dizziness that comes and goes

Overview

Dizziness that comes and goes means you have episodes of feeling dizzy, lightheaded, or off-balance that start and stop. These episodes can last seconds, minutes, or hours, and may happen without warning.

Yes, dizziness that comes and goes is very common. Many people experience it at some point in their lives.

It can affect people of all ages but is more common in older adults. Children may also experience it, especially during growth spurts or ear infections.

Symptoms

Common symptoms

• Feeling faint or lightheaded
• A spinning sensation (vertigo)
• Feeling unsteady or like you might fall
• Nausea or vomiting
• Blurred vision

Symptoms in children

• Describing themselves as 'wobbly' or 'off-balance'
• Nausea and vomiting
• Clinging to furniture or people for support
• Reluctance to move or play

Symptoms in older adults

• More frequent falls or near-falls
• Dizziness when standing up (often due to blood pressure changes)
• Hearing loss or ringing in the ears
• Unsteadiness that makes daily tasks harder

Causes

Main causes

• Benign paroxysmal positional vertigo (BPPV) – tiny crystals in the inner ear move out of place, causing brief spinning episodes
• Orthostatic hypotension – a sudden drop in blood pressure when you stand up
• Low blood sugar (hypoglycemia) – common in people with diabetes or after skipping meals
• Anxiety or panic attacks – can cause lightheadedness and a sense of unreality
• Migraine – some migraines cause dizziness without headache

Risk factors

• Being over age 65
• Taking medications that lower blood pressure or cause dizziness
• Dehydration or not drinking enough fluids
• A history of inner ear problems or head injuries
• Conditions like diabetes, heart disease, or anxiety

When to see a doctor

See a doctor urgently if:

• If dizziness leads to a fall or injury
• If you also have chest pain, palpitations, or shortness of breath
• If dizziness comes with new weakness, numbness, or trouble speaking

Book a routine appointment if:

• If dizziness happens repeatedly and affects your daily life
• If you are concerned about what might be causing it
• If dizziness started after a new medication or change in dose

Diagnosis

A doctor will take a careful history of your dizziness – when it happens, how long it lasts, and what triggers it. They will also do a physical exam, including checking your blood pressure lying down and standing up.

Tests that may be done

• Balance tests (like standing with eyes closed)
• Hearing tests if inner ear problems are suspected
• Blood tests to check for anaemia, diabetes, or thyroid problems
• Electrocardiogram (ECG) to check heart rhythm
• Imaging such as an MRI or CT scan – only if there are concerning symptoms

What to expect at your appointment

The doctor will ask you to describe your dizziness in your own words. They may move your head gently to see if that triggers the sensation. The process is painless, and you can ask questions at any time.

Treatment

Treatment depends on the cause of your dizziness. Many cases improve with simple self-care, and specific therapies can help when the cause is known.

Self-care at home

• Sit or lie down as soon as you feel dizzy
• Avoid sudden head movements or getting up too quickly
• Stay well hydrated – drink water regularly
• Use handrails on stairs and keep pathways clear at home

Medical treatments

If the cause is BPPV, a doctor or physiotherapist can perform a series of guided head movements called the Epley manoeuvre. Vestibular rehabilitation therapy – a type of balance retraining – can help with long-standing dizziness. Medications may be used short‑term to control nausea or vertigo, but they are not a cure. Your doctor will recommend the best approach for your specific situation.

When is surgery considered?

Surgery is rarely needed. In very severe cases of inner ear disorders that do not respond to other treatments, a procedure may be considered. This is only done after careful discussion with a specialist.

Living with this condition

Dizziness can be unsettling, but most people learn to manage it. Keep a diary of your episodes – note when they happen and what you were doing. This can help you spot and avoid triggers.

Lifestyle tips

• Stand up slowly from sitting or lying down
• Avoid quick head turns, especially when bending over
• Make your home safer – secure rugs, add grab bars in the bathroom
• Move carefully in low light

Diet and exercise

Eat regular meals to keep your blood sugar steady. Drink plenty of water. Gentle exercises like walking, tai chi, or yoga can improve your balance over time. Avoid activities that involve spinning or rapid changes in head position until you feel more stable.

Mental health and emotional wellbeing

Dizziness can make you feel anxious or worried about when the next episode will happen. This anxiety can actually make dizziness worse. Talking to a counsellor or therapist can help you break this cycle. Relaxation techniques such as deep breathing may also help.

Prevention

Not all dizziness can be prevented, but you can reduce your risk. Stay hydrated, eat regularly, and move slowly when changing positions. If you know your triggers – like turning over in bed – you can learn to do them more gently.

Complications

If left untreated

• Falls and related injuries, especially in older adults
• Chronic imbalance that limits your activities
• Anxiety or fear of dizziness that leads to avoiding daily life

Long-term outlook

The outlook is generally good. Most causes of dizziness that comes and go are treatable. With the right diagnosis and care, the vast majority of people see improvement. Even when a complete cure isn’t possible, you can learn to manage the symptoms and live well.

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