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Last week I saw five different patients who came to the clinic because they felt "dizzy and lightheaded"; eventually each of them had different diagnosis. People use the word dizzy to describe different feelings. The first thing you need to know before you visit your doctor is what exactly you mean when you say "dizzy". The word dizzy is usually used to describe lightheadedness; it is sometimes used to describe vertigo. As soon as you figure out which one of these two you have you narrow the differential diagnosis at least to the half.

But how can you differentiate dizziness from vertigo?

I have prepared a few questions to help you out.

Question number 1: Stand in the middle of the room and ask yourself do you feel like you are going to pass out? Or you feel like the room is spinning or tilting? Or do you feel like you are about to lose balance and fall?

Question number 2: Try to identify what makes you feel better and make the dizziness go away? And what aggravates the dizziness?

Question number 3: Does the feeling change when changing your posture?

Question number 4: What are the other associated symptoms?


is the right term to use when you feel that you are going to pass out. One of the important characteristics of lightheadedness is that it often goes away when you lie down. Sometimes lightheadedness is so severe that it can cause fainting. Lightheadedness is also commonly associated with vomiting and nausea.


is the right term to use when you feel that you or the room around you is moving spinning, tilting, or falling. An important characteristic of vertigo that it does not goes away when you lie down. Vertigo does not cause fainting. Vertigo also can be associated with nausea and vomiting. Vertigo can cause trouble standing or walking, and may result in losing balance and even falling.


Usually, lightheadedness is nothing to worry about and rarely it is caused by a serious problem. Usually, lightheadedness happens if you suddenly stand up from lying or sitting position. What happens is that when you lie for a while the blood pools in the veins and the heart decreases its pumping capacity since it doesn't need to pump blood against gravity; when you stand up it takes the heart a few moments to catch up with the extra workload that is caused by the gravity, as a result, the brain will not get enough blood for a short moment you feel this as lightheadedness and darkening in front of your eyes.


  • Flu and colds
  • Allergies
  • Anything that causes dehydration such as diarrhea, vomiting or just playing football in a hot weather without getting enough water.
  • Anxiety
  • Alcohol and some of the abused substances.
  • Bleeding: This is a serious cause. The source of bleeding must be sought and identified. Bleeding can be caused by another serious medical condition such as cancer.
  • Many prescription and over the counter medications can cause lightheadedness.


Vertigo usually is caused by a neurological problem or a problem in the organs responsible for balance and position sensing and controlling the body posture these organs are (the eyes, the inner ear, and pressure sensors in the skin).

I recommend you see your doctor if you have vertigo or lightheadedness that persists for a long time.

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