Tag Archives: dizziness

Frequently feel dizzy? It could be vertigo.

Dr Pawan Ojha gives the lowdown on the disease of the vestibular system.

Do you often get a spinning feeling while lying down on your bed or when you are still? Often do you experience dizziness that disrupts your balance? This could be a sign of vertigo. Dizziness might imply vertigo, fainting, poor body balance, or even fits. Vertigo is a type of dizziness where you feel like spinning. These feelings may last from a few seconds to days and often worsen with movement.

WHAT CAUSES DIZZINESS? Vertigo is commonly caused by disease of the vestibular system. The vestibular system inside the inner ear helps in sensing our head position in space relative to the body, and works in an integrated manner with the brain to maintain body position. Vertigo can also result from diseases of the vestibular nerve or parts of the brain that deal with body balance.

IS VERTIGO A BIG PROBLEM? The diseases related to the inner ear and its nerve supply are generally considered less worrisome. ‘Benign Positional Vertigo’ often causes the most severe vertigo but can be treated easily by experts. It occurs when the calcium deposits of Otolith organs of the inner ear fall in the inner ear canals to cause short episodes of severe vertigo upon head movement, such as while lying down or getting up from the bed. Another important cause of vertigo is ‘Vestibular Neuritis’ which occurs due to viral infection or autoimmune disease of vestibular nerve, where vertigo, nausea, or vomiting can last up to several days. Meniere’s Disease is caused by a build-up of fluid in the inner ear tubes, causing episodic vertigo with ringing in the ears and hearing loss. The exact cause is unclear, a viral infection, an autoimmune reaction or a genetic component coule be the trigger. Many people who have migraine often complain of vertigo with or without headache, that is called ‘Vestibular Migraine.’ A neurologist can often easily identify and treat the underlying migraine to relieve vertigo.

WHAT’S THE MOST WORRISOME KIND OF VERTIGO? Vertigo that is caused by brain disease should be considered worrisome and treated on an urgent basis. Stroke is an important and serious condition causing dizziness. In a population-based study of more than 1,600 patients, 3.2% of those presenting to an emergency department with dizziness were diagnosed with a Stroke. Apart form this, brain infection, Multiple Sclerosis, hypothyroidism and other biochemical disturbances can cause vertigo even in the absence of fever.

So, one should not delay consulting a doctor as soon as one feels sudden dizziness. Warning signs for a serious cause of vertigo include severe headache, persistent vomiting and imbalance, double vision, vision problems, sudden hearing loss, or early signs of brain stroke (weakness or numbness in arm or leg , face drooping to one side, trouble while speaking or swallowing). People who are older than 60 years, with diabetes, hypertension, smoking and history of heart disease or brain stroke, should be extra careful. Doctors might require an urgent MRI of the brain to diagnose the brain problem and treat it in time.

TREATMENTS ARE AVAILABLE: Medications prescribed to relieve Vertigo include betahistine, antihistamines and anti-emetics. Benign Paroxysmal Positional Vertigo (BPPV) can be treated by physical repositioning procedures performed by expert doctors. Video-Nystagmography equipment might need to be used for complex cases. Special precautions in vertigo are limiting sodium intake, avoiding caffeine, chocolate, alcohol, and tobacco. If diagnosed in time, brain stroke can be effeciently treated with clot busters and/or interventional treatment. If vertigo is caused other serious problem, such as brain tumor or injury to the brain or neck, surgical treatment might be necessary to rectify those problems. Vestibular rehabilitation in the hands of expert physiotherapists forms an essential part of vertigo treatment. With correct diagnosis and treatment, most patients can be relieved of their vertigo effectively.

(Dr Pawan Ojha is Senior Neurologist-Hiranandani Hospital, Vashi-A Fortis network Hospital)

Things you should do to manage your PCOS/PCOD

Statistics state that one in every five women in India suffers from Polycystic Ovarian Syndrome or Polycystic Ovarian Disease and cannot live a healthy life. PCOS and PCOD bring along complications that deteriorate the quality of life.

