Dizziness and vertigo – causes and when to worry
Feeling faint, off-balance or as if the room is spinning are different problems with different causes. How to tell them apart, and the signs that mean call an ambulance.
Three different things people call dizziness
Describing it precisely is most of the diagnosis, so it is worth working out which one you mean before you get to the clinic.
- Spinning (vertigo): the room moves, or you do. Usually an inner-ear problem, often triggered by turning your head or rolling over in bed.
- Feeling faint or light-headed: as if you might pass out, often on standing. Usually about blood pressure, dehydration, blood sugar, anaemia or a medicine.
- Unsteadiness: no spinning, but your balance is off when walking. More common with age, with poor vision, with nerve problems in the feet, and with sedating medicines.
Common causes worth checking
- Standing up too fast, especially on blood-pressure or prostate medicines, or when dehydrated.
- Inner-ear conditions, which can produce intense spinning that is frightening but not dangerous.
- Low blood sugar in someone on diabetes treatment.
- Anaemia, which also causes tiredness and breathlessness.
- Medicines and combinations of medicines, including sedatives, some antidepressants and several blood-pressure tablets together.
- Alcohol, dehydration, heat, and skipping meals.
What helps
- Sit or lie down as soon as it starts. Most injuries from dizziness are from the fall, not the dizziness.
- Stand up in stages: sit on the edge of the bed for a moment, then stand.
- Drink fluids through the day, especially in heat.
- Keep the path from bed to toilet clear and lit at night.
- Do not drive while this is happening, and do not work at height or with machinery.
Medicines such as cyclizine (Valoid) can dull the nausea of severe vertigo for a short time. They treat the symptom, not the cause, and they cause drowsiness, so they are not something to keep taking without advice.
Dizziness that is an emergency
- 10177Emergency Medical Services
- 10111South African Police Service
- 112Universal Emergency (mobile)
- 0800 029 999SADAG Mental Health Crisis Line
- 0861 554 911Poisons Information Helpline
- Also arrange a clinic visit for dizziness that keeps returning, comes with new hearing loss or ringing, follows a new medicine, or has caused a fall.
Common questions
- What is the difference between dizziness and vertigo?
- Vertigo is a false sense of movement — the room spins — and usually comes from the inner ear. Dizziness more often means feeling faint or unsteady, which points to blood pressure, blood sugar, anaemia or medicines instead.
- When is dizziness a sign of a stroke?
- When it comes with a sudden severe headache, one-sided weakness or numbness, a drooping face, slurred speech, double vision or difficulty walking. Treat that as an emergency and call an ambulance.
- Can my tablets be making me dizzy?
- Yes, often. Blood-pressure tablets, prostate medicines, sedatives and several medicines taken together are common causes. Take your full list, including over-the-counter items, to the clinic rather than stopping anything yourself.
Sources
- Adult Primary Care guide: symptom-based integrated approach to the adult in primary careNational Department of Health, South Africa
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Medicines Online Directory and approved patient information leafletsSouth African Health Products Regulatory Authority
Last reviewed 11 August 2026.