Dr. Ashish Shah of Mount Carmel on vertigo, dizziness

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Dizziness is a common occurrence, and while it’s often not cause for alarm, it can get in the way of your ability to fully function. Healthy New Albany Magazine spoke with Mount Carmel Health System otolaryngologist Dr. Ashish Shah on the ins and outs of managing dizziness, and some of its potential causes. 

Healthy New Albany Magazine: What’s the difference between vertigo and dizziness?

Dr. Ashish Shah: Vertigo is one form of dizziness and results from abnormalities inside the inner ear or the vertigo centers in the brain. It is a sense of motion such as spinning or tilting, similar to the feeling when getting off of a carnival ride.

HNA: How can someone experiencing symptoms tell them apart?

AS: It is important for the patient to be able to describe symptoms accurately, as the history often provides a diagnosis better than examination and testing. Symptoms of other types of dizziness include passing out, near passing out, lightheadedness, wooziness and falling.

HNA: How does hydration play into vertigo and/or dizziness?

AS: Even mild dehydration can cause dizziness by lowering blood pressure. Vertigo, when associated with vomiting, can lead to dehydration, which further exacerbates the dizziness. Many people are not aware of their own inadequate hydration. A general rule is to drink half your body weight in ounces.

HNA: At what point should someone experiencing the symptoms of vertigo and/or dizziness visit his or her doctor?

AS: You should seek medical attention immediately with any signs of stroke, such as FAST (facial drooling, arm weakness, speech difficulties and time). Quick intervention can lead to better outcomes. Severe or persistent symptoms also warrant evaluation. If the vertigo is associated with hearing loss, an urgent evaluation by an ear, nose and throat specialist is warranted as earlier treatment leads to better outcomes.

HNA: What can someone do to lessen his or her symptoms at home? 

AS: Preventively, hydration, balanced diet, regular exercise, good sleep hygiene and stress reduction. With symptoms, even light activity and “exercises” in eye, body and balance coordination can help the brain to compensate for a vertigo disorder. In fact, golf is a great way to strengthen balance function. A sedentary lifestyle will often allow a dizziness disorder to persist longer than it should.

HNA: What about over-the-counter medication?

AS: We try to avoid medications except when patients have severe vertigo especially with vomiting. Motion sickness medications may be taken for short periods, but these medications can cause drowsiness and prevent brain compensation.

HNA: What medication might a physician prescribe to treat severe vertigo and/or dizziness?

AS: The most common medication is Meclizine, a motion sickness medication. Diazepam (Valium) and steroids are also sometimes prescribed but, as stated, we prefer to prescribe medications only for short-term use. It sounds like dizziness can be related to a number of conditions, such as ear infections, insufficient vitamins, heart disease and anxiety, to name a few.

HNA: Are there lesser-known conditions that come into play?

AS: The common inner ear causes of vertigo include benign paroxysmal positional vertigo, a “loose crystal” disorder; vestibular neuronitis/labyrinthiti,  essentially an inner ear viral infection; and Ménière’s disease, a disorder of excess inner ear fluid. Medication side effects, allergies and even obstructive sleep apnea can cause dizziness. Neurological disorders such as migraines can cause vertigo. Multiple sclerosis, stroke and brain tumors are other entities, but these disorders are usually associated with other symptoms.

HNA: Are there specific foods one should emphasize that can help offset symptoms?

AS: Adequate hydration, replenishing electrolytes, a balanced diet and treatment of hypoglycemia in certain patients.

HNA: Are there specific foods that might enhance symptoms and should be avoided?

AS: For Ménière’s disease, excessive salt often causes vertigo attacks. A high-salt diet may also contribute to hypertension, which can cause dizziness. Food with high sugar content may be an aggravating factor. Migraines may be triggered by certain foods such as nuts, avocados, bananas, citrus, onions, dairy, processed meats, and pickled or fermented products such as wine. Often alcohol, caffeine, chocolate and tobacco can be exacerbating factors in dizziness.

HNA: Is there a certain age range that experiences vertigo more often?

AS: Typically, older adults get the higher risk of most forms of dizziness.

HNA: What are the more serious side effects of vertigo and dizziness? Vomiting, fainting, etc.? How should one address these symptoms?

AS: By itself, dizziness is distressing and may lead to anxiety and limitation of activities out of fear which will often only exacerbate symptoms. Falls are a major concern in terms of head and orthopedic injuries. Appropriate precautions should be in place, such as avoiding throw rugs and obstacles in the home. Some patients require equipment to assist with balance. Often, patients with severe symptoms benefit from physical therapy focused on the balance system.

Dr. Ashish Shah is an ENT-otolaryngologist who is affiliated with multiple hospitals in the area, including OhioHealth Grant Medical Center and Nationwide Children’s Hospital. He received his medical degree from The Ohio State University College of Medicine.

Hannah Bealer is an editor. Feedback welcome at adeperro@cityscenemediagroup.com.

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