Nosebleed, dizziness and fatigue: what to know

A small nosebleed can be triggered by dry air, irritation or nose picking and may not explain ongoing fatigue. Heavier or repeated bleeding can leave someone lightheaded, while dehydration, heat exhaustion or low blood sugar can also cause dizziness and tiredness. Anaemia, including iron-deficiency anaemia, may cause fatigue and lightheadedness and can have several possible sources of blood loss. Dizziness may instead be a spinning sensation, such as with benign paroxysmal positional vertigo. Atrial fibrillation can cause palpitations and dizziness, but symptoms alone cannot establish the cause.

Sit upright, lean forward and pinch the soft part of the nose continuously for several minutes while breathing through your mouth. Spit out blood rather than swallowing it. Once bleeding stops, avoid blowing or picking the nose and avoid strenuous activity for a while. Sip fluids if you can swallow normally. Note how long the bleeding lasted, whether it was heavy, and any medicines that affect bleeding. Do not stop prescribed medicines without medical advice. Arrange a review if fatigue or dizziness continues, or if nosebleeds recur.

Seek urgent care if bleeding is heavy, follows a significant injury, does not settle with firm pressure, or comes with fainting, confusion, breathing difficulty, chest pain, weakness or a very fast or irregular heartbeat. Prompt assessment is also needed for black stools, vomiting blood or worsening dizziness. A clinician may check blood pressure, hydration and a blood count.

Could anaemia or dehydration explain my fatigue and dizziness? Do my medicines or blood pressure matter? Do I need a blood count or other tests? How can I prevent further nosebleeds?