Why Am I feeling dizzy all the time?
Dizziness is a common feeling of being light-headed and unsteady that is not generally associated with a serious condition. Large population-based studies reported that dizziness affects around 15% to 20% of adults yearly. It is prevalent in women and its frequency increases with age [1].
What Are the Causes of Dizziness?
The common causes of dizziness are labyrinthitis, stress and anxiety, headache and migraine, hypoglycemia, vertebrobasilar insufficiency, and dehydration. Less common causes are associated with excessive alcohol consumption (binge drinking), Illness, and Carbon Monoxide Poisoning.
1- Labyrinthitis
Labyrinthitis is an inflammation of the inner ear and specifically of the membranous labyrinth that leads to its irritation and swelling. This ear structure is made of a network of passages full of liquid which play an essential role in the control of sound detection and balance by the inner ear. Labyrinthitis is usually caused by a bacterial or viral infection (e.g., cold or flu).
2- Stress and Anxiety
Dizziness has been associated with panic symptoms in stressed and anxious individuals due to central-neurologic links between the vestibular system which controls the sense of balance and spatial orientation and the autonomous nervous system controls the nervous system’s unconscious activity [2].
3- Migraine
Dizziness is one of the symptoms of vestibular migraine whose causes are unknown. However, one possible explanation is a potential link between pain and swelling during inner ear inflammation and migraine and dizziness.
4- Hypoglycaemia
To function the brain requires energy that is produced from glucose that is supplied by the blood. Normally, glucose is maintained in the range of 3.9 to 6.1 millimoles per liter (mmol/L) of blood; however, diabetes patients receiving a diabetic treatment can periodically experience hypoglycemia (Low glucose level) which causes dizziness, fatigue, and weakness.
5- Hypotension
The normal blood pressure in a healthy adult is between 90/60 and 120/80 mmHg. A blood pressure of less than 90/60 mmHg can lead to dizziness. This is commonly observed in individuals with diabetes or cardiovascular diseases.
6- Vertebrobasilar Insufficiency
Vertebrobasilar Insufficiency is transitory ischemia of the vertebrobasilar circulation associated with decreased blood flow in the posterior circulation of the brain that is provided by the basilar artery. Diseases such as atherosclerosis can block or narrow this artery causing a reduced blood supply to several parts of the brain leading to dizziness and imbalance [3].
7- Dehydration
Dehydration prevents a sufficient supply of water and electrolytes to the body resulting in blood dehydration and a decrease in blood flow leading to an insufficient supply of nutrients to tissues and organs, including the brain.
8- Excessive Alcohol Consumption
Excessive alcohol consumption leads to alcohol intoxication and alcoholic ketoacidosis reduces the secretion of insulin by the pancreas which affects glucose usage by the cells in tissue and organs of the body. Diabetes can also lead to ketoacidosis, known as diabetic ketoacidosis.
9- Medication
Discontinuation of antidepressant medication, such as selective serotonin reuptake inhibitors (e.g., Prozac) results in a high frequency of dizziness that may be due to their role in improving balance control and cognitive functioning [4]. Blood pressure medication can also induce hypotension leading to dizziness.
10- Illness
Disorders such as vestibular neuritis or diseases such as Ménière’s Disease comprise dizziness as one of the main symptoms.
- Vestibular neuritis
This disorder affects the vestibulocochlear nerve within the inner ear that sends balance and head position information from the inner ear to the brain. Damage to this nerve (e.g., viral infections) disturbs the function of the nerve which results in dizziness and unbalance [5].
- Ménière’s Disease
Although the causes are not well known, this disease affects the inner ear, and its symptoms include tinnitus (Perception of internal sounds), loss of hearing, and vertigo.
11- Carbon Monoxide Poisoning
The blood transport oxygen to tissues and organs of the body to produce the energy necessary for their functions. Following, carbon monoxide exposure, blood oxygen is replaced by carbon monoxide which results in cellular toxicity.
What Is the Difference Between Dizziness and Vertigo?
Although dizziness and vertigo have been interchangeably used, dizziness is a perception associated with feeling light-headed and unsteady, while vertigo is the perception of being in movement or that your surrounding is in movement. Vertigo is also characterized by symptoms such as nausea, vomiting, sweating, and walking difficulty.
How to Prevent or Treat Dizziness?
The prevention or treatment of dizziness is focused on dealing with its causes. For instance, labyrinthitis and Vestibular neuritis, are treated with antihistamines or motion-sickness tablets. Vestibular rehabilitation through physiotherapeutic exercises is also recommended to help restore balance. Changes in lifestyle, staying hydrated, avoiding binge drinking, and reducing stress levels can prevent dizziness.
Conclusion
Dizziness is not generally associated with a serious condition; however, in certain cases, it can be due to chronic conditions such as diabetes and cardiovascular diseases which require specific treatments. It can also be related to mental disorders such as migraines, and anxiety, which also rely on anti-depressant treatments.
Unfortunately, the causes of Ménière’s disease are not well-known and the potential involvement of hereditary transmission has been proposed. In this case, the treatment relies on the use of medications that reduce nausea and diuretics to reduce liquid build-up in the inner ear.
Finally, dizziness is a symptom that is shared by several disorders such as vertigo, and therefore, it is confusing to differentiate between the two if the right questions are not asked during the diagnostic stage.
References
[6] Harcourt, J., Barraclough, K. and Bronstein, A.M., 2014. Meniere’s disease. Bmj, 349.
