What Can Cause Lightheadedness and Dizziness?

Lightheadedness and dizziness are commonly used interchangeably, but they are different. Dizziness means different things for different people. The first question you should ask yourself and your healthcare provider is: What exactly do you mean by feeling dizzy?

Lightheadedness describes the feeling that you are about to pass out (faint or collapse). If it leads to passing out (fainting) we call the spell “syncope.” Vertigo, on the other hand, is a feeling that you or your surroundings are moving when there is no actual movement (illusion of movement). Vertigo and lightheadedness are different symptoms caused by different disease processes.

When should you seek medical attention for lightheadedness?

Please note that it is OK to feel brief and occasional bouts of lightheadedness. But prolonged, persistent and/or frequent feeling of lightheadedness need medical attention and thorough evaluation.

What causes lightheadedness?

Common causes of light-headedness include:

• bleeding and anemia
• dehydration caused by vomiting, diarrhea, heat exhaustion and other illnesses, and decreased water intake
• drop in blood sugar
• heart disease and rhythm problems
• medications like blood pressure medications, diuretics, prostate medications, opiates, muscle relaxants and anxiolytics, recreational drugs like alcohol, cannabis and other drugs
• psychological causes, including anxiety, depression, panic attacks and hyperventilation (rapid and deep breathing).

Medication review is crucial

Many cases we evaluate at our clinic are related to medications, especially in older patients. Blood pressure medications and diuretics are common culprits where blood pressure targets need to take age and symptoms into consideration. Many commonly used medications can cause lightheadedness like opiates, anxiolytics and sleeping aids. Medications used for enlarged prostate like Flomax (tamsulosin) can cause significant lightheadedness and patients need to know about.

Anxiety and depression are common causes of lightheadedness and dizziness

A significant number of cases we see for lightheadedness and dizziness are caused by anxiety and depression. When other causes are ruled out it is helpful to consider psychological and psychiatric factors as potential contributors.

Management of lightheadedness

If you feel lightheaded, lie down immediately to prevent passing out and falling due to passing out. Prevention and treatment depend on the cause of lightheadedness.