal) were performed.
The doctor prescribed anti-dizziness medication (eriSPAN).
4.
Fourth occurrence (March 6): While walking (for 10 minutes), I suddenly felt dizzy, with increased heart rate and rapid breathing.
After resting for 1 hour, I returned to normal and did not seek medical attention.
5.
I was referred to cardiology (for arrhythmia) and neurology (for EEG) for examinations, both of which were normal.
I switched to the anti-dizziness medication prescribed by the neurologist (Diphenidol) and have been taking it regularly.
Other than feeling more dizzy in the morning, I have been in a state of persistent dizziness at other times.
6.
Fifth occurrence (March 25): With the weather getting colder, I got out of bed and felt dizzy within 5 minutes, affecting my balance while walking.
I experienced mild tinnitus and sought medical attention (ENT).
I was prescribed anti-dizziness medication (Diphenidol, betaHISTIME) and a blood circulation medication (Nicametate).
Current symptoms (under medication):
1.
I experience dizziness and palpitations (90-120 bpm) for about 2 hours upon waking in the morning, occasional mild tinnitus, and sometimes diarrhea.
Occasionally, I feel dizzy before going to sleep at night.
2.
Slight head movements (turning my head, walking around corners, standing up, or walking faster) can trigger dizziness.
3.
Staring at moving objects (like cars) for a while can also cause dizziness.
4.
I have a poor appetite, difficulty concentrating, easy fatigue, and dry eyes.
Other notes: My blood pressure is normal, I have not had a cold recently, I sleep over 7 hours a day, and I have not engaged in any exercise other than walking.
I would like to ask you:
1.
Are the abnormal symptoms mentioned (palpitations, tinnitus, diarrhea, poor appetite, difficulty concentrating, easy fatigue, dry eyes) all caused by dizziness?
2.
Can the factors causing dizziness be confirmed as ear-related diseases, or do I need further examinations to determine this? If so, what examinations should I undergo?
3.
Given my current symptoms, it seems appropriate to see an ENT specialist, right? Or should I consult other specialties?
4.
Is there any way to alleviate dizziness when it occurs, or do I just have to wait for it to resolve on its own?
5.
Besides avoiding caffeine, salty and spicy foods, and ensuring adequate sleep, are there any other precautions I should take?
Thank you for taking the time to respond.

Xiao Xin, 20~29 year old female. Ask Date: 2010/03/27

Dr. Ye Dawei reply Otolaryngology

For dizziness, please visit the outpatient clinic for a detailed examination.
You can also refer to the "Health Education" section at http://www.ccie.nctu.edu.tw/~yehdame.

Reply Date: 2010/03/27

More Info

Dizziness can be a complex symptom with various underlying causes, and your detailed account of the episodes you’ve experienced provides valuable information for understanding your condition. Let's break down your questions and concerns regarding dizziness, its potential causes, and treatment options.

1. Symptoms and Their Relation to Dizziness: The symptoms you describe—palpitations, tinnitus (ear ringing), diarrhea, poor appetite, difficulty concentrating, fatigue, and dry eyes—can indeed be associated with dizziness. Dizziness can lead to anxiety, which may exacerbate these symptoms. Additionally, the sensation of dizziness can cause a cascade of physiological responses, including increased heart rate and changes in breathing patterns. However, it is essential to consider that these symptoms may also arise from other conditions, and a thorough evaluation is necessary to determine their exact cause.

2. Potential Causes of Dizziness: Dizziness can stem from various sources, including vestibular disorders (related to the inner ear), cardiovascular issues, neurological conditions, or even anxiety and stress. Given your episodes of dizziness, particularly with associated symptoms like tinnitus and changes in heart rate, it is plausible that an ear-related issue could be contributing to your symptoms. Conditions such as benign paroxysmal positional vertigo (BPPV), Meniere's disease, or vestibular neuritis could be potential culprits. However, further diagnostic testing may be required to confirm any ear-related disorders.

3. Consulting the Right Specialist: Given your symptoms, it is appropriate to continue consulting with an ear, nose, and throat (ENT) specialist. They can perform specific tests to evaluate your vestibular function and assess for any inner ear disorders. If the ENT specialist rules out ear-related issues, you may need to consult a neurologist for further evaluation, especially if your symptoms persist or worsen.

4. Managing Dizziness: While waiting for a definitive diagnosis, there are several strategies you can employ to manage dizziness. When you feel dizzy, try to remain still and avoid sudden movements. Staying hydrated and ensuring you have a balanced diet can also help. If you experience dizziness upon standing or changing positions, consider standing up slowly to give your body time to adjust. Additionally, vestibular rehabilitation therapy (VRT) may be beneficial if your dizziness is related to vestibular dysfunction.

5. Lifestyle Modifications: Beyond avoiding caffeine and salty or spicy foods, consider incorporating regular, gentle exercise into your routine, as this can improve overall circulation and reduce dizziness. Staying well-hydrated is crucial, as dehydration can exacerbate dizziness. Additionally, managing stress through relaxation techniques, such as deep breathing exercises or mindfulness, may help alleviate some of the anxiety associated with your symptoms.

In summary, your symptoms warrant a comprehensive evaluation to determine their underlying cause. It is essential to work closely with your healthcare providers, including specialists, to explore potential diagnoses and treatment options. Keeping a symptom diary may also be helpful for your doctors to identify patterns and triggers related to your dizziness. Remember, while dizziness can be distressing, many underlying causes are treatable, and with the right approach, you can find relief and improve your quality of life.

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