Numbers show that over 12% of Americans will develop some thyroid condition in their lifetime, and about 20 million people in the United States have some form of the disease that affects butterfly-shaped gland. Up to 60% of people with thyroid disease are unaware of their condition[i]. Sometimes people experience various symptoms without realizing it was thyroid disease that caused them. One of those symptoms is dizziness or lightheadedness. Can thyroid problems really cause dizziness and how it happens? Learn more about lightheadedness in general and its link to the thyroid in the post below.
What is dizziness, actually?
We come across the term dizziness all the time, or we often feel dizzy, but have you ever wondered what it is actually? Dizziness is a term that refers to an array of sensations such as feeling woozy, faint, unsteady, or weak. Sometimes people feel like their surroundings are spinning around them and say they’re dizzy, but in fact, that’s just a form of dizziness called vertigo. Lightheadedness is one of the most common reasons why people schedule an appointment to see their doctor or health care provider.
It is worth noting that dizziness is not a “standalone” disease or health condition, but rather a symptom that occurs due to a wide range of health problems. That’s exactly why dizziness is not something you should ignore. Multiple diseases can make us feel dizzy, but your doctor can make an accurate diagnosis and find the root cause.
What causes dizziness?
People can feel dizzy due to more reasons than one, and, in some situations, it can be difficult to pinpoint a specific cause of dizziness. In order to determine the cause of dizziness and narrow down the list of potential problems, doctors take into account factors such as duration of dizziness and the presence of other symptoms.
Dizziness tends to occur due to inner ear problems, underlying health condition, motion sickness, and as a side effect of a wide range of medications. When it comes to inner ear problems that cause dizziness, the inner ear sends signals to the brain that are inconsistent with signals that sensory nerves and eyes receive. It’s useful to mention that a person’s balance depends on the combined action of eyes, sensory nerves, and inner ear, which comprise the sensory system. The brain is trying to work out this confusion with inconsistent signals, but during the process, a person experiences vertigo. Common inner ear problems that cause dizziness include Meniere’s disease (excessive accumulation of fluid in the inner ear), infection of the vestibular nerve, migraine, and benign paroxysmal positional vertigo (BPPV) which causes brief, intense, and a false sense that you are moving and spinning.
You can also feel dizzy due to:
- Changes in blood pressure
- Neurological conditions
- Overheating and dehydration
- Hypoglycemia (low blood sugar)
- Anxiety disorders
Can thyroid problems cause dizziness?
Thyroid hormones participate in a number of processes and functions in our body. Higher or lower production of these hormones is manifested through a wide range of symptoms. That being said, some symptoms of thyroid problems are widely discussed. For example, hair loss and weight gain/loss are often addressed, while symptoms such as dizziness do not get enough attention although it’s important to get informed and know as much as possible in order to manage your condition successfully. Studies on this subject are scarce, but hopefully, things will change in the near future.
If you’re wondering whether thyroid problems can indeed cause lightheadedness, the answer is yes. In fact, both hypo- and hyperthyroidism[ii] can make you feel dizzy or lightheaded. How? Let’s see.
Hypothyroidism or underactive thyroid is a condition wherein the body produces an insufficient amount of T4 and T3 hormones which, as stated above, are necessary for multiple functions in our body. You’re probably wondering how hypothyroidism can contribute to dizziness. Well, it does so through changes in the blood pressure.
What many people do not realize is that hypothyroidism can lower blood pressure and cause hypotension. Hypotension occurs when a person’s blood pressure is lower than 90/60. Low blood pressure can make you feel weak, tired, and dizzy. Our blood pressure doesn’t remain constant, it can go up and down, but certain health conditions can cause prolonged hypotension episodes which can become dangerous if left untreated. American Heart Association reports that endocrine disorders such as hypothyroidism or underactive thyroid are one of many causes of hypotension[iii]. It’s useful to monitor your blood pressure regularly, especially if you are in the high-risk group of developing some cardiovascular condition. If you experience dizziness coupled with fatigue, nausea, depression, clammy skin, chances are your blood pressure has dropped, and if you’re hypothyroid, this condition could be the reason why. Of course, bear in mind that symptoms may vary from one person to another.
Not only does hypothyroidism contribute to hypotension, but it can also pose a major factor in hypertension. Udovcic et al. report that thyroid hormones play a profound role in normal heart function and vascular physiology and hypothyroidism induces profound cardiovascular effects[iv]. The relationship between hypothyroidism and hypertension is complicated and can be described as quite a controversial subject in scientific circles. Throughout the years, there has been a debate about whether hypothyroidism can really cause hypertension, although a high prevalence of diastolic hypertension had been found in patients ages 50 and older with over hypothyroidism. Their blood pressure was normalized after adequate therapy. That being said, hypothyroidism as a cause of hypertension is oftentimes overlooked[v]. Just like hypotension, high blood pressure can also make you feel dizzy and lightheaded.
