Why am i dizzy and feel like throwing up

Overview

Dizziness is a word that's often used to describe two different feelings. It's important to know exactly what you mean when you say "I feel dizzy." It can help you and your doctor narrow down the list of possible problems.

• Lightheadedness is a feeling that you are about to faint or "pass out." You may feel dizzy. But you don't feel as though you or your surroundings are moving. The feeling often goes away or improves when you lie down. If it gets worse, it can lead to a feeling of almost fainting or to a fainting spell (syncope). You may sometimes feel nauseated or vomit when you are lightheaded.
• Vertigo is a feeling that you or your surroundings are moving when there is no actual movement. You may feel as though you are off balance, spinning, whirling, falling, or tilting. When you have severe vertigo, you may feel very nauseated or vomit. You may have trouble walking or standing. And you may lose your balance and fall.

Dizziness can occur in people of any age. But it's more common among older adults. A fear of dizziness can cause older adults to limit their physical and social activities. Dizziness can also lead to falls and other injuries.

Lightheadedness

It's common to feel lightheaded from time to time. Brief bouts of lightheadedness aren't usually caused by a serious problem. Lightheadedness often is caused by a quick drop in blood pressure and blood flow to your head. This can occur when you get up too quickly from a seated or lying position (orthostatic hypotension). Lightheadedness that lasts may mean that you have a more serious problem that needs to be checked.

Lightheadedness has many causes. They include:

• Allergies.
• Illnesses such as the flu or colds. Home treatment of your flu and cold symptoms usually will relieve lightheadedness.
• Vomiting, diarrhea, fevers, and other illnesses that cause dehydration.
• Very deep or rapid breathing (hyperventilation).
• Anxiety and stress.
• The use of tobacco, alcohol, or illegal drugs.

A more serious cause is bleeding. Most of the time, the location of the bleeding and the need to seek medical care are clear. But sometimes bleeding isn't obvious (occult bleeding). You may have small amounts of bleeding in your digestive tract over days or weeks without noticing the bleeding. When this happens, lightheadedness and fatigue may be the first signs that you are losing blood. Heavy menstrual bleeding also can cause this type of lightheadedness.

Sometimes the cause of lightheadedness is an abnormal heart rhythm (arrhythmia). This can cause fainting spells (syncope). Unexplained fainting spells need to be checked by a doctor. You can check your heart rate by taking your pulse.

Many prescription and nonprescription medicines can cause lightheadedness or vertigo. How bad it is depends on the medicine you take.

Vertigo

Vertigo occurs when there is conflict between the signals sent to the brain by the different systems of the body that sense balance and position. Your brain uses input from four sensory systems to maintain your sense of balance and orientation to your surroundings.

• Vision gives you information about your position and motion in relationship to the rest of the world. This is an important part of the balance mechanism. It often overrides information from the other balance-sensing systems.
• Sensory nerves in your joints allow your brain to keep track of the position of your legs, arms, and torso. Your body can then make tiny changes in posture that help you keep your balance (proprioception).
• Skin pressure sensation gives you information about your body's position and motion in relationship to gravity.
• A portion of the inner ear, called the labyrinth, which includes the semicircular canals, contains specialized cells that detect motion and changes in position. Injury to or diseases of the inner ear can send false signals to the brain. They can tell the brain that the balance mechanism of the inner ear (labyrinth) detects motion. If these false signals conflict with signals from the other balance and positioning centers of the body, vertigo may occur.

Common causes of vertigo include:

• Inner ear disorders. Examples are benign paroxysmal positional vertigo (BPPV), Ménière's disease, vestibular neuritis, and labyrinthitis.
• Injury to the ear or head.
• Migraine headaches. They are painful, debilitating headaches that often occur with vertigo, nausea, vomiting, and sensitivity to light, noise, and smell.
• Decreased blood flow through the arteries that supply blood to the base of the brain (vertebrobasilar insufficiency).

Less common causes of vertigo include:

• A noncancerous growth in the space behind the eardrum (cholesteatoma).
• Brain tumors and cancer that has traveled from another part of the body (metastatic).

