Dizziness and Nausea: Possible Causes

The room suddenly starts to swim, the floor drops away from under your feet, and nausea rises in your throat — a familiar sensation that makes you want to sit down and not move. Dizziness and nausea rarely come separately: dizziness, regardless of its cause, is usually accompanied to some degree by nausea and vomiting. Let's look at what this may be connected with and which signs change everything.

Why dizziness is accompanied by nausea

Doctors distinguish systemic dizziness — the false sensation of the space around you rotating or of yourself rotating in space, associated with damage to the vestibular analyzer — from non-systemic dizziness, when a person feels faintness, uncertainty, or unsteadiness. Regardless of the cause, dizziness is usually accompanied to some degree by nausea and vomiting, pallor, and changes in pulse and blood pressure. Attacks may last from a few seconds to several hours and even days.

Causes of dizziness, nausea, and vomiting

The most common cause of dizziness is benign paroxysmal positional vertigo: short attacks lasting 5–30 seconds when bending over or turning the head, lying down in bed, or getting up, with no attacks at rest. Other common causes include a sharp drop in blood pressure when standing up, dehydration, a side effect of medications, inner ear problems, including Meniere's disease and labyrinthitis, motion sickness, migraine, and head injury. Dizziness often occurs against the background of another condition — an ear infection, stress or anxiety, low blood sugar in diabetes, iron-deficiency anemia, or overheating.

Dizziness, nausea, and weakness: what may lie behind the combination

When general weakness is added to dizziness and nausea, the range of causes widens: it includes low blood pressure, anemia, arrhythmia, hypoglycemia, and hypoxia. With systemic dizziness, it may be difficult to walk, and sweating and tinnitus appear. Non-systemic dizziness more often produces a feeling of faintness and instability without rotation. The doctor builds the first hypothesis based on the nature of the sensations.

• Short attacks when turning the head — suggestive of positional vertigo
• Unsteadiness and hearing loss, tinnitus — inner ear problems
• Faintness when standing up — a sharp drop in blood pressure
• Weakness and faintness — the doctor checks blood pressure, pulse, blood sugar, and anemia

How a doctor determines the cause: examination

Diagnosis begins with taking a history: the type of dizziness, its duration, triggering factors, medications, injuries, and accompanying symptoms. Among the accompanying symptoms of dizziness are anxiety, sleep disturbance, and low mood — the doctor identifies these during history-taking. The doctor checks hearing, balance, and gait and may order a vestibular function test — after a standard examination, the diagnosis is confirmed in 75% of cases. If a stroke is suspected or after a head injury, imaging may be used; in positional vertigo, MRI and CT are uninformative, and the cause is identified with special maneuvers.

When urgent help and a doctor's visit are needed

You should see a doctor if dizziness does not go away or returns, if hearing or speech worsens, if tinnitus, double vision or blurred vision, numbness and weakness in the face, arms, or legs appear, and also in case of fainting, headache, changes in pulse, and nausea.

Dizziness by itself is not a reason to call an ambulance; 103 or 112 — if sudden or severe dizziness is accompanied by visual disturbance, slurred speech, or weakness, which may be a sign of a more serious condition.

This material is for reference: it helps you get your bearings but does not replace a doctor's consultation, which will assess your specific situation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer