Unexplained Dizziness: Seeking Answers for Persistent Discomfort

It's really distressing to experience discomfort and dizziness without being able to identify the underlying issue?

I do not smoke or drink alcohol, but due to a shift work schedule, my sleep patterns are quite irregular.
Since early 2015, I have experienced occasional dizziness, which has progressed from once every few months to once a week, and sometimes even several days in a row.
The sensation is not exactly spinning; it feels more like extreme fatigue or a sudden loss of consciousness, almost fainting.
When I go to the library and look at the books on the shelves, I feel dizzy as they sway back and forth.
My neck sometimes feels like I've slept too long, and tapping on the back of my neck can lead to feelings of lightheadedness (this occurs intermittently).
I visited Cheng Kung University Hospital for examinations.
In cardiology, I had an electrocardiogram, and the doctor noted that my heart rate is slower than normal but found no other abnormalities.
In neurology, my carotid artery blood pressure was elevated at 17X.
A subsequent CT scan of the brain showed normal cerebral blood vessels with no abnormalities.
Blood tests revealed a cholesterol level of 211, LDL at 106, triglycerides at 54, and HDL levels that the doctor said were acceptable and likely unrelated to my dizziness.
In family medicine, they could not find a cause and attributed it to significant psychological stress and lack of timely relaxation.
I also have other physical discomforts that I am unsure are related to the dizziness, but I would like to mention them in case anyone has suggestions.
I experience discomfort in my back, similar to slouching (intermittently), occasional tinnitus (intermittently), and although I do not eat much, I often feel a sense of fullness in my abdomen.
My lower abdomen has a protrusion resembling a beer belly (possibly gastric ptosis?).
In March, I underwent gastroscopy and colonoscopy at a new hospital, and in August, blood tests showed no signs of anemia or blood in the stool.
Sometimes when I sit down, I can distinctly feel my heart beating, causing my body to sway back and forth (not sure if this is normal, and it occurs intermittently).
I also wonder if this is related to Meniere's disease.
That’s about it.
I hope someone can help me.
It’s incredibly frustrating to feel unwell without a clear diagnosis.
P.S.
As I write this, I have been experiencing mild dizziness for several days...

Bai Chuan, 30~39 year old female. Ask Date: 2015/12/31

Dr. Gao Chunde reply Neurology

Based on your description, the initial dizziness is likely related to inner ear dysfunction, but it gradually transformed into a feeling of lightheadedness with occasional swaying.
This can sometimes be attributed to anxiety stemming from the brain's perception of an unsafe environment following the dizziness.
Additionally, your irregular work schedule may contribute to accumulated stress and emotional strain, leading to generalized symptoms without any significant abnormalities found in examinations.
It may be beneficial to first try adjusting your routine, incorporating regular exercise and outdoor activities to help relax your mind.
If these measures do not help, seeking assistance from a mental health professional may be advisable to address your concerns.

Reply Date: 2015/12/31

More Info

Unexplained dizziness can be a frustrating and concerning symptom, especially when it persists despite thorough medical evaluations. Based on your description, it seems that you have undergone various tests, including cardiac evaluations, neurological assessments, and imaging studies, which have not revealed any significant abnormalities. This can leave you feeling helpless and anxious, particularly when the dizziness affects your daily life.

Dizziness can stem from a variety of causes, and it is essential to consider both physical and psychological factors. Given your history of irregular sleep patterns due to shift work, it is possible that fatigue and sleep deprivation could contribute to your symptoms. Sleep is crucial for overall health, and inadequate rest can lead to cognitive impairments, mood disturbances, and physical symptoms like dizziness.

Additionally, you mentioned experiencing neck discomfort and a sensation of pressure in your head. Poor posture, especially if you have a tendency to slouch, can lead to muscle tension in the neck and upper back, which may contribute to headaches and dizziness. It might be beneficial to explore physical therapy or exercises that focus on improving posture and relieving muscle tension.

You also noted episodes of tinnitus (ear ringing) and abdominal discomfort. While these symptoms may not seem directly related to dizziness, they could indicate an underlying issue that warrants further investigation. For instance, Meniere's disease, which you mentioned, is characterized by episodes of vertigo, tinnitus, and hearing loss. However, your symptoms and test results do not seem to align with this diagnosis.

Psychological factors, such as stress and anxiety, can also play a significant role in the experience of dizziness. The mind-body connection is powerful, and stress can manifest physically in various ways, including dizziness. If you are experiencing significant stress or anxiety, it may be helpful to consult with a mental health professional who can provide support and coping strategies.

In terms of management, here are some suggestions:
1. Lifestyle Modifications: Prioritize sleep hygiene by establishing a consistent sleep schedule, creating a restful environment, and avoiding stimulants close to bedtime. Regular physical activity can also improve overall well-being and reduce stress.

2. Posture and Ergonomics: Pay attention to your posture, especially if you spend long hours sitting. Ergonomic adjustments to your workspace may alleviate neck and back discomfort.

3. Stress Management: Consider relaxation techniques such as mindfulness, meditation, or yoga to help manage stress and anxiety. These practices can promote relaxation and may reduce the frequency of dizziness episodes.

4. Follow-Up with Specialists: If your symptoms persist, consider seeking a second opinion from a specialist, such as an otolaryngologist (ear, nose, and throat doctor) or a neurologist with expertise in vestibular disorders. They may offer additional insights or tests to explore less common causes of dizziness.

5. Keep a Symptom Diary: Documenting your symptoms, triggers, and any associated factors can help you and your healthcare providers identify patterns and potential causes.

In conclusion, while unexplained dizziness can be distressing, a comprehensive approach that includes lifestyle changes, stress management, and ongoing communication with healthcare providers may help you find relief. It is essential to advocate for your health and seek the support you need to navigate this challenging experience.

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