Internal Medicine

Dizziness and tiredness

definition

Two symptoms are referred to as dizziness with tiredness, which can occur together and are often mutually dependent.The cause is often a combination of many factors, such as lack of sleep and stress. But there are also various diseases that can be the cause.

These include, for example, an existing anemia or a dysfunction of the thyroid gland, as well as tension in the upper spine.

Often the symptoms are not taken seriously by people in the environment, but they mean a severe restriction of the quality of life and the daily routine for those affected, both in professional and private everyday life. Finding a diagnosis is also not easy for the doctor and so the patients are often referred to a wide variety of specialist disciplines. Below are some common causes and diseases that can lead to the combination of dizziness and fatigue.

causes

There are many different causes for dizziness and fatigue. Often times it is a combination of different factors that together contribute to the symptoms. For many people, stress and lack of sleep are reasons for dizziness and fatigue. Too little exercise, a lack of fresh air and an unbalanced diet can also promote these symptoms.

An acutely too low blood sugar level is also a possible cause. However, various diseases, such as a dysfunction of the thyroid gland or anemia, can manifest themselves as dizziness and tiredness. Certain breathing disorders while sleeping, as well as some medications, can also make you dizzy and tired. Depression or other psychological problems can also be possible causes.

What is the role of the thyroid gland?

Thyroid disease can manifest itself through various symptoms. These often include the feeling of exhaustion, along with fatigue, as well as dizziness and headaches. The cause here can be an over- or under-functioning of the thyroid gland. The thyroid hormones play a role in various processes in the body.

An imbalance becomes noticeable through very different symptoms. Often there are additional symptoms such as restlessness, weight changes, sweating and an accelerated heartbeat, which some perceive as a racing heart.

What role does stress play?

Stress is very common and plays a role in causing many symptoms. For example, stress can lead to a lack of sleep or sleep disorders, which in turn leads to long-lasting fatigue. Dizziness can also be an expression of insomnia and accompany it.

However, it can also happen that existing symptoms lead to stress, which in turn intensifies the symptoms themselves. In all cases, attempts should be made to lower the stress level. Here, for example, relaxation exercises can also have a supportive effect.

sleep disorders

Patients with a sleep disorder often experience tiredness and dizziness the next day. In addition to problems falling asleep and staying asleep, which the person concerned clearly perceives, other patients suffer from so-called sleep apnea, in which breathing is briefly interrupted during sleep without the person concerned waking up.

Due to the inadequate supply of oxygen during sleep, those affected often feel very weak and exhausted during the day or have to struggle with circulatory problems such as dizziness.

Read more on the topic: Sleep apnea syndrome

What role does the psyche play?

The psyche can play a major role in the symptoms of dizziness and fatigue. In many cases, it is at least part of the underlying cause, not least because the symptoms themselves are a psychological burden. In anxiety disorders or depression, dizziness and tiredness are common symptoms.

But other psychological burdens, such as stress or the processing of a traumatic event, can also express themselves. Another important role is the perception, acceptance and processing of psychological stress.

anemia

In a relatively large number of cases there is so-called anemia (anemia) behind persistent tiredness with accompanying dizziness. The hemoglobin, which is responsible for transporting oxygen in the blood, is reduced here, so that, in addition to dizziness and tiredness, there may be signs such as paleness or headaches (please refer: Symptoms of anemia).

For example, anemia can develop due to iron deficiency. This often affects young women with heavy menstrual bleeding who lose large amounts of blood with each menstrual period.

Read more on the topic: Iron deficiency anemia

Low blood pressure

The symptoms are similar if the blood pressure is too low (Hypotension), for which in turn various causes come into question. In addition to an underactive thyroid (Hypothyroidism) to name a heart failure or anemia.

The hypothyroidism itself causes symptoms such as dizziness, tiredness and headaches. However, the hormone deficiency can be remedied relatively easily with tablets.

Insufficient nutrition / hydration

An inadequately balanced diet can also be responsible for the symptoms. This can lead to a lack of vitamins and nutrients. The iron deficiency, which can lead to the development of anemia, should be mentioned here in particular.

But even if the calorie intake is lower than the energy consumption due to stress or dieting, circulatory problems such as dizziness or fatigue can easily occur. You should also ensure that you drink a sufficient amount (at least 2l per day, with physical activity or significantly more in summer), otherwise a lack of fluids can lead to circulatory problems or ultimately even to circulatory collapse.

You might also be interested in this article: Dizziness and circulation

diagnosis

The anamnesis, i.e. the doctor-patient conversation, plays an important role in the diagnosis of dizziness and fatigue. The more detailed circumstances and possible causes can be identified more precisely. Further diagnostic tools are available depending on the suspicion. This includes, for example, the physical examination, which is particularly important in the case of tension or balance problems in connection with dizziness.

If you suspect anemia or thyroid dysfunction, a blood test is an important part of the diagnosis.

Concomitant symptoms

Many different symptoms can accompany dizziness and fatigue, depending on the cause. The tiredness itself can be constant throughout the day or worsen or even improve over the course of the day. Dizziness is often described as diffuse when it occurs together with fatigue.

