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Ask Dr. D. Love Your Own Question

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17548
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I aam 65. Female. Just recently I have been not feeling

Customer Question

Hi I aam 65. Female. Just recently I have been not feeling too well in that I have had a few dizzy spells and generally not feeling good. I've been to see Dr who checked heart, pulse and b.p. Aand all ok. My neck crunches quite badly aand do take painkillers which help. Also I sometimes get a weird feeling going through me if I'm sitting down aand sometimes standing up. Difficult to explain, but passes off in about a minute or so. At the moment I feel I can't be bothered to do things which is not me at all, aand my husband has aalzheimers (early). I did wonder if I was depressed or is it stress? I really just want to feel better, but don't know what to do. Not sure if you can help.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. D. Love replied 1 year ago.
Hello from JustAnswer.
How long has this been bothering you?
Do you have the ability to check your blood pressure at home?
If so, could you check your blood ressure and pulse first when lying down, then after one minute of sitting, and then after one minute of standing up?
In this assessment, it is not an issue of whether the blood pressure or pulse is high or low, but how they change in the different positions.
What, if any, chronic medicines are you taking?
Customer: replied 1 year ago.
I do have a bp monitor, so will go aand do that it you can give me a few minutes
Expert:  Dr. D. Love replied 1 year ago.
That is fine. Just respond once you have obtained the numbers.
Customer: replied 1 year ago.
I can't find my monitor at the moment. It's been about 2/3 weeks I guess.
Expert:  Dr. D. Love replied 1 year ago.
What, if any, chronic medicines are you taking?
Customer: replied 1 year ago.
I'm taking simvastaatins, alendronic acid, levothryoxine, 75gms, citaalopraam
Expert:  Dr. D. Love replied 1 year ago.
Thank you for the additional information.

There are many different possible causes if dizziness.

It is common for dizziness to be due to an inner ear condition. When the dizziness is of short duration, the most common cause is from inflammation of the inner ear, called labyrinthitis. It also can be due to crystals forming in the liquid of the inner ear or water accumulation in the inner ear. It may help to take a medicine that suppresses the inner ear, such as meclizine or dimenhydrinate.

Another common cause of dizziness is a drop in blood pressure when changing from lying to sitting to standing. A decrease in blood pressure by 20 points or an increase in blood pressure by 20 points is considered significant, even if all of the values are within the normal range. If you find that this is true for you once you find your blood pressure monitor, there are several possible causes of this, but the most common are dehydration, which can also be due to many different conditions, or as a side effect to medicines. The medicines that you are taking are not common causes of these changes, but the citalopram has been reported to cause this. The usual first intervention if there are found to be a significant change in blood pressure or pulse would be to increase fluid intake.

Another consideration would be a decreased blood flow through the arteries in the neck. This can occur from narrowings within the arteries or from compression from outside the blood vessels. WIth the crunches that you have noted in the neck, it is possible that arthritic changes in the neck could be impacting the arteries. An ultrasound of the arteries can assess blood flow.

It is true that depression or anxiety can also contribute to these symptoms, but we usually look for physical problems as the cause of symptoms first.

So, at this point, it would be reasonable to check your blood pressure and pulse once your monitor is found and to try either meclizine or dimenhydrinate to see if it helps ease symptoms. If the symptoms persist, then further evaluation with an ultrasound would be appropriate.

If I can provide any further information, please let me know.
Customer: replied 1 year ago.
I've got figures now for you. Lying down, 151, 76, 80. Sitting, 153,88,78 aand standing 139,83 85
Expert:  Dr. D. Love replied 1 year ago.
Although there is a drop when changing to the standing position, it does not reach the threshold of 20 points noted above, so this is not a concern.

It would be appropriate to next try the meclizine or dimenhydrinate.
Customer: replied 1 year ago.
Thank you very much for your help
Expert:  Dr. D. Love replied 1 year ago.
You are most welcome.

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