Some Causes and Features of Dizziness or Light-Headedness When Standing Up
Cause | Common Features* | Tests |
|---|---|---|
Central nervous system† disorders | ||
Muscle stiffness Slow, shaky movements Loss of coordination and/or balance Incontinence or inability to urinate | A doctor's examination Sometimes MRI | |
Muscle stiffness Tremor Slow, shaky movements and a shuffling gait Difficulty walking | Only a doctor's examination | |
Strokes if several have occurred | In people who are known to have had strokes | Only a doctor's examination |
Spinal cord disorders | ||
Syphilis that affects the spinal cord (tabes dorsalis) | Intense, stabbing pains in the legs that come and go Unsteady walking Decreased sensation in the legs and numbness or tingling | Blood tests and sometimes a spinal tap (to obtain cerebrospinal fluid) to check for syphilis |
Tumors | Back pain Muscle weakness and decreased sensation in the legs | MRI |
Peripheral nerve† disorders | ||
Numbness, tingling, and weakness | Biopsy | |
Nerve damage caused by diabetes, excessive alcohol use, or nutritional deficiencies | Often burning pain and/or numbness in the feet and hands Sometimes weakness Usually in people who are known to have a disorder that can cause nerve damage | Nerve conduction testing and electromyography |
Sometimes decreased sweating and intolerance of heat Constipation or loss of control over bowel movements (fecal incontinence) Difficulty emptying the bladder | A doctor's examination Blood tests | |
A decreased volume of blood (hypovolemia) | ||
Thirst, decreased urination, and sometimes confusion | Only a doctor's examination | |
Excessive loss of blood | Often in people who have had an injury or surgery Blood in stool or black, tarry stool | A doctor's examination, including testing stool for blood A complete blood count |
Weakness and fatigue | Blood tests | |
Heart and blood vessel disorders | ||
Sometimes chest pain Palpitations (awareness of heart beats) Fatigue Shortness of breath Symptoms often occur suddenly | ||
Chronic venous insufficiency (causing blood to pool in the legs) | Long-lasting swelling in one or both legs Chronic mild discomfort or aching in the ankles or legs but no pain Sometimes reddish brown, leathery areas on the skin and shallow sores, usually on the lower legs Often varicose veins | A doctor's examination |
Shortness of breath and fatigue | A doctor's examination Usually echocardiography (ultrasound study of the heart) | |
Heart attack (myocardial infarction) | Chest pain or pressure Shortness of breath or fatigue Sometimes in people who are known to have had a recent heart attack | ECG and blood tests to measure substances that indicate heart damage (cardiac biomarkers) |
Shortness of breath Often chest pain or pressure | Echocardiography | |
High levels of the hormone aldosterone (hyperaldosteronism) or catecholamines (pheochromocytoma), usually caused by a tumor in the adrenal gland) | Weakness, tingling, muscle spasms, high blood pressure, and headache | Blood tests |
Drugs | ||
In people known to use one of these medications | A doctor's examination Sometimes stopping the medication to see if symptoms go away | |
Medications that affect the central nervous system: Antipsychotics (particularly phenothiazines), monoamine oxidase inhibitors, or tricyclic or tetracyclic antidepressants | In people known to use one of these medications | Only a doctor's examination Sometimes stopping the medication to see if symptoms go away |
Sedatives: Alcohol, opioids, or barbiturates | In people known to use one of these substances | Only a doctor's examination Sometimes stopping the medication to see if symptoms go away |
In people known to use one of these medications | Only a doctor's examination Sometimes stopping the medication to see if symptoms go away | |
Other problems | ||
Age-related changes in blood pressure regulation | In older adults No other symptoms | Only a doctor's examination |
Bed rest if prolonged | In people who have been at bed rest for a long time | Only a doctor's examination |
A low level of potassium in the blood (hypokalemia) | Muscle weakness and cramping Pins-and-needles sensation Often in people who take certain diuretics | Blood tests |
* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. | ||
† The central nervous system includes the brain and spinal cord. The peripheral nervous system includes the nerves outside the brain and spinal cord. | ||
CT = computed tomography; ECG = electrocardiography; MRI = magnetic resonance imaging. | ||