Dizziiness

WHEN TO SEE YOUR DOCTOR

* Your dizziness is unexplained, severe, recurrent or persistent.

* You also have ringing in your ears or a sudden loss of hearing.

* Your vision also suddenly gets worse or you have double vision.

* You have a severe headache.

* You have a family history of dizziness.

What Your Symptom Is Telling You

The world seems to rise up to the very tip-top of the horizon and then cascade down into an endless swirl. That sensation might be okay if you're riding on a roller coaster, but it's disconcerting, to say the least, if you happen to be standing on your patio.

At one time or another, we all feel dizzy—a sensation that you or the world around you is spinning. Many people feel it when they look down from a tall building or after riding on a merry-go-round. Even astronauts can be overcome by dizzy spells while traveling through space.

About 70 percent of the time, dizziness is a sign that your inner ears—which act like gyroscopes to keep you standing upright—aren't working right. But dizziness also is an elusive symptom that can be caused by more than 350 ailments, including colds, flu, allergies, poor dietary habits, stress, certain drugs, viral infection, high blood pressure, diabetes, internal bleeding, heart disease or an impending stroke.

Symptom Relief

There are things that people can do to cope with their dizziness. But if you experience an unexplained dizzy spell, see your doctor, because you can't be sure if it's a trivial problem or a symptom of a serious illness," says Robert Slater, M.D., an assistant professor of clinical neurology at the University of Pennsylvania School of Medicine in Philadelphia.

Here are some suggestions you might use at home to stop the spinning.

Turn off your ears. Along with your inner ears, your feet and eyes help you maintain your balance. Just sitting in a chair with your feet on the ground, holding the chair with your arms and staring at a stationary object for a few minutes may help subdue your dizziness. That's because your brain will learn to ignore the faulty messages coming from your inner ears, says Jim Buskirk, a physical therapist at the Dizziness and Balance Center in Wilmette, Illinois. He cautions, however, that this technique should not be overused. If you have persistent dizziness, see your doctor.

Go slow, but steady. "The name of the game when you're really dizzy is to move as slow as a turtle," says Diran Mikaelian, M.D., professor of otolaryngology at Thomas Jefferson University in Philadelphia. Avoid rapid changes in head position, especially when standing up or lying down. Instead, move in stages. When getting out of bed, for example, sit on the edge of the mattress for at least 30 seconds before standing.

Check your medications. Many over-the-counter and prescription drugs, particularly those used to control blood pressure, can cause dizziness as a side effect. Ask your doctor if it would be appropriate to make changes in any of your medications.

Shake the salt habit. Too much salt in the diet causes the body to retain fluid, which can disrupt the workings of the inner ear. Avoid cheese, bacon and canned foods and limit your overall salt consumption to less than 2,000 milligrams a day (about one teaspoon), says Ronald Amedee, M.D., associate professor of head and neck surgery at Tulane University Medical Center in New Orleans. That's about the amount of sodium in one cheeseburger and a small chef's salad.

Say sayonara to stimulants. Avoid coffee and tobacco, because they heighten your body's sensitivity to motion, doctors say. If you insist on drinking coffee, limit your consumption to one or two cups a day. But herbal teas that don't contain caffeine are a better choice.

Banish the booze. Even modest amounts of alcohol—in some cases, just three sips of beer—can trigger violent dizzy spells in some people, Dr. Slater says. If you notice that alcohol makes you dizzy, cut back or cut it out altogether.

Find a stress buster. People who are under stress or feel anxious, particularly people who have hard-driving Type-A personalities, are prone to dizziness, Dr. Amedee says. Relaxation exercises such as deep breathing, yoga or biofeedback might help.

Watch out for allergies. Dizziness may be a symptom of allergies caused by pollen, pets or even foods. "I had a patient who got dizzy every time he ate hot dogs," says Peter Roland, M.D., an otologist at the University of Texas Southwestern Medical Center in Dallas. "It's rare, but food allergies can do that." If something you eat leaves you spinning, eliminate it from your diet.

Take a pill. Some over-the-counter motion sickness drugs containing dimenhydrinate or meclizine reduce the sensitivity of the inner ear to motion and may suppress your dizziness. But in severe cases, stronger prescription drugs may be needed.

Drugs are usually a last resort reserved for people who have the most serious forms of dizziness, says Dr. Slater. That's because over time the brain has a remarkable ability to compensate for most types of dizziness.

Exercise Your Dizziness Away

"Keeping active is actually one of the best treatments for dizziness caused by an inner ear problem," Dr. Slater says. "Any exercise that involves a lot of head and body movement such as walking, swimming, jogging, even karate will help the brain overcome it. If you keep turning and moving, it will work." Here are a couple of suggestions to get you going.

Start slow if you have to. For some people with severe dizziness, just standing up and walking across a room can cause dizziness. But you can gradually overcome this by moving into a position where you just begin feeling dizzy, then returning to your chair. If that means you can take only three steps before you feel dizzy, that's fine. It's still a good start, Dr. Slater says. "The exercise—moving, feeling dizzy, sitting down—should be done several times a day. The optimum would be three times every day for 2 to 15 minutes a session," he says. "But in the beginning, if you can only do it for 20 seconds at a time without feeling dizzy, that's okay. Twenty seconds of exercise is better than nothing."

Swing your partner. "Dancing is a fantastic exercise for dizzy people because it involves a lot of turns and swinging around," Dr. Slater says. "If you're really dizzy, you can start out making slow 90-degree turns. Then, as your body adapts, you can work your way up to fancy spins."

See also Balance Problems; Walking Difficulty