Medical care is needed right away if vertigo occurs suddenly with a change in speech or vision or other loss of function. Vertigo that occurs with loss of function in one area of the body can mean a problem in the brain, such as a stroke or a transient ischemic attack (TIA).

Alcohol and many prescription and nonprescription medicines can cause lightheadedness or vertigo. These problems may develop from:

• Taking too much of a medicine (overmedicating).
• Alcohol and medicine interactions. This is a problem that often affects older adults, who may take many medicines at the same time.
• Misusing a medicine or alcohol use disorder.
• Drug intoxication or the effects of withdrawal.

Check Your Symptoms

Is dizziness your main problem?

How old are you?

3 years or younger

3 years or younger

4 to 11 years

4 to 11 years

12 years or older

12 years or older

Are you male or female?

• If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
• If your symptoms aren’t related to those organs, you can choose the gender you identify with.
• If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.

Have you had a head injury?

Did you pass out completely (lose consciousness)?

If you are answering for someone else: Is the person unconscious now?

(If you are answering this question for yourself, say no.)

Are you back to your normal level of alertness?

After passing out, it's normal to feel a little confused, weak, or lightheaded when you first wake up or come to. But unless something else is wrong, these symptoms should pass pretty quickly and you should soon feel about as awake and alert as you normally do.

Yes

Has returned to normal after loss of consciousness

No

Has returned to normal after loss of consciousness

Did the loss of consciousness occur during the past 24 hours?

Yes

Loss of consciousness in past 24 hours

No

Loss of consciousness in past 24 hours

Have you had any new neurological symptoms other than dizziness?

Yes

Other neurological symptoms

No

Other neurological symptoms

Do you have these symptoms right now?

Yes

Neurological symptoms now present

No

Neurological symptoms now present

Is the dizziness severe?

Severe means that you are so dizzy that you need help to stand or walk.

Yes

Arrhythmia or change in heart rate

No

Arrhythmia or change in heart rate

Yes

Symptoms of serious illness

No

Symptoms of serious illness

Have you had sudden, severe hearing loss?

Yes

Sudden, severe hearing loss

No

Sudden, severe hearing loss

Is vertigo a new problem?

Are your symptoms getting worse?

Yes

Dizziness is getting worse

No

Dizziness is getting worse

Did the symptoms start after a recent injury?

Yes

Symptoms began after recent injury

No

Symptoms began after recent injury

Have you recently had moments when you felt like you were going to faint?

Yes

Episodes of feeling faint

No

Episodes of feeling faint

Have you felt faint or lightheaded for more than 24 hours?

Yes

Has felt faint or lightheaded for more than 24 hours

No

Has felt faint or lightheaded for more than 24 hours

Are you nauseated or vomiting?

Nauseated means you feel sick to your stomach, like you are going to vomit.

Are you nauseated a lot of the time or vomiting repeatedly?

Yes

Persistent nausea or vomiting

No

Persistent nausea or vomiting

Do you think that a medicine could be causing the dizziness?

Think about whether the dizziness started after you began using a new medicine or a higher dose of a medicine.

Yes

Medicine may be causing dizziness

No

Medicine may be causing dizziness

Have you been feeling dizzy for more than 5 days?

Yes

Dizziness for more than 5 days

No

Dizziness for more than 5 days

Is the problem disrupting your daily activities?

Yes

Dizziness interfering with daily activities

No

Dizziness interfering with daily activities

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

• Your age. Babies and older adults tend to get sicker quicker.
• Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
• Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
• Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
• Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

• Try home treatment to relieve the symptoms.
• Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Vertigo is the feeling that you or your surroundings are moving when there is no actual movement. It may feel like spinning, whirling, or tilting. Vertigo may make you sick to your stomach, and you may have trouble standing, walking, or keeping your balance.

Symptoms of a heart attack may include:

• Chest pain or pressure, or a strange feeling in the chest.
• Sweating.
• Shortness of breath.
• Nausea or vomiting.
• Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
• Lightheadedness or sudden weakness.
• A fast or irregular heartbeat.

