Lightheadedness

Overview

Lightheadedness is the feeling of near-fainting, faintness, or “going grey or black” — distinct from the spinning of vertigo. It is very common and often related to blood pressure, hydration or medication, but it can also point to a heart problem. This page covers lightheadedness specifically; for spinning sensations, see Vertigo, and for dizziness in general, see Dizziness.

Common causes

• Orthostatic hypotension — a drop in blood pressure on standing, causing lightheadedness that eases on sitting or lying.
• Dehydration — from inadequate fluids, heat, vomiting or diarrhoea.
• Anaemia — reduced oxygen-carrying capacity causing tiredness and lightheadedness.
• Medication — especially blood-pressure tablets, diuretics and sedatives.
• Low blood sugar — particularly in people with diabetes.
• Prolonged standing, heat exposure or heavy meals.
• Cardiac causes — slow, fast or irregular heartbeat reducing blood flow to the brain.
• Anxiety and hyperventilation.

Evaluation

Evaluation includes measuring blood pressure lying and standing, examining the heart, and blood tests for anaemia, blood sugar, electrolytes and thyroid function. An ECG may be done when a cardiac cause is suspected. A careful medication review is essential, as lightheadedness is frequently a side effect.

Warning features

• Lightheadedness with actual fainting (loss of consciousness).
• Chest pain, palpitations or shortness of breath with lightheadedness — possible cardiac cause.
• Lightheadedness that is new, persistent or worsening.
• Lightheadedness with neurological symptoms.

Management

Management targets the cause: adjusting medication, improving hydration and salt intake where appropriate, treating anaemia or low blood sugar, and investigating the heart when indicated. For orthostatic hypotension, standing up slowly and staying well hydrated help. Consultations are available in-clinic in Bhubaneswar and over teleconsultation.

How we help

Dr. Nayak identifies the cause of lightheadedness — with attention to blood pressure, medication, anaemia and the heart — and builds a targeted plan, arranging ECG or further cardiac tests when needed. Consultations are available in-clinic in Bhubaneswar and over teleconsultation.

Related conditions and patient concerns

• Dizziness
• Vertigo
• Hypertension & Cardiovascular Risk
• Palpitations & Cardiovascular Symptoms
• Fatigue, Weakness & General Symptoms
• Abnormal Test Results