Dizziness (lightheadedness)

When to see your GP 

You should see your GP if you're feeling lightheaded or off balance, particularly if you also have other symptoms, such as fainting episodes or headaches.

Your GP will first want to find out exactly what you mean by dizziness. For example, if it is a severe type of dizziness, where you feel your surroundings are spinning or moving, you may be describing vertigo.

They’ll also want to know:

• whether the dizziness started for no obvious reason, or if it followed an illness
• whether you have repeated episodes of dizziness and, if so, when you tend to experience these
• how long the dizziness lasts

Dizziness can sometimes be caused by an ear condition. Dizziness happening when you move your head, that fits the pattern of vertigo, and which lasts for several days, is often caused by a viral ear infection.

This can't be treated with antibiotics. However, there is medication available to help reduce the symptoms while the infection runs its course.

Dizziness that occurs when you're standing upright is probably not related to the ear.

It’s a good idea to keep a diary of your dizziness, and take it with you to your GP appointment.

For example, keeping a note of:

• what you were doing at the time of your dizziness
• how long it lasted and how bad it was
• whether you had any other symptoms – such as fainting, vomiting, nausea, blurred vision, headache, hearing loss or tinnitus (hearing sounds that come from inside your body, rather than from an outside source)

If you're taking prescription medicine, your GP will probably review this to check whether dizziness is a possible side effect. If necessary, they can prescribe a different medication for you to try.

You may be referred to a specialist for further tests and investigations.

Common causes of dizziness 

The most common causes of dizziness are outlined below.

• labyrinthitis – an inner ear infection that affects your hearing and balance, and can lead to a severe form of dizziness called vertigo
• migraine – dizziness may come on before or after the headache, or even without the headache
• stress or anxiety – particularly if you tend to hyperventilate (breathe abnormally quickly when resting)
• low blood sugar level (hypoglycaemia) – which is usually seen in people with diabetes
• postural hypotension – a sudden fall in blood pressure when you suddenly sit or stand up, which goes away after lying down (this is more common in older people)
• dehydration or heat exhaustion – dehydration could be due to not drinking enough during exercise, or illness that causes vomiting, diarrhoea or fever
• vertebrobasilar insufficiency – decreased blood flow in the back of the brain, which may be caused by the blood vessels that lead to the brain from the heart being blocked (known as atherosclerosis)

Less common causes of dizziness 

Less common causes of dizziness include:

• having a severe illness or condition that affects the whole body
• using recreational drugs or drinking too much alcohol (either binge drinking or long-term alcohol misuse)
• certain types of prescription medicine – such as antidepressants or blood pressure medication
• having a heart rhythm problem – such as atrial fibrillation (a fast, irregular heartbeat)
• carbon monoxide poisoning

Rare causes of dizziness 

Rare causes of dizziness include:

• Meniere's disease (a rare progressive disorder of the inner ear of unknown cause) typically causes recurrent episodes of vertigo, hearing loss, tinnitus (hearing sounds that come from inside your body, rather than from an outside source), and a sense of pressure in the ear (aural fullness)
• stroke and transient ischaemic attack
• Brain tumours
• acoustic neuroma
• multiple sclerosis

More useful links

• How to use your health services