Dizziness that comes and goes: what to know

Dizziness may feel like spinning, swaying, lightheadedness or a brief feeling that you might faint. Episodes after standing, missing food or becoming overheated can occur with dehydration, low blood sugar or heat exhaustion. Anaemia, including iron deficiency anaemia, can reduce oxygen delivery and contribute to lightheadedness. Brief spinning brought on by turning in bed or moving the head can fit benign paroxysmal positional vertigo. Anxiety can change breathing and intensify unsteadiness. A racing or irregular heartbeat with dizziness needs medical assessment because atrial fibrillation can present with palpitations, breathlessness or reduced exercise tolerance.

When an episode starts, sit or lie down somewhere safe and avoid driving, heights and machinery until your balance returns. Note what you were doing, whether the room seemed to spin, how long the feeling lasted, and any food, heat, illness, medication or position change beforehand. Drink fluids if you may be dehydrated, and eat regular meals unless a clinician has given you different advice. Arrange a clinical review if episodes recur, interfere with daily activities, or come with paleness, tiredness, palpitations, hearing changes or falls.

Seek emergency help for dizziness with facial drooping, one-sided weakness or numbness, trouble speaking, severe new headache, fainting, chest pain, severe breathlessness, a sustained irregular heartbeat, or inability to walk safely. Urgent assessment is also appropriate after a head injury, repeated vomiting, or a sudden severe episode that does not settle.

Ask: Could my symptoms fit a balance problem, dehydration, anaemia, blood sugar change or heart-rhythm issue? Which medicines or supplements should I review? Do I need blood tests, a heart tracing or a balance examination? What should I do if the sensation returns?