Do you often experience lightheadedness for a moment (or longer) when you go from lying or sitting to standing? It may simply be a consequence of advancing age, but there are other possible causes to be aware of. If you experience lightheadedness on a regular basis, the risks include injury from a fall should you faint, so it’s very important to get a medical evaluation and find the best treatment for you. Hypertension expert Gary L. Schwartz, MD, explains here the causes of and the treatments for lightheadedness.
Many people use the terms lightheadedness and dizziness interchangeably, but there is a difference. The word “dizzy” is associated with being off balance or having vertigo, a sense that the room is moving or spinning. Dizziness often signals an inner-ear or a balance issue.
Being lightheaded, on the other hand, is more about feeling weak and usually is related to a drop in blood pressure. When that drop is significant enough, you can experience underperfusion of the brain—not enough blood is getting to the brain so you faint.
Health-care providers often need to ask questions to get a better sense of what a patient is trying to describe. When you go into more detail and specifically explain what you’re feeling, it becomes easier for your doctor to sort out.
While lightheadedness is caused by a drop in blood pressure, there are many possible underlying causes of—or pathways to—that drop. Here are five of the most common ones…
As we age, we progressively lose our sense of thirst. If you wait until you’re thirsty to drink, you’re probably not drinking enough. This can become a big problem if you’re active and work up a sweat, especially when exercising outdoors in hot weather and sweating profusely but not replenishing those fluids. This is especially a concern for the elderly due to decreased thirst sensation and other factors, including use of certain drugs and impaired cognitive function.
How to stop feeling lightheaded: Review how much water you drink in a day, and keep up your fluid intake. For adults, the recommended daily intake of fluid is 125 ounces (about 15.5 cups) for men and 91 ounces (about 11.5 cups) for women…for older people, at least 67 ounces (eight cups) per day. These recommendations include fluid from drinking and from the food that is eaten. Be extra conscientious if you get sick, such as with the flu or a stomach bug, and stop eating and/or drinking because of nausea or vomiting—you can forgo food until you feel better, but be sure to sip water, electrolyte-replenishment drinks and other liquids.
This is when blood pressure drops when you stand up. Normally, when we stand, gravity pulls blood into the veins of the legs and the abdomen, and that sudden shift in circulating blood causes blood pressure to momentarily drop. When blood pressure drops (for this or any reason), the body’s autonomic nervous system—the part of the nervous system tasked with keeping our blood pressure at a certain level—tries to restore it as a natural reflex. There are pressure sensors, called baroreceptors, in the blood vessels in the neck and the aorta near the heart. When they sense a drop in blood pressure, they send a message to the brain. That stimulates the nervous system very quickly, leading to constriction of blood vessels and increases in the heart rate and the force with which the heart pumps blood to restore normal blood pressure. (Similarly, if blood pressure goes too high, it evokes the opposite response—slowing the heart rate and the force of the blood leaving the heart and relaxing blood vessels to return the blood pressure to normal.)
These reflexes happen in a millisecond, so under normal circumstances you wouldn’t even notice them. But as we age, blood vessels can become stiff and the receptors may not work as well as they used, so it takes longer for blood pressure to rebalance, causing that feeling of lightheadedness.
How to stop feeling lightheaded: For mild cases, the remedy can be as simple as taking more time to stand and holding the arm of a sturdy chair for balance. Your doctor may order tests to look for a cause other than advancing age…suggest other lifestyle steps…and possibly prescribe medication to regulate blood pressure.
If you have sudden lightheadedness and tingling sensations when you stand up: That could be caused by temporary numbness from crossing your legs, causing your leg to “fall asleep,” as it used to be called. But tingling that persists could be some type of sensory nerve issue that merits investigation by your doctor.
There’s a long list of drugs that can make you feel lightheaded. While blood pressure–lowering medicines, such as diuretics and ACE inhibitors, are most frequently blamed, other suspects include psychotropic medications…cardiovascular medicines like beta blockers…and prostate drugs. They have the potential to cause blood pressure to drop when you change position because they can impair the autonomic nervous system reflex…and the effects can be magnified if you’re also dehydrated.
How to stop feeling lightheaded: Talk to your doctor about doing a full review of all the medications you take and possibly switching to other classes of drugs to lessen this side effect.
Having low blood sugar from not eating can cause lightheadedness as well as that “hangry” feeling.
How to stop feeling lightheaded: Eating regular meals and snacks can help. But if you have diabetes, this is a more serious situation and should be discussed with your endocrinologist or certified diabetes educator to find the right plan of action for you.
This is lightheadedness, along with weakness, fatigue, nausea, blurred vision, sleepiness and other symptoms, that occurs after a meal (postprandial). When we eat, a certain amount of blood is diverted to the intestines to break down and absorb the nutrients in the food. In most people, the autonomic nervous system can deal with this slight drop in blood pressure. But for some, especially older people, it can’t compensate, leaving you lightheaded and even at risk of fainting within 30 minutes or so of eating.
How to stop feeling lightheaded: If you’re diagnosed with postprandial hypotension, your doctor likely will have you eat smaller but more frequent meals and pay attention to staying hydrated. If needed, there are medications that support blood pressure following meals.
