Dizziness and nausea are two common complaints that may occur simultaneously and often without any other clinical features to highlight a possible cause. Even with the presentation of vomiting and headaches, it is difficult to isolate a possible cause without considering a person’s medical history, events that preceded the onset of these symptoms and a thorough clinical evaluation.
Nausea and/or dizziness must be taken seriously in these situations or with the following signs and symptoms :
- Chest pain – heart attack
- Numbness, tingling or paralysis – stroke
- History of recent head trauma or concussion
- Headaches with other signs and symptoms of raised intracranial pressure
Causes of Nausea and Dizziness
The most common causes of dizziness and nausea includes :
- Low blood sugar levels
- Side effects of certain medication
- Headaches or migraines
Nausea and dizziness are commonly reported by the elderly although it may not be associated with any underlying disease.
- Hypoglycemia (low blood sugar levels)
- Prolonged fasting, strict dieting or starvation
- Poorly managed diabetes mellitus (sugar diabetes)
- Use of diabetic medication, insulin or certain weight loss supplements
- Use of alcohol, pharmaceutical drugs (like sedatives) or narcotics.
- Slurred speech, poor coordination, dilated pupils, confusion and stupor may be noticed.
- Nausea is a common side effect of most medication and often resolves with time or if discontinued. Often associated with gastritis.
- Dizziness may be noticed with medication for hypertension (high blood pressure), arrhythmias, psychiatric disorders.
- Nausea and dizziness due to pregnancy and PMS (premenstrual syndrome) is related to change in hormone levels.
- Similar effects may be noticed with certain drugs like the “morning after” pill (emergency contraceptive).
- Migraines and Headaches
- Nausea and dizziness is commonly present with a migraine.
- Nausea and dizziness is a prominent feature of certain types of headaches, especially those associated with raised intracranial pressure and T4 syndrome.
- Severe head pain, like with any pain, may trigger dizziness and nausea (vasovagal).
- Inner Ear
- Meniere’s disease and labyrinthitis are two inner ear disorders where dizziness is common and nausea may be reported in some cases. Ringing sound in the ears (tinnitus) and/or diminished hearing, hearing loss may also be present.
- Motion sickness is a common cause of dizziness and nausea but is clearly triggered by motion and therefore easily identified.
- Dizziness and nausea is commonly seen in many generalized viral infections.
- Septicemia in complicated bacterial infections is a more serious cause.
- Fever is usually present, however in the incubation period, nausea and dizziness may be noticed along with a general sense of feeling unwell although there is no fever.
- Nausea and dizziness are commonly reported in panic attacks, anxiety, depression and certain psychiatric disorders.
- Vasovagal Response
- Triggered by shock, fear, even unpleasant or disturbing thoughts or images, and severe pain (like kidney stone pain, heart attack pain)
- Causes a drop in blood pressure, slow heart rate and syncope (fainting).
- Chronic Diseases
- Nausea and dizziness are just two of the symptoms that may be seen in many chronic diseases, especially if the disease is advancing.
- This includes cancer, AIDS and organ failure (kidney, liver).
- Other Causes
- Eating disorders – bulimia, anorexia
- Insect, snake bites