Dear doctor;

At different times of the day (no regular pattern) I feel very lightheaded and very dizzy, like when you have had too much to drink. During these attacks I struggle to find my bearings. It’s like I don’t have enough oxygen. I am a fitness instructor so I would like to say that I am rather fit. What could be the problem?

Jean T. 37.

Dear Jean T,

There are many causes for one to feel light-headed at 37 years of age. Vasovagal syncope, that is, a low blood pressure after standing for a long time, is a common cause for dizziness. This is commonly seen in military, and other jobs where individuals have to stand for long hours continuously. Normally, as one stands up from a lying down or sitting position, blood pressure tends to fall by two to 10 mm.Hg. But some people are prone to have a speedy fall in blood pressure on standing up (orthostatic hypotension), manifesting as dizziness or light headedness. Staying without food for long hours can result in light headedness due to drop in blood glucose levels.  Spinning sensation of the head (vertigo) may also be perceived as lightheadedness. In a young individual, this can occur due to infections or inflammation of the ears. Here along with lightheadedness one would have pain and or discharge from the ears. 

Regular drinking can also make one prone to dizziness. Uncommon causes for light headedness in a young person are heart failure, disturbances in heart beat, among others, where one has dizziness along with breathing problems. Medicines such as those used to cure depression, blood pressure can cause dizziness as secondary effects.

As fitness instructor, you would definitely be doing warming up exercises before beginning any exercise. It is also important to take a balanced diet containing all vital nutrients and avoid toxic substances like alcohol. Never stay without meals for long hours. If standing for long time, keep toes moving. This helps in improving return of the blood to heart and prevents low blood pressure. Avoid standing up suddenly from sitting or lying positions. If any ear pain or discharge is present, it should be investigated and treated.