For men and women, the most common symptom is chest pain or pressure. But women are somewhat more likely than men to have other symptoms, like shortness of breath, nausea, and back or jaw pain.

Symptoms of serious illness may include:

• A severe headache.
• A stiff neck.
• Mental changes, such as feeling confused or much less alert.
• Extreme fatigue (to the point where it's hard for you to function).
• Shaking chills.

Heartbeat changes can include:

• A faster or slower heartbeat than is normal for you. This would include a pulse rate of more than 120 beats per minute (when you are not exercising) or less than 50 beats per minute (unless that is normal for you).
• A heart rate that does not have a steady pattern.
• Skipped beats.
• Extra beats.

Neurological symptoms—which may be signs of a problem with the nervous system—can affect many body functions. Symptoms may include:

• Numbness, weakness, or lack of movement in your face, arm, or leg, especially on only one side of your body.
• Trouble seeing in one or both eyes.
• Trouble speaking.
• Confusion or trouble understanding simple statements.
• Problems with balance or coordination (for example, falling down or dropping things).
• Seizures.

Many prescription and nonprescription medicines can make you feel lightheaded or affect your balance. A few examples are:

• Antibiotics.
• Blood pressure medicines.
• Medicines used to treat depression or anxiety.
• Pain medicines.
• Medicines used to treat cancer (chemotherapy).

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Adults and older children often have several symptoms of shock. These include:

• Passing out (losing consciousness).
• Feeling very dizzy or lightheaded, like you may pass out.
• Feeling very weak or having trouble standing.
• Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

• Call your doctor now to discuss the symptoms and arrange for care.
• If you cannot reach your doctor or you don't have one, seek care in the next hour.
• You do not need to call an ambulance unless:
  • You cannot travel safely either by driving yourself or by having someone else drive you.
  • You are in an area where heavy traffic or other problems may slow you down.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

• Call your doctor today to discuss the symptoms and arrange for care.
• If you cannot reach your doctor or you don't have one, seek care today.
• If it is evening, watch the symptoms and seek care in the morning.
• If the symptoms get worse, seek care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

After you call 911, the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

• Make an appointment to see your doctor in the next 1 to 2 weeks.
• If appropriate, try home treatment while you are waiting for the appointment.
• If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Head Injury, Age 4 and Older

Head Injury, Age 3 and Younger

Self-Care

Lightheadedness usually isn't a cause for concern unless it is severe, doesn't go away, or occurs with other symptoms such as an irregular heartbeat or fainting. Lightheadedness can lead to falls and other injuries. Protect yourself from injury if you feel lightheaded. Here are some things you can do.

• Lie down for a minute or two.

  This will allow more blood to flow to your brain. After lying down, sit up slowly. Stay sitting for 1 to 2 minutes before you slowly stand up.

• Get some rest.

  It's not unusual to be lightheaded during some viral illnesses, such as a cold or the flu. Resting will help prevent attacks of lightheadedness.

• Be safe with activities.

  Don't drive a motor vehicle, operate equipment, or climb on a ladder while you are dizzy.

• Be careful with substances.

  Don't use substances that can affect your circulation. These include caffeine, tobacco, alcohol, and illegal drugs.

• Stay hydrated.

  Dehydration can cause or increase lightheadedness. It can happen when you have an illness that causes diarrhea, vomiting, or a fever.

  • Drink more fluids, especially water.
  • Other fluids are also helpful, such as fruit juice mixed to half-strength with water, rehydration drinks, weak tea with sugar, clear broth, and gelatin dessert.
  • If you have kidney or heart disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
• Protect yourself if you have vertigo.
  • Don't lie flat on your back. Prop yourself up slightly to relieve the spinning sensation.
  • Move slowly to avoid the risk of falling.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

• New or worse nausea or vomiting.
• Fainting.
• Symptoms occur more often or are more severe.

Learn more

• Vertigo: Staying Safe When You Have Balance Problems
• Preventing Falls in Older Adults

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Credits

Current as of: August 25, 2022

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine