Patient chief concerns come in waves. Lately I’ve been seeing a number of patients for chronic vertigo and dizziness.
The Vestibular System and Dizziness
The labyrinth of your inner ear senses where you are in space, and transmits this information to the cranial nerve in your ear (the vestibulocochlear nerve). This nerve sends signals to your eyes to help keep you appropriately oriented in space. The vestibular system also communicates with your cerebellum, the back part of your brain, which tells your spinal cord how to control your muscles in response to the signals it receives.
An imbalance anywhere in the vestibular system can result in dizziness. Therefore, a full workup of dizziness will include a referral to an ENT doctor and a neurologist. Vertigo that comes on suddenly should be worked up by a cardiologist.
Assuming these workups are negative, though, here are some other possible causes I’ve seen.
- Adrenal fatigue. The fluid inside the inner ear is dependent upon the appropriate balance of electrolytes (positively and negatively charged ions). Because the adrenals produce a hormone called aldosterone which affects blood volume and electrolytes, adrenal fatigue often presents with orthostatic hypotension (or that feeling that the room goes dark when you stand up too quickly). Sometimes this also causes dizziness.
- Dehydration. Again, electrolytes are crucial to the inner ear apparatus, and the vast majority of us don’t drink enough water (especially in Arizona). Make sure you get half your body weight in ounces daily.
- Hypoglycemia. Often the blood sugar roller coaster (which may be secondary to candida overgrowth or to diabetes) can make you not just shaky and irritable, but lightheaded, and sometimes dizzy.
- Labyrinthitis. Technically the word just means inflammation of the inner ear, and a referral to the ENT should uncover it. It can occur as a result of a viral or bacterial infection, a head injury, or as a side effect of certain medications.
- POTS (Postural Orthostatic Tachycardia Syndrome). This one came to my attention recently; it’s a disorder of the autonomic nervous system, and it’s more or less a diagnosis of exclusion. However, it appears to be mediated by low aldosterone, and often occurs concurrently with Chronic Fatigue Syndrome.
- Anxiety. This one is tricky, because anxiety can be secondary to adrenal fatigue, labyrinthitis, or POTS… or you might be anxious because you’re dizzy! But if you know the anxiety came first, this may be a physical manifestation of it.
I always prefer to find a root cause whenever possible. But if all else fails, I’ve found that several cases of refractory dizziness resolve with a well-chosen homeopathic remedy.
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