Feel woozy? Do this first

Your body is signaling distress. Take it seriously and follow these instructions.

Published: November, 2020

Quick, what do you do if a bout of wooziness strikes? Since the symptom can be a sign of either something minor or a more serious problem, you need a plan of action.

What is wooziness?

Wooziness is a tricky word. People use it to describe many symptoms, such as feeling mentally unclear or confused; a little weak; lightheaded, like you might faint; unstable, like the world is bobbing around; or even mildly nauseated. And doctors say wooziness can be all of those things. "But wooziness is not the world spinning around you. That's vertigo," says Dr. Natalia Rost, a Harvard Medical School professor and chief of Stroke Services at Harvard-affiliated Massachusetts General Hospital.

What happens when you call 911?

When paramedics respond to a complaint of wooziness, they check your vital signs (blood pressure, heart rate, and oxygen levels), do a stroke screening, and ask about your medications. If there's no good explanation for your symptoms, they'll take you to the local emergency department.

There, a nurse will ask about your symptoms, probably obtain an ECG to look for signs of a heart rhythm abnormality or heart attack, and start intravenous fluids to ward off dehydration. Then a doctor will evaluate you. "We need to consider every function in the body because wooziness could be caused by almost anything. We'll do a neurological exam, look at your medications, and order blood tests to look at electrolytes and see if your sodium or potassium levels are off. Whatever is causing your symptoms, we'll get to the bottom of it," says Dr. Natalia Rost, chief of Stroke Services at Massachusetts General Hospital.

What causes wooziness?

Wooziness could be a symptom of many conditions, such as the following.

A sudden drop in blood pressure. If your blood pressure drops — perhaps because you stood up too quickly, or you are dehydrated, or your blood pressure medications were recently increased — your brain may not get enough blood, causing wooziness.

Low blood sugar. Your brain needs sugar to operate; too little fuel can cause wooziness. People most at risk for low blood sugar are those with diabetes who are taking medicine to lower blood sugar.

Neuropathy. "A loss of sensation in your legs [neuropathy] can make you feel unstable," Dr. Rost says. "This is common in people with diabetes."

Urinary tract infection. Confusion is a common sign of urinary tract infections in older adults.

Low blood counts or poor lung function. An underlying condition affecting your lungs or blood cells could keep the brain from getting enough oxygen.

An inner ear infection. An ear infection typically causes vertigo, but it also can cause balance problems and make you feel unsteady.

A heart attack. A heart attack can make you feel like you're going to faint, as well as usually causing chest pain, shortness of breath, nausea, arm pain, back pain, or jaw pain.

Heart failure. When the heart cannot pump blood around the body effectively enough, the reduced blood flow through the brain can cause a sense of unsteadiness.

Stroke. In a stroke, blood flow to a part of the brain is blocked, and brain cells die. While this can sometimes cause wooziness, "it's almost always accompanied by other symptoms, including sudden facial drooping, difficulty speaking, changes in vision, weakness on one side of the body, or difficulty thinking," Dr. Rost says.

Action steps

If you suddenly feel woozy and you've never felt that way before, don't panic, but also don't ignore it. Wooziness can be the result of a new condition that needs to be treated immediately. "If you've never experienced wooziness before and it comes on suddenly or severely, you should call 911, especially if it's accompanied by other symptoms, Dr. Rost advises."

On the other hand, if you've experienced wooziness before from a chronic condition, or if you've been a little under the weather recently, Dr. Rost recommends that you take these steps:

  • Sit down. You don't want to fall and suffer an injury.
  • Drink a glass of water or juice.
  • Rest. Give your body time to absorb the fluid, about 10 or 15 minutes.
  • If you start to feel better, call your doctor's office to report the symptoms. "But if the feeling of wooziness persists, you get other symptoms, or you can't get up without feeling like the world is moving or you may pass out, call 911," Dr. Rost says.

Note: Don't avoid medical care out of fear of catching COVID-19 in a medical setting. As we reported in October 2020, those concerns are believed to have kept thousands of people away from hospitals when the pandemic first struck, sometimes with deadly consequences. "If you need to be seen, be seen," Dr. Rost says. "Just follow the rules the hospital has in place in terms of COVID screening, masks, and distancing."

Image: © mrdoomits/Getty Images

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