In addition, headache and body aches can occur. Increased sweating, restlessness and changes in weight are possible accompanying causes if the cause is related to the thyroid gland. Furthermore, palpitations or visual disturbances can occur.

a headache

Headache is a common accompanying symptom with dizziness and fatigue. This could be caused by tension in the spine, for example. Here, especially in the area of the cervical spine, nerves can be pinched or constricted. In addition, the headache can also accompany an upcoming infection, such as flu.

Even with sleep disorders or psychological stress, such as increased stress, there is often an additional headache. In many cases, it helps to ensure that you are getting enough exercise and fresh air.

Read more on the subject below: A headache

Neck pain

Many people experience dizziness and fatigue combined with neck pain. The main cause for this is mostly tension in the spinal column. They are caused by an incorrect load on the back or an incorrect posture, which is made worse by daily office work, for example. Therefore, sufficient exercise and, if necessary, physical therapy are important methods of combating neck pain.

In the case of acute pain, a heat pad can also have a pain-relieving effect. If the symptoms are pronounced and, for example, a clouding of consciousness occurs, a doctor should be consulted as soon as possible to clarify any injuries to the spine.

Read more on the subject below: Neck pain

Difficulty concentrating

Dizziness and tiredness occur again and again in combination with difficulty concentrating. In many cases, this can be explained by the symptoms themselves, as lack of sleep and recurring dizziness can have a negative effect on alertness. In order to reduce short concentration difficulties, a few minutes in the fresh air can already have a supportive effect.

If the concentration difficulties recur over a longer period of time and go e.g. If there is an inner restlessness or tension, a doctor should be consulted for clarification, as these can also be signs of a malfunction of the thyroid gland.

Body aches

If dizziness and tiredness occur together with aching limbs, this is in many cases a sign of overloading the body. This can arise, for example, from stress or increased exertion in everyday life. Psychological stress is also often expressed through these symptoms. Furthermore, the body aches and pains in combination with dizziness and tiredness can be signs of an infection.

Many infections start with such unspecific symptoms. Therefore, in such a case, it is advisable to keep bed rest whenever possible. If there is also a fever, a doctor should be consulted for clarification.

Visual disturbances

Occasionally, dizziness and tiredness can go hand in hand with visual disturbances. Depending on the type of visual disturbance, there are various possible causes. Is it e.g. around lightning bolts that appear suddenly, these symptoms can herald a migraine attack (see also: Migraine attack), which is accompanied by a strong, throbbing headache.

Visual disturbances can also occur in the context of depression, which also leads to loss of appetite and lack of drive. If anything is unclear, an ophthalmologist should be consulted for clarification.

You might also be interested in this article: Dizziness and migraines - what is the underlying disease?

dizziness

Often dizziness and tiredness go hand in hand (see above). If dizziness is in the foreground and occurs independently of tiredness, other causes must be considered. Dizziness is a disorder of the organ of equilibrium in the inner ear, which receives information from the entire body, processes it and forwards it to the brain.

For those particularly interested: Structure and function of the inner ear

Non-vestibular (not affecting the organ of equilibrium) dizziness can have various causes, such as too high or too low blood pressure, cardiac arrhythmias or visual disturbances or poorly fitted glasses.

Furthermore, dizziness can be triggered by a disease of the inner ear itself (vestibular cause). Here, the sense of balance is often through detached ear stones (Otoliths) caused. If dizziness without an apparent cause (e.g. a carousel ride, standing up suddenly after lying down for a long time, or low blood pressure) occurs frequently, a doctor should always be consulted.

Read more on the topic: Dizziness through the inner ear

Accompanying exhaustion

In addition to the organic causes described above, persistent exhaustion can often also have psychological causes. In the case of a depressive mood, in addition to lack of drive, a lack of enthusiasm and thoughts of fear, physical symptoms often occur. These include, above all, persistent tiredness and exhaustion, which can be associated with a sleep disorder, as well as headaches, loss of appetite and gastrointestinal complaints.

Read more on the subject at: Symptoms of depression

If the person concerned reports that he has recently felt an inner emptiness and is finding it difficult to motivate himself to undertake activities that would otherwise have given him joy, then a psychological cause of the physically noticeable exhaustion should be considered.

Professional treatment is of great importance for both permanent stress and depression, as otherwise burnout syndrome or chronic fatigue syndrome can occur.

Organic causes such as anemia or an underactive thyroid should also be clarified.

Accompanying exhaustion

Fatigue is another symptom that is more often associated with dizziness and fatigue. In addition to the organic causes of such complaints mentioned above, a weakened immune system is also conceivable as a cause. If the immune system is constantly busy fending off or fighting an infection, persistent tiredness and circulatory problems such as dizziness (similar to those of a bad cold or the flu) can result.

Read more on the subject at: Symptoms of a cold

Accompanying palpitations

A palpable palpitation (Palpitation) can also occasionally occur in healthy young people and has no pathological significance without further complaints. However, if the stumbling of the heart occurs in connection with dizziness and fatigue, suspicion of a cardiac arrhythmia must be investigated.

