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Help profile picture
Help
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from Singapore asked a question

Could my dizziness be due to excessive exercise and diet changes?

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Health & Fitness Sport Medicine Neurology

I'm a 17 year old female. I woke up today with dizziness and slight nausea. The feeling is more apparent when I get up quickly from bed - I find myself needing to sit back down so the dizziness can go away. I changed my diet completely 1 week ago (my diet is now mainly high fibre bread with peanut butter and nuts), and started exercising so I can lose weight and be in the healthy BMI range. My period also started 3 days ago. I suspect it may be the period and blood loss that makes my situation worse. I'm scared that this may be a sign of low blood pressure, or something worse since the dizziness won't go away at all. Is there something I need to change? How will I know if this dizziness requires me to see the doctor urgently?

DOCTOR’S ANSWER (3)

Dear Help,

Sorry to hear about your symptoms - I can see that my colleagues, Drs Gan and Nandakumar, have both added quite a lot of information already., but perhaps I could add something from a Sports Medicine perspective?

Usually, its advisable to make changes in small steps - either with your physical activity levels first or your diet.  Doing too much too soon might well be a significant contributor to your symptoms - in addition your current menstrual period.  Speaking of your periods, if you do endure heavy, prolonged and painful menses - as with many young women I have met in my career - it might be worth seeking advice from a gynecologist and consider something like to contraceptive pill to regulate your menstrual cycle.  This in turn might stem the losses each month and hence help your symptoms.

I believe in an earlier post I discussed about diet and how this can affect liver function, and there was another about how you can try to bulk up

While I know both are not immediately relevant to your symptoms, there is some information about healthy eating that I gleaned from my Sports Dietician colleague.  Essentially, our bodies need a balance of nutrients and not all calories are equal.  Some come from more healthy sources than others.  Perhaps in your case it would be good to visit a dietician with an interest in sports/physical activity and discuss your goals. 

Equally, if you would like more advice about exercising safely and perhaps considering potential pitfalls before they happen, might I suggest a Pre-Participation Screening?  This involves a thorough medical assessment, various investigations and a discussion on your health/fitness goals.  It might be a good starting point before you progress further!

Hope things go well.

BW

Dr Dinesh

Consult Doctor
0 432 views 0 Doctors agree 21 Mar 2018

Dear Help,

Thank you for your question. Dizziness is a common term used to describe a whole range of symtoms including lightheadedness, vertigo, imbalance, spaced out and drowsiness. It is important for you to describe the exact nature of your symptom to your doctor as different types of dizziness have different causes. It is beyond this Q&A section to cover all possible causes of giddiness.

From the history provided, it sounds like your dizziness is triggered by a sudden change in body position ("getting up quickly from bed"). The two most common cause of positional giddiness are:

Benign Paroxysmal Positional Vertigo (BPPV) - This is due to calcium depositis or "stones" in the inner ear balance system. When the head or body moves, the "stones" will move and trigger the sensors in the balance system, giving the brain a sensation of the room spinning (vertigo) even though the body or head movement has stopped. It typically lasts a few minutes and may be accompanied by nausea and vomiting. Diagnosis can usually be achieved by a combination of suggestive clinical history and a clinical test called a Dix Hallpike test. The treatment consist of a series of head and body turnings that is done in the clinic (known as an Epley's manoeuvre). This is commonly done by an ENT Specialist.

2. Postural hypotension - This is a condition in which your body's blood pressure drops when you get up from a lying or sitting position. Again, there are many potential causes for this and from the description of your condition, dehydration (e.g from intense exercise and lack of hydration) or low blood level (medically known as anaemia from heavy bleeding from your recent menstruation) may be  possible reasons for this. Your General Practitioner can check your blood pressure and blood level (Hemoglobin level) to determine if this is the cause of your giddiness.

Since you have amended your diet recently, it is also important to ensure that your nutrition throughout the day is adequate and you are not suffering from low blood sugar level which can also cause dizziness. 

Your should visit a Family Physician/General Practitioner for a start for an assessment. In the meantime, I would suggest moderating the intensity of your exercise and the change in your diet so your body can adapt better.

Hope this helps and all the best!

Consult Doctor
0 500 views 0 Doctors agree 17 Mar 2018

Hi, as suggested by Dr Gan below there are many reasons for your symptoms, but the likely cause in your situation is either related to your recent change in diet (drastic drop in calories even if intentional) and/or the onset of menstruation (if heavy blood loss)

Occasionally, there are uncommon types of "dizziness" which can be caused by posture as your internal "thermostat" for blood pressure maybe a bit more sensitive . This causes postural hypotension (i.e a fancy name for "low BP when you stand up" ) but this may need formal testing with tilt-table test which can be done either by general physicians or cardiologists.

If on returning to a reasonable diet (i.e. please seek help of a professional dietician or family physician who knows you well) and once the periods have settled if you continue to have these symptoms please do seek medical help. 

In the interim do take care especially on arising from a sitting or lying posture - do get up slowly and with support and give yourself a minute or two before movement. drink plenty of water especially on a hot humid day.

But it is likely that a visit to your family physician will sort this out for you and a cardiologist visit is less likely to be required.

Wishing you good health!

Consult Doctor
0 491 views 0 Doctors agree 17 Mar 2018
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