Dehydration, certain medicines, a sudden drop in blood pressure and getting up too quickly may all cause dizziness, so any of them could be behind a room that goes gray as you stand up. When it starts, sit or lie down right away, and if you are lying down, raise your feet above the level of your heart. Before you ring your own doctor's office about it, note what you have been drinking, every tablet you take and anything else that came with each gray-out, because your doctor will ask about all three.
Why the room goes gray for a few seconds
In those seconds your blood pressure may be falling as you shift from lying down to standing, and orthostatic hypotension, the name for that fall, usually lasts only a few seconds or minutes. When blood pressure is below normal, the heart, the brain and other parts of the body may not get enough blood.
Symptoms of low blood pressure may include blurry vision, confusion, dizziness, fainting, lightheadedness, nausea or vomiting, sleepiness and weakness. Describe the gray-out to your doctor the way it happened, and say which of those came with it. Fainting or sudden confusion is different: either one needs an emergency department or 911, not a phone call to the office.
Dizziness and vertigo are not the same thing, though they are often mixed up. Dizziness can make you feel lightheaded, woozy or unsteady on your feet, and vertigo is the feeling that you or the room is spinning even when nothing is moving. Either may get worse when you walk, stand up or move your head, and either can make you lose your balance. An inner ear problem, benign paroxysmal positional vertigo or BPPV, is vertigo's most common cause, so tell your doctor whether the room spun or went gray.
Say so as well if the episodes come after meals: low blood pressure on standing that happens after eating is called postprandial orthostatic hypotension, and it most often affects older adults, people with high blood pressure and people with Parkinson disease.
Could smaller meals and fewer drinks be doing this?
If your meals have shrunk, look at what you are drinking as well. Not drinking enough fluids, which is dehydration, can cause low blood pressure, and a provider looking for the cause asks whether your eating and drinking have been normal lately.
Dehydration happens when you are losing more fluids than you are taking in, so that your body does not have enough fluids to work properly. Diarrhea, vomiting, sweating too much, fever and not drinking enough water or other fluids can all cause it, and so can urinating too much, which can happen because of certain medicines and illnesses. Smaller meals can mean fewer drinks, so count what you drink in a day, including the drinks that used to come with a meal.
Thirst is not a dependable signal for everyone, because some people lose their sense of thirst as they age and so do not drink enough fluids. Each person's needs can be different, so ask your own doctor how much you should be drinking each day, or, if a doctor has set you a fluid limit, ask that doctor.
Check yourself against both columns:
| In adults, symptoms of dehydration include | Get medical help right away if they also include |
|---|---|
| feeling very thirsty | confusion |
| dry mouth | fainting |
| urinating and sweating less than usual | lack of urination |
| dark-colored urine | rapid heartbeat |
| dry skin | rapid breathing |
| feeling tired | shock |
| dizziness |
Dehydration can be mild, or it can be severe enough to be life-threatening, so if anything in the second column comes with the dizziness, get that medical help at an emergency department, or by calling 911. If vomiting is part of it and liquids will not stay down, try sipping small amounts of water or sucking on ice chips (see Can't keep fluids down for 12 hours? Contact a provider right away).
If you have diabetes, eating less matters for your blood glucose too: if you do not eat enough carbohydrates or skip or delay any meals, your blood glucose level could fall lower than is healthy for you. A low can make you feel dizzy, lightheaded, confused or irritable, among other symptoms, so ask whoever prescribes your diabetes medicines whether any of them can cause a low, and how you would prevent or treat one (see Shaking at your desk before lunch can be a low blood sugar).
Is it the tablets, or something else?
Your tablets could be a cause, because certain medicines and substances can lead to low blood pressure, including:
- alcohol
- anti-anxiety medicines
- certain antidepressants
- diuretics
- heart medicines, including those used to treat high blood pressure and coronary heart disease
- medicines used for surgery
- painkillers
That list is not complete, so ask whoever prescribed a tablet missing from it whether it could be one too.
Low blood pressure has other causes besides dehydration: nerve damage from diabetes or other disorders, changes in heart rhythm (arrhythmias) and heart failure.
Your doctor looks for which of these is behind the gray-outs, and whether the tablets play a part, by examining you to determine the cause of your low blood pressure, and tests may be done too. Your normal blood pressure is one of the questions, so have it ready if you know it (see Why your prescriber needs your home blood pressure log). For dizziness, your medicines and symptoms are asked about, and a physical exam may check your hearing, your balance and how you walk.
If medicines are the cause, your provider may change the dosage or switch you to a different medicine. Keep taking each one until you have talked to the provider who prescribed it.
Getting up more slowly from now on
Falls can be dangerous at any age, and their common causes include some medicines, which can make you feel dizzy, confused or slow, and certain illnesses, such as low blood pressure. Older adults are at higher risk of falling and more likely to break a bone when they fall, especially with osteoporosis, and falls due to low blood pressure in older adults can lead to a broken hip or spine fracture.
Getting up slowly after sitting or lying down is one of the steps your provider may recommend to prevent or reduce your symptoms, along with drinking more fluids, not drinking alcohol and wearing compression stockings so blood does not collect in the legs.
When a gray-out needs your doctor's office or 911
Ring your own doctor's office about the gray-outs you have had: dizziness and lightheadedness from low blood pressure need a call right away, and so do black or maroon stools, an irregular heartbeat and a fever higher than 101°F (38.3°C).
Dizziness often gets better on its own, but if it keeps happening, your provider can help you find the cause. Two gray-outs in a week is dizziness that keeps happening, so do not wait for a third.
If you pass out, whoever is with you should call 911, and start CPR if you are not breathing or have no pulse. Call 911, not the office, for chest pain that comes with the dizziness: chest pain with nausea, dizziness, sweating, a racing heart or shortness of breath is a 911 call, and so is sudden crushing, squeezing, tightening or pressure in your chest, or pain that spreads to your jaw, your left arm or between your shoulder blades.
Trouble breathing needs an emergency department or 911, with or without chest pain, and severe shortness of breath needs 911.
Call 911 as well for sudden or severe dizziness or vertigo along with vision problems, slurred speech or weakness, which may be signs of a more serious condition. A gray-out dims your vision too. One that passes once you sit or lie down is for your doctor's office; one that is severe, comes with slurred speech or does not go away is for 911.
If your weight treatment is prescribed by a state-licensed physician you reached through NicoCares, ring your own doctor's office about the gray-outs first; that is the call they need. Your NicoCares care team should also hear about a change in your health like this one, and their messages come through Spruce Health, the secure messaging service that emailed you its invitation. Then send the care team a message there with what happened and what the office told you.
