Is it just a dizzy spell or a sign of something more serious? A GP provides her advice

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Feeling lightheaded or off-balance is common and usually goes away by itself. However, if recurrent or accompanied by complaints such as blurred vision, ringing in the ears, loss of hearing or nausea, it can hugely affect your day to day life.

Dizziness can be a symptom of a large number of different conditions however, some can be more prevalent than others. We asked GP, Healthspan Medical Director and author Dr Sarah Brewer , for her insights regarding the prevention and treatment of some of its common causes.

1. Low blood pressure

Otherwise known as hypotension, low blood pressure's usually diagnosed when it falls below 90/60 mmHg. It can be hereditary but it is also affected by external factors too. “Low blood pressure can be caused by standing up too quickly, (especially in older people), by dehydration, side-effects of medication, or even by eating a heavy meal which diverts blood towards the intestines to aid digestion,” says Dr Brewer. Symptoms of hypotension include feeling lightheaded with cold, clammy skin, blurred vision, buzzing in the ears and an elevated heart rate. Sudden and severe low blood pressure attacks can also occur as a result of more serious medical causes such as loss of blood (haemorrhage) and severe allergic reactions.

What you can do

Dr Brewer recommends seeing a doctor if you’re experiencing symptoms or persistent headaches, fatigue and anxiety as it might mean that you have hypotension syndrome. If you’re on any prescribed medication, she also recommends checking with your pharmacist to see if that might be contributing to it. Making some dietary modifications can also prove effective. “If there are no treatable underlying causes, you may be advised to increase your intake of dietary table salt (sodium chloride) and to avoid dehydration by drinking plenty of water,” she says.

She also advises drinking coffee with meals to stop blood pressure falling after eating and avoiding alcohol, which can raise blood pressure, as well as avoiding rigorous exercise as this can cause the blood vessels to dilate and blood pressure to plummet further. Dr Brewer’s also found that Korean ginseng or Guarana supplements can also be helpful in regulating blood pressure, as can compression socks for stopping blood from pooling in the legs.

2. Dehydration

As well as being a cause of low blood pressure as detailed above, dehydration in itself can be responsible for feelings of dizziness and lightheadedness. One of their most common causes, it can occur as a result of having heatstroke , diabetes or diarrhoea, vomiting, drinking too much alcohol or after strenuous exercise. Common signs are thirst, tiredness, darker coloured urine, dry skin, a dry mouth, headaches, rapid breathing, lack of energy, confusion, irritability and even fainting.

What you can do

Up your water intake. Dr Brewer also recommends drinking it slowly and regularly (two to three litres a day) and if a side-effect of vomiting, taking a diuretic or other medication, to see your doctor. If you're well hydrated, your urine should be pale yellow or clear.

MORE GLOSS: Water bottles, tried and tested

3. Inner-ear problems

If you’re feeling off-balance and are suffering from hearing loss and ringing in your ears (tinnitus), you could have an inner-ear problem. Dr Brewer highlights build-up of fluid in the inner ears, constriction of blood flow, allergies and autoimmune reactions as some of the most common causes.

What you can do

Dr Brewer recommends booking in with your doctor for tests and a diagnosis after which you may be prescribed medication and advised to limit salt, caffeine, alcohol and smoking. For short-term relief from dizziness caused by an inner-ear problem, she recommends lying down and closing your eyes or keeping them fixed on an object. Also avoid turning your head quickly.

4. Benign positional vertigo

Benign positional vertigo (BPV) is a specific inner-ear problem that causes repeated, brief periods of vertigo (dizziness with spinning sensations) when moving the head, lying down, turning over or getting up. Dr Brewer highlights that it might also be accompanied by nausea, vomiting or abnormal rhythmic eye movements. It’s thought to be the most common cause of vertigo (accounting for 20 per cent of cases). Symptoms usually last less than a minute.

There is no obvious cause for BPV. “It may be due to oversensitivity to swirling movements of fluid inside the semicircular canals of the ear, (which detect movement and position changes),” says Dr Brewer. “It may also be due to small crystals of calcium carbonate dislodged from other parts of the inner ear.”

What you can do

Dr Brewer recommends avoiding movements that can bring on symptoms and while it may go away on its own, seeking a referral from your doctor to an ear, nose and throat specialist will ensure it’s dealt with quicker. She also recommends asking your GP about canalith repositioning, a procedure comprising of specific movements designed to move dizziness-inducing particles that have collected in the inner ear.

5. Stress

Dizziness can also be brought on by stressful situations and in more serious cases, can be a symptom of a  panic attack . Other symptoms of the latter include feelings of fear and anxiety, sweating, nausea, shaking and heart palpitations. Individual triggers vary from person to person and can range from a previous shock or trauma to an accumulation of stress over time.

What you can do

This is probably one of the trickiest causes to tackle due to its complexity. For a long-term solution, Dr Brewer recommends cognitive behaviour therapy . NLP and Reiki can also provide benefits in this regard too. Discuss your options with your doctor though to formulate a plan of action with your individual needs in mind.

In terms of short-term solutions, Dr Brewer advises avoiding over-breathing as hyperventilation can increase symptoms. Instead, breathe slowly and deeply. She also advises taking supplements such as Healthspan’s St John’s Wort Mood Relief , £14.45, a traditional herbal medicine used to help relieve symptoms of low mood and mild anxiety (check with a pharmacist first though if you’re taking any prescribed medicine to avoid conflicts), or adaptogenic  herbs such as Panax ginseng , rhodiola, ashwagandha and Siberian ginseng and drinking chamomile tea. Taking a bath with magnesium salts  has also been shown to help relax both body and mind.

6. Migraine

Dizziness or even vertigo can often be a signal of a migraine  (particularly those accompanied by an aura).

It’s usually combined with visual impairment, nausea and sometimes also a headache.

What you can do

In terms of cases of migraine-associated dizziness, avoidance of triggers is key. Stress, dehydration and/or neck strain are some of the most common. If it’s too late to stop the migraine from coming on though, maintaining a good stock of paracetamol, aspirin or ibuprofen in your handbag is essential. If particularly painful, it could be worth seeing your GP about triptans. A more targeted medication, it causes the blood vessels in the brain to contract to prevent further dilation and worsening of the migraine. Dr Brewer also recommends Feverfew , £7.98, a traditional herbal medicine that can reduce symptoms.

7. Labyrinthitis

Labyrinthitis is an inner-ear infection and common symptoms include vertigo, nausea, vomiting, hearing loss, headache and tinnitus. In addition to this though, Dr Brewer tells us that it can also be characterised by fluid or pus leaking from the ear, ear pain and blurred or double vision. “Most cases are due to a viral infection,” says Dr Brewer. “Rarely, it can result from an autoimmune condition which attacks the inner ear tissues.”

What you can do

Drinking plenty of fluids, bed rest and anti-dizziness medication can help if the infection's viral, but see a GP as soon as possible for diagnosis. “If symptoms persist, vestibular rehabilitation therapy (a specialised form of physiotherapy) is useful,” says Dr Brewer. It can be serious if not caught early enough and Dr Brewer cautions that loss of hearing can occur if a bacterial infection is suspected. Antibiotics will be needed in that case as well as possible hospitalisation due to meningitis being a possible complication.

Follow Dr Brewer  @DrSarahBHealthy  and Ayesha  @Ayesha_Muttu .