Healthy Living

Lightheadedness

When should lightheadedness make you worry?

Lightheadedness

What is lightheadedness?

Lightheadedness or feeling faint may not always be a cause for concern. However, it may also indicate an underlying health problem and can increase the risk of falling and fall-related injuries. If you feel lightheaded, drink water or fluids containing electrolytes and take rest. If the symptom still persists for more than 15 minutes, seek immediate medical help. 

A person who experiences lightheadedness may feel as though he or she is going to pass out, which can either be persistent or come in distinct episodes. In some cases, lightheadedness can be very severe with other accompanying symptoms, such as nausea and vomiting, sweating, overheating, partial loss of vision, and ringing or buzzing in the ears. 

Lightheadedness mostly occurs when a person quickly moves from being seated to a standing position (postural hypotension). This sudden change in position causes a reduced blood flow to the brain and results in low blood pressure, making you feel faint. This condition is more likely experienced when a person is dehydrated due to sickness or when there is not enough fluid intake. This unpleasant sensation tends to improve when you lie back down or back in a seated position. Postural hypotension is more commonly experienced by the elderly. 

Recurrent or severe lightheadedness must always be brought to the doctor's attention for proper diagnosis and treatment. Ongoing lightheadedness may indicate a more serious problem that needs to be evaluated.

Are lightheadedness and dizziness the same?

When people complain about feeling dizzy, they either mean lightheadedness or vertigo. Lightheadedness or feeling faint is not the same with vertigo, which is a spinning sensation. 

Another dizziness complaint of patients is disequilibrium, which is a sensation of unsteadiness or imbalance, especially when walking. The common causes of disequilibrium usually involve musculoskeletal and nervous system problems, which may also be accompanied by lightheadedness, depending on the exact cause. 

If you see a doctor regarding your dizziness, make sure to describe the sensations you particularly experience. 

What causes lightheadedness?

There are other common causes of lightheadedness aside from being dehydrated and changes in position. They include:

  • Anxiety and stress
  • Altitude sickness
  • Allergies
  • Illnesses that can cause dehydration (diarrhea, vomiting, high fever, the flu, or the common cold)
  • Low blood sugar
  • Hyperventilation (deep and rapid breathing)
  • The use of alcohol, tobacco, including illegal drugs

In some cases, lightheadedness is also caused by certain prescription and over-the-counter (OTC) medications. 

Serious Causes of Lightheadedness

Certain causes of lightheadedness, such as low blood sugar, can be easily resolved and is not always a cause for worry. However, moderate to severe lightheadedness may lead to fainting or falling with corresponding injuries.

Other serious causes of lightheadedness include:

1. Stroke

Lightheadedness caused by a stroke may also have other accompanying symptoms, such as numbness, slurred speech, headache, difficulty walking, loss of balance, changes in vision, and facial drooping on one side. In some older adults, a stroke or heart attack may only have one symptom, and that is lightheadedness. 

2. Heart Attack

One of the symptoms of a cardiovascular problem is dizziness or lightheadedness. Heart disease is one of the leading causes of death in the United States, so it is very important to recognize its early signs and symptoms. 

The earliest warning of a heart attack might be a recurrent pressure (angina) or chest pain that is often triggered by exertion and is relieved by rest. Aside from feeling lightheaded or dizzy, also pay attention to its other accompanying symptoms, such as heart palpitations, shortness of breath, and chest pain. 

3. Anemia or Iron Deficiency

Anemia is a condition in which there is an inadequate amount of red blood cells (RBCs) in the body to supply oxygen.  Iron is also needed to make red blood cells. When the body does not have enough iron, the level of oxygen in the body also becomes low. This condition is called iron deficiency anemia.

Along with lightheadedness, it also causes other symptoms, which include headaches, fatigue, shortness of breath, and pale skin. 

4. Internal Bleeding

Internal bleeding is usually a result of an injury or trauma. However, there are also less obvious causes of internal bleeding, such as organ damage, a bleeding disorder, or gastritis. A person with internal bleeding needs immediate medical attention. 

The most common symptoms of internal bleeding include:

  • Dizziness or lightheadedness
  • Fainting
  • Low blood pressure
  • Vision problems
  • Weakness or numbness on one side of the body
  • Severe abdominal pain
  • Severe headache
  • Chest pain
  • Shortness of breath
  • Nausea
  • Blood in vomit
  • Blood in stool
  • Diarrhea

Bruising around the navel and sides of the abdomen may indicate bleeding in the internal organs of the abdomen. Less severe cases of internal bleeding should also be evaluated by a doctor as soon as you notice the symptoms. 

Prevention

To help prevent lightheadedness, avoid standing up too quickly from a seated position or any sudden changes in posture. When you are ill or perform intense exercise routines, make sure to drink plenty of water. Wear sunglasses when going outdoors and try to avoid bright lights. 

Be careful when using substances or medications, such as tobacco, alcohol, sedatives, antihistamines, and antinausea drugs because they can also cause lightheadedness. Talk to your doctor when you are taking any of these medications. Do not stop taking your medications without your doctor's advice. 

Other preventive measures you can take when you regularly experience lightheadedness:

  • Use a cane for better mobility (when necessary)
  • Remove things that you may trip on at home (e.g., electrical cords, rugs)
  • Put nonslip mats to the shower floor or bathtub
  • Lie or sit down the moment you feel lightheaded to avoid falls and related injuries
  • Do not operate heavy machinery or drive a vehicle if you feel lightheaded
  • Get enough sleep
  • Consume a healthy, balanced diet
  • Be well hydrated by drinking at least eight glasses of water a day
  • Practice relaxation techniques (e.g., yoga, meditation, deep breathing, etc.)

References

Dizziness. (August 2015) https://www.mayoclinic.org/diseases-conditions/dizziness/symptoms-causes/syc-20371787

Dizziness. (May 2015) my.clevelandclinic.org/head-neck/diseases-conditions/hic-what-is-dizziness.aspx

Causes of Dizziness. https://vestibular.org/about-vestibular-disorders/causes-dizziness

Lightheadedness. (July 2016) https://www.healthline.com/health/lightheadedness#causes

Strupp, M. and Brandt, T. Diagnosis and Treatment of Vertigo and Dizziness. Dtsch Arztebl Int. 2008 Mar; 105(10): 173–180. Published online 2008 Mar 7. doi: [10.3238/arztebl.2008.0173].

Kerber KA., et al. Stroke among patients with dizziness, vertigo, and imbalance in the emergency department: a population-based study. Stroke. 2006 Oct;37(10):2484-7. DOI: 10.1161/01.STR.0000240329.48263.0d.