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Suggest Remedy For Dizziness And Anxiety
Question: Hi.
I have been suffering from some form of anxiety for last 6 months for which i am taking therapy (CBT) and my anxiety is pretty much controlled . The only physical symptom i have most of the days , or almost all days is dizziness . Dizziness in my
case is more of a feeling out of space kind of feeling . I do not feel spinning sensations at all . I also get a lot heavy headed sometimes.
Also during exercise too i feel dizzy . I get heart palpitations too but they are very rare (limited to 2 - 3 times a week)
I am 28 , i have a resting heart rate of 70 , my blood pressure is normal , but i am obese and my cholesterol levels are a bit high just touching maximum defined lab ranges . I had a stress echo and TMT done which was normal , and my ECG was normal too .
I was a regular smoker earlier but for past 6 months i have quit both smoking and drinking ,
But the dizziness i have on daily basis is something which gives me a lot of stress . I have got almost all the tests done including Brain MRI which came normal too .
Please let me know on whether should i undergo any further tests for heart (like angiography etc) and see a cardiologist or should i keep my focus to treatment of anxiety only .
I have been suffering from some form of anxiety for last 6 months for which i am taking therapy (CBT) and my anxiety is pretty much controlled . The only physical symptom i have most of the days , or almost all days is dizziness . Dizziness in my
case is more of a feeling out of space kind of feeling . I do not feel spinning sensations at all . I also get a lot heavy headed sometimes.
Also during exercise too i feel dizzy . I get heart palpitations too but they are very rare (limited to 2 - 3 times a week)
I am 28 , i have a resting heart rate of 70 , my blood pressure is normal , but i am obese and my cholesterol levels are a bit high just touching maximum defined lab ranges . I had a stress echo and TMT done which was normal , and my ECG was normal too .
I was a regular smoker earlier but for past 6 months i have quit both smoking and drinking ,
But the dizziness i have on daily basis is something which gives me a lot of stress . I have got almost all the tests done including Brain MRI which came normal too .
Please let me know on whether should i undergo any further tests for heart (like angiography etc) and see a cardiologist or should i keep my focus to treatment of anxiety only .
Brief Answer:
No need to consult cardiologist
Detailed Answer:
Hi XXXXXXX
Thanks for writing to us again.
I read your detail.You have already undergone almost all or say more than the required investigations and all came normal.There is not at all any need for further investigations.
Your main concern is dizziness.It is likely more due to psychological disturbance as you are already on treatment for anxiety disorder or another thing is cochlear(inner ear)disturbance or smoking withdrawal.
You should ask your psychiatrist to check for dizziness due to ear cause or to refer to some ENT surgeon for evaluation and rule out the cause of dizziness related to inner ear problem.
One simple thing you can take cinnarizine / betahistine two times a day and if dizziness improves cause might be inner ear related else psychiatric approach is needed.
It is really good that you are taking CBT.You are not taking any medicine as per narration, so I guess low dose benzodiazepine can be used if dizziness is due to psychological reasons.Simultaneous CBT would also help.
And last thing smoking withdrawal.You have mentioned that you have stopped smoking since 6 months as well as anxiety and dizziness are also since 6 moths.This make me to think about this aspect.Ask your psychiatrist for detail evaluation. In this case also benzodiazepines as well as Bupropion will be helpful.
And considering your age and from all reports, I am sure that you need not to go for any cardiac check up or consultation.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
No need to consult cardiologist
Detailed Answer:
Hi XXXXXXX
Thanks for writing to us again.
I read your detail.You have already undergone almost all or say more than the required investigations and all came normal.There is not at all any need for further investigations.
Your main concern is dizziness.It is likely more due to psychological disturbance as you are already on treatment for anxiety disorder or another thing is cochlear(inner ear)disturbance or smoking withdrawal.
You should ask your psychiatrist to check for dizziness due to ear cause or to refer to some ENT surgeon for evaluation and rule out the cause of dizziness related to inner ear problem.
One simple thing you can take cinnarizine / betahistine two times a day and if dizziness improves cause might be inner ear related else psychiatric approach is needed.
It is really good that you are taking CBT.You are not taking any medicine as per narration, so I guess low dose benzodiazepine can be used if dizziness is due to psychological reasons.Simultaneous CBT would also help.