There are numerous cardiac arrhythmias, which are symptomatic to different degrees and differ in therapy. The most common is atrial fibrillation, in which the auricles occasionally or permanently beat in a disorderly manner and much too quickly. In Germany, around every hundredth inhabitant is affected, although the likelihood of illness increases with age.

Other cardiac diseases are also possible causes. These include heart valve diseases, heart failure (Heart failure) or myocarditis (inflammation of the heart muscle).

Read more on the subject at: Diseases of the heart

Also extracardiac (non-cardiac) diseases or certain medications, hypoglycaemia (Hypoglycemia) or anxiety disorders must be considered for the combination of these symptoms.

Racing heart

If dizziness and tiredness occur together with a racing heart, there are many possible causes. Often it is a temporary disturbance of the circulatory system or an acute lack of fluid, i.e. dehydration. These causes can be counteracted quickly and effectively by drinking water and sitting or lying down for a few minutes, ideally in the fresh air.

Furthermore, diseases of the cardiovascular system, such as high blood pressure or a disease of the heart, can be possible triggers.

Accompanying back pain

Tension in the spine is very common. If these occur in the area of the cervical spine, it can also cause nerves to become trapped. This can manifest itself as dizziness and tiredness. However, as many important nerves and other structures run here, caution should be exercised. If symptoms of dizziness and tiredness occur in connection with severe pain or movement in the cervical spine, a doctor should be consulted as soon as possible for clarification.

It was also found that depression, which often manifests itself as tiredness, fatigue and circulatory problems such as dizziness, is also associated with chronic back pain.

Read more on the subject at: Back pain and psyche

Chronic back pain is often difficult to treat and severely restricts the quality of life of those affected. This can lead to psychological problems. Patients with severe back pain also often have difficulty finding a comfortable sleeping position and can suffer from fatigue and dizziness due to lack of sleep.

Read general information on the topic at: Back pain

After eating

Dizziness and tiredness after eating can have various causes, which must be clarified by a doctor if the symptoms persist. Slight tiredness or drowsiness after a large meal is normal in so far as the stretching of the stomach releases messenger substances in the brain. On the one hand, these messenger substances have an inhibitory effect on further food intake and, on the other hand, they inhibit the activity center in the brain, which leads to fatigue.

In metabolic diseases such as diabetes mellitus (sugar disease) it can be caused by a disrupted interaction of sugar (Glucose) and insulin (a hormone that lowers blood sugar levels), especially after high-carbohydrate meals, cause dizziness, which is often accompanied by a drop in blood pressure and a racing heart.

Older people often feel dizzy after eating because their blood pressure drops sharply during the digestive process. The autonomic nervous system is responsible for this - during the digestive process, the parasympathetic nervous system is activated, which lowers blood pressure and pulse at the same time, which also occurs in people who otherwise suffer from high blood pressure.

Another cause of post-meal dizziness can be pregnancy, where pregnancy hormones often lead to nausea and dizziness after a meal.

Read more on the topic: Dizziness during pregnancy

Histamine intolerance causes symptoms such as dizziness, rapid heartbeat, high blood pressure, rash or gas, and diarrhea after a meal. This becomes particularly noticeable after consuming foods rich in histamine, such as certain types of cheese or red wine.

Read more on the subject at: Dizziness after eating

treatment

Treatment for symptoms of dizziness and fatigue depends on the underlying cause. In the case of acute attacks of dizziness and tiredness, it helps many sufferers to go outside for a few minutes or to sit or lie down outside for a short time. This stimulates the circulation again and allows it to stabilize.

Often times, a lack of fluids or low blood sugar levels make symptoms worse. Accordingly, it is important to drink enough water and, for example, to eat a piece of glucose.

If the dizziness and tiredness occur due to discomfort in the cervical spine, physiotherapy treatment should be considered, depending on the nature of the problems.

If the thyroid plays a role in the development of the problem, the dysfunction must be further clarified. Depending on the type of illness, different drugs are available, for example to replace thyroid hormones.

If you have an increased level of stress, relaxation exercises can be helpful. In addition, attempts should be made to reduce the stress in everyday life. In the case of psychological problems, such as depression, the focus is on psychotherapeutic treatments.

Course of disease

The course of dizziness and tiredness depends heavily on the underlying cause. Since these symptoms as such are often ignored at first, this can lead to a longer course of the disease. In many cases, the causes are more benign problems, such as stress or sleep problems.

Accordingly, the symptoms are usually reduced again when tackling the physical overload. If there is a more serious illness, it must be looked after by a doctor. In most cases, however, the course of the disease remains mild, even if it sometimes lasts for several months.

Duration

The duration of dizziness and tiredness can vary greatly depending on what is causing the symptoms. The symptoms themselves usually last a few minutes to hours, but can occur regularly over weeks. With appropriate treatment or elimination of the causes, the duration of the occurrence is usually no more than a few months. Accordingly, the prognosis is quite good in most cases.