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Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Medical
Satisfied Customers: 5300
Experience:  American Board Certified Neurologist, Internal Medicine
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Light-headed when standing. BP ok but on adderall. BP normal

Customer Question

Light-headed when standing. BP ok but on adderall.
JA: Is this consistent, or is there some fluctuation in blood pressure?
Customer: BP normal - at pharmacy machines
JA: Anything else in your medical history you think the doctor should know?
Customer: no. otherwise normal, I think.
Submitted: 5 months ago.
Category: Medical
Expert:  Dr Subbanna MD replied 5 months ago.

Hi, I am an American Board Certified Neurologist with vast experience in diagnosing and treating neurological & all health conditions and I am very glad to help you with your health concerns.

For how long are you having the lightheadness?

I am double checking with you, are you experiencing the fainting or woozy type lightheadedness (dizziness), or is it the spinning type dizziness (which is called as vertigo)?

Was the blood pressure checked first in lying down position and then few minutes later in standing position?

Have you had any blood tests or any other investigations done recently (after this symptom started)?

Best Regards!

Expert:  Dr Subbanna MD replied 5 months ago.

Hi, have you received the questions I have posted above? I hope you are not encountering any technical glitches to access this site properly. If you require more time it is perfectly fine. Please take your time and reply to the above posted questions when your time permits & when you can, and I will get back to you at the earliest with my diagnosis & recommendations related to your concerns about lightheaded feeling when standing.

Best Regards!

Expert:  Dr Subbanna MD replied 5 months ago.

Hi, I had earlier asked few questions above so that I can gather additional information related to your health concerns about lightheaded feeling when standing. It is possible you are encountering some technical glitches to access this site properly or you may be busy now and not in a position to reply, so what I will do is post an initial answer here based on the amount of information I have received through your initial question here, please go through it when your time permits & when you can, and please get back to me if you want to discuss this further.

I assume you meant the fainting type or woozy type of lightheadedness but I will include my discussion here for the other type too (the vertigo type too).

A) This discussion is for the fainting or woozy type of lightheadedness;

I had earlier asked about the blood pressure in both lying and standing position because there is a condition called as postural hypotension which is associated with drop in blood pressure when one changes position from lying down to standing position. So this condition presents with lightheaded feeling when standing. To diagnose this condition the blood pressure need to be measured initially in lying down position and then in standing position within about 3 minutes or so. If there is significant drop in blood pressure (at least 20 mm hg of systolic and at least 10 mm hg of diastolic blood pressure) then it is considered as postural hypotension

If postural hypotension is confirmed then you will require additional investigations to find out what is causing the postural hypotension.

There are various other causes too for lightheadness as mentioned below;

Anemia

Electrolyte disturbances

Hypoglycaemia

Dehydration

Heart diseases

Autonomic neuropathy etc

If any of the above possibilities have not already been ruled out then they need tobe ruled out because all these above conditions can cause lightheadedness. You will require a thorough evaluation & appropriate investigations by your doctors to explore all the above possibilities and then treated appropriately depending upon the final diagnosis. In the meantime you may try the following to help symptomatically with the lightheadednes;

Avoiding abrupt standing

Making sure you are near to supportive structures when you are standing up

If lightheaeded ness occurs to take a comfortable position as quickly as possible

Keeping well hydrated

Daily exercises especially involving the legs because leg exercises help in return of the blood to the heart so that there is more blood to circulate

Using compressive stocking to the legs or using abdominal binders etc and these also help in improving the return of the blood to the heart and increasing blood circulation and this can help in preventing or getting relief from attacks of lightheadedness

Symptomatically some patients may also benefit from medications like fluoxetine or propranolol etc but these kinds of medications are used only after a thorough evaluation and investigations by your doctors and the best course of treatment will be decided based on what the investigations show.

B) Regarding the other type of dizziness (the vertigo type or spinning type);

This is most often caused by inner ear dysfunction or sometimes there can be neurological possibilities too. For ruling out these possibilities you will require a brain scan like MRI scan of the brain and also certain ear related tests and then treated appropriately depending upon the test results. I had mentioned above the treatments for the lightheadedness (the fainting type) and some of them are applicable for this symptom too – like for example avoiding abrupt standing etc. And you may also try oral Meclizine pill which can help with vertigo type of dizziness. And if inner ear condition is diagnosed then a special kind of exercise or manuever called as Epley manuever can help with vertigo.

To summarize once again;

First we need to differentiate whether your symptom is the woozy or fainting feeling type of dizziness, or whether it is the spinning or vertigo type of dizziness

Either of these above symptoms has many causes and a thorough examination in the clinic followed by certain relevant investigations will help in identifying the precise cause for the symptom you are having and once the precise diagnosis is made it will be treated appropriately

And in the meantime you may also consider the additional recommendations provided above depending upon which type of dizziness you are having.

Please go through the above answer which is based on what information I had gathered from your original question. If you want to discuss this further or if you need any additional clarifications please get back to me, and also please try to provide me the additional information I had requested earlier through the questions I had posted above and I am available here for further discussions until you are satisfied. And please click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. If you have follow-up or additional questions you can ask them after the rating too.

Best Regards!

Expert:  Dr Subbanna MD replied 5 months ago.

Hi, have you had a chance to go through the answer I had posted above earlier? Do you have any additional questions? Do you want to discuss this health situation further? Please let me know and I am available here.

Best Regards!