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Dealing with Dizziness Is Difficult

Determining the cause of dizziness is the first step to finding a way to relieve it.

Doing cartwheels, riding rollercoasters or spinning until they’re dizzy makes children scream with delight. For older people, though, dizziness is a disaster.

When adults feel dizzy, they frequently become nauseated. Nausea may be harder to handle than pain. It can be difficult to function when vomiting seems imminent.

Vertigo, a sensation of the world spinning around, can be very disorienting. Lightheadedness can make a person unsteady on her feet and could lead to a fall.

Could Allergies Cause Dizziness?

Q. I have been having a problem with dizziness for around 10 years. Each year, my symptoms (spinning, nausea, diarrhea) became more frequent and thus more debilitating. It can feel like I am falling–like the bottom just dropped out.

Symptoms tend to occur in the morning but could happen at any time. They also tend to be seasonal, late winter through spring being the worst time. They could be brief, an instantaneous drop, or last an hour or more. I was diagnosed with Meniere’s disease two years ago. Restricting salt made no discernible difference. Neither did the Epley maneuver.

Due to the seasonality, I have come to believe allergies are a trigger. Is this possible?

A. We recently spoke with a leading expert on vertigo and dizziness, Dr. David Kaylie. He is a neuro-otologist and Professor in the Department of Head and Neck Surgery & Communication Sciences at Duke Health. He told us that symptoms like yours could be made worse by allergies.

One treatment he recommends is a medication called betahistine (Serc in the UK). Unfortunately, the FDA has not approved it. If a physician prescribes it, however, the drug can be ordered online from a Canadian pharmacy at a reasonable price. Another option would be to have a US compounding pharmacy make some. Side effects may include digestive upset.

Dizziness Due to Drugs:

Sometimes dizziness is a consequence of drug treatment. Many useful medications, such as those to lower blood pressure, can cause dizziness as a side effect. Patients and physicians must weigh the benefits of the drug against the unpleasant reaction, and see whether another treatment might work just as well.

When a drug has little evidence of benefit, however, any dizziness that results is simply a tragedy. We spoke recently with a delightful older woman who described a medical misadventure that began with tinnitus. The ringing in her ears was incessant, and her primary care physician referred her to an ENT specialist. That doctor prescribed an antipsychotic medicine called risperidone (Risperdal), although we can find no evidence that risperidone alleviates tinnitus. The Risperdal made her so unsteady that she fell and broke her ankle, putting her in a cast for months.

Dizziness from Inner Ear Changes:

In other cases, dizziness results from changes in the inner ear.

Benign paroxysmal positional vertigo (BPPV) occurs when small calcium crystals (“rocks”) in the inner ear drift out of position. As a result, rolling over in bed, standing up or turning the head can make a person feel violently dizzy for up to several minutes.

Sometimes people with BPPV are given inappropriate treatments. One reader shared this experience:

“I first had vertigo about 20 years ago. I woke up in the middle of night spinning and vomiting, thinking I was dying. I went to the doctor and was put on vertigo medications. The doctor said it would go away in a few weeks, and I just had to deal with it.

“Eventually the vertigo improved but it came back a few years later. This time the ENT moved my head back and forth and had me sit up and lie down. It made everything spin and I threw up, but was told to sleep in a recliner for three days. By the fourth morning, the spinning was gone!

“When it recurred, I had that same Epley maneuver done again, and it worked like a charm. I’ll go for the same thing if I get BPPV again.”

The Epley Maneuver

To understand the Epley maneuver and BPPV better, readers can listen to our one-hour interview with dizziness expert David Kaylie, MD. Radio show 1426 can be streamed for free at PeoplesPharmacy.com. Dr. Kaylie also discusses Meniere’s disease, vestibular neuronitis and other balance disorders and offers valuable practical information about these conditions.

Treating dizziness with the antinausea medicine meclizine doesn’t always help. According to Dr. Kaylie, if the problem is vestibular neuronitis, drug treatment with meclizine can actually aggravate the condition and slow recovery.

Diagnosing dizziness can be difficult. It often requires special expertise. Describing the nature and duration of the sensation can help the doctor determine the cause and the best treatment.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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