And last thing smoking withdrawal.You have mentioned that you have stopped smoking since 6 months as well as anxiety and dizziness are also since 6 moths.This make me to think about this aspect.Ask your psychiatrist for detail evaluation. In this case also benzodiazepines as well as Bupropion will be helpful.
And considering your age and from all reports, I am sure that you need not to go for any cardiac check up or consultation.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thanks for your response sir , i have already seen an ENT specialist and he has ruled out the ear problems . Actually because of my high cholestrol levels and my obesity(my wt is 100 kg) , i am worried about my health these days.
Since doing exercise causes dizziness to me, so i do not know how to control my weight without exercising . I have not taken any medication (benzo) for last 5 months (though i took benzos for initial 1 months) .
Also i have been working hard on my CBT and in last few months i have succesfully changed a Job and i am quite a functioning person . The only thing which worries me every now and then is my health .
Can u please let me know how to contain these health worries , and why do i get dizziness/heavy headed on exercise . One more thing . On my Brain MRI it is written that
"Type 1 loop of anterior inferior cerebellar artery is seen coursing over 7th and 8th nerve without distorting the nerve or entering the internal auditory canal "
Could this be the cause .Please let me know if need to see any specialist.
Since doing exercise causes dizziness to me, so i do not know how to control my weight without exercising . I have not taken any medication (benzo) for last 5 months (though i took benzos for initial 1 months) .
Also i have been working hard on my CBT and in last few months i have succesfully changed a Job and i am quite a functioning person . The only thing which worries me every now and then is my health .
Can u please let me know how to contain these health worries , and why do i get dizziness/heavy headed on exercise . One more thing . On my Brain MRI it is written that
"Type 1 loop of anterior inferior cerebellar artery is seen coursing over 7th and 8th nerve without distorting the nerve or entering the internal auditory canal "
Could this be the cause .Please let me know if need to see any specialist.
Brief Answer:
Weight Reduction
Detailed Answer:
Hello,
Thanks for info.
Your concern regarding health issues can be dealt with CBT only. However your concern is not at all absolutely wrong too. You are obese and obesity is the mother of many diseases. So you should take care and try to reduce the weight.
Simple logic behind the weight reduction is calorie deficit. It can be created either by burning more calorie or taking less calorie. There are many psychological factors with hormonal factors responsible for obesity. This can be discussed in CBT and you should follow conclusion according to that discussion. Because of 100 kg weight when you do exercise, you need calorie from your fat and conversion of fat to glucose leads to metabolic changes which may be responsible for your dizziness.
You should consult dietitian and physiotherapist respectively for what diet you should take according to your body physique and what type of exercise to begin with which would not make you dizzy.
You should decide your goal for week and months and years to reduce weight accordingly and it is part of CBT.
The MRI report you mentioned suggest that there is no pressure on nerves though there is loop and it has no relation with your dizziness. But according to me you should take opinion of neurophysician once for that MRI report.
Hope this will help you, I will be glad to answer further.
Regards,
Dr.Chintan Solanki
Weight Reduction
Detailed Answer:
Hello,
Thanks for info.
Your concern regarding health issues can be dealt with CBT only. However your concern is not at all absolutely wrong too. You are obese and obesity is the mother of many diseases. So you should take care and try to reduce the weight.
Simple logic behind the weight reduction is calorie deficit. It can be created either by burning more calorie or taking less calorie. There are many psychological factors with hormonal factors responsible for obesity. This can be discussed in CBT and you should follow conclusion according to that discussion. Because of 100 kg weight when you do exercise, you need calorie from your fat and conversion of fat to glucose leads to metabolic changes which may be responsible for your dizziness.
You should consult dietitian and physiotherapist respectively for what diet you should take according to your body physique and what type of exercise to begin with which would not make you dizzy.
You should decide your goal for week and months and years to reduce weight accordingly and it is part of CBT.
The MRI report you mentioned suggest that there is no pressure on nerves though there is loop and it has no relation with your dizziness. But according to me you should take opinion of neurophysician once for that MRI report.
Hope this will help you, I will be glad to answer further.
Regards,
Dr.Chintan Solanki
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
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