New Delhi, March 5, 2021: Ever since Lata entered puberty, she has had difficulty in managing her weight. She craved carbohydrates and even skipped dinner, but her weight increased at a faster rate month over months. Apart from her weight problem, she faced acne and Hirsutism issues (male-pattern facial hair growth). She also has visited her primary care physician on several occasions, complaining of dizziness, feeling shaky, and irregular menses. Her doctor started her on birth control pills to regulate her periods but in vain. Later, she was detected with Hypoglycemia; her physician and her family encouraged her to follow a strict diet and exercise regimen.

Lata is now married for two years and plans to begin a family but cannot conceive. She continues to struggle with severe Hypoglycemia, has elevated serum triglyceride levels and feels miserable. However, recently when Lata visited a reproductive Endocrinologist, she was diagnosed with Polycystic Ovarian Syndrome (PCOS).

Like Lata, many young women suffer from Polycystic Ovarian Syndrome (PCOS) or Polycystic Ovarian Disease (PCOD) and cannot live a healthy life. These conditions bring along complications that deteriorate the quality of life among young women. Statistics state that one in every five women in India suffers from PCOS.

DIFFERENCE BETWEEN PCOS AND PCOD: In women with PCOS, their ovaries produce higher levels of androgen than usual, which interferes with the development and release of the eggs. Some of the eggs develop into cysts – which are the little sacs filled with liquid. Instead of being released during ovulation, these cysts build up in the ovaries and even get enlarged. PCOD (Polycystic Ovarian Disease) is a condition where the ovaries release many immature or partially mature eggs, which eventually turn into cysts. Some common symptoms are abdominal weight gain, irregular periods, male pattern hair loss, and infertility. In this condition, the ovaries usually become enlarged and secrete large amounts of androgens that can cause havoc with a woman’s fertility & her body.

Symptoms of PCOS/PCOD.

EFFECTIVE WAYS TO MANAGE PCOD AND PCOS: Obesity is recognized as an important contributory factor in these conditions. So, diet control, exercise, and monitored weight loss are the first line of treatment. Even 10% weight loss helps quite a lot for hormone imbalance management and in bringing body mass index <25. This also improves menstrual disorders, infertility, insulin resistance, Hirsutism, and acne.

Hormonal management with combined Oral Contraceptive Pills (OCP) is effective in reducing Luteinizing Hormone and Testosterone Hormone. PCOD/ PCOS is not a disease; it is a hormonal imbalance where male hormones increase, so we can control these hormonal changes with OCPs. Insulin resistance is associated with Diabetes Mellitus, central obesity, Dyslipidemia and Hypertension, which can be managed.

Hormonal changes cause abnormal uterine bleeding, prolonged menses, and anovulation (absence of ovulation), for Endometrial Hyperplasia, sometimes endometrial biopsy has to be done. For young females presented with infertility, ovulation induction is done with hormones. Sometimes if the person is not responding to medicine, then Laparoscopic Ovarian Drilling is done. There are rare cases where if weight loss is not possible with diet and exercise, then bariatric surgery is prescribed. Anti-androgen medicines are used for cosmetic purposes in Hirsutism patients. Laser is also used for hair removal.

So, eating the right foods and avoiding certain carbohydrates & fat helps manage the symptoms. Try to consume whole foods which are free from sugar, hormones and preservatives; fruits, vegetables whole grains and legumes should be preferred. Moreover, plant-based proteins and unprocessed high carbohydrates can improve insulin sensitivity. Try to consume more fibre in your diet, reduce the consumption of coffee. Soy, Turmeric, Cinnamon, Vitamin-D3, Calcium, Zinc, Primosa oil, and Cod liver oil should be added to your diet.

(Text by Dr Sushma Tomar, Consultant Obstetrics and Gynecology Fortis Hospital, Kalyan; Images by Soleha Shaikh, Mumbai-based nutritionist and certified diabetes educator, and calligraphy artist.)