Speaking of hypothyroidism in relation to dizziness, it is also important to mention the high prevalence of underactive thyroid in people with Meniere’s disease. Remember, Meniere’s disease is one of those inner ear problems that can make you dizzy. Santosh et al. report that the underlying cause of Meniere’s disease remains unknown, but it is a multifactorial condition, and previous research found that 3% to 17% of patients also had hypothyroidism. Their study found a high prevalence of hypothyroidism in people with Meniere’s disease, particularly in middle-aged patients and calls for screening for thyroid dysfunction in patients with this complicated disease[vi]. While this study does not imply that hypothyroidism causes Meniere’s disease, it confirms the link between two conditions and outlines the association between a thyroid problem and dizziness.
Hashimoto’s thyroiditis is an autoimmune disease wherein the immune system attacks healthy cells and tissues of the thyroid gland, gradually destroying it. This autoimmune condition is the most common cause of hypothyroidism. Evidence shows Hashimoto’s thyroiditis is associated with health problems that can make you lightheaded and dizzy. For example, Chiarella et al. reported that Hashimoto’s thyroiditis was associated with vestibular dysfunction and disorders such as Meniere’s disease and BPPV, all of which can cause dizziness. The vestibular system includes parts of the inner ear and brain that are in charge of your balance and eye movements. Dysfunction of this system is one of the most common reasons behind dizziness. Scientists advise that people with Hashimoto’s disease are screened for vestibular dysfunction in the presence of even slight signs and symptoms[vii].
Evidence shows that there is a clear relationship between thyroid autoimmunity and inner ear damage regardless of the thyroid function. Hashimoto’s thyroiditis is, therefore, linked to autoimmune inner ear disorders[viii]; which doesn’t really come as a surprise if we bear in mind that autoimmune conditions can contribute to one another. Autoimmune inner near disorders can also cause dizziness. Hashimoto’s thyroiditis is, just like hypothyroidism, a type of condition that affects multiple systems in our body and manifests itself in different ways. Regular checkups at the doctor’s office are necessary to keep track of the condition and prevent potentially serious complications.
Hyperthyroidism or overactive thyroid occurs when the thyroid produces an excessive amount of T4 hormone. Unlike hypothyroidism which slows metabolism, hyperthyroidism accelerates it and induces a wide spectrum of other symptoms. Similarly to hypothyroidism, an overactive thyroid can cause dizziness through changes in blood pressure. A growing body of evidence confirms that hypertension is more common in hyperthyroid adults due to the fact that T3 dilates resistance arterioles, decreases systemic vascular resistance, and enhances cardiac output and pulse pressure[ix]. As seen above in this post, hypertension can also make you dizzy and lightheaded.
What to do when you’re dizzy?
Dizziness tends to come “unannounced” or suddenly. You may be working or doing something and suddenly start feeling unsteady and weak. As seen throughout this post, having a thyroid-related disorder can, indeed, contribute to dizziness. The question is what to do when this happens? You need to sit or lie down immediately to lower your chances of falling down, especially if you also have vertigo. In cases of vertigo, the most useful thing to do is to lie down in a dark, quiet place and close your eyes.
If you experience dizziness quite often, there are many ways to make these episodes more tolerable, lower their intensity, or even prevent them. These tips will help you handle lightheadedness in a more effective manner:
- Stay hydrated throughout the day – dehydration is a common cause of dizziness, but the problem is that people wait until they feel thirsty to drink some water. By then, the body has already started experiencing some symptoms of dehydration. Instead, try to drink a glass of water throughout the day, and you’ll feel better
- Ginger – helps alleviate symptoms of dizziness and motion sickness. The best thing about ginger is that you can take it in many ways, including supplements, drinking ginger tea, adding it to diet, etc.
- Eat more vitamin C – especially if you also have Meniere’s disease, this vitamin can reduce vertigo
- Consume enough iron – don’t forget that iron deficiency anemia is a common problem, and one of its most noticeable symptoms is dizziness. Fortunately, you can obtain enough iron from your diet
- Avoid alcohol, tobacco, and caffeine because they can worsen dizziness
- Get plenty of sleep – lack of good night’s rest can also change your blood pressure, generate the uncomfortable feeling of dizziness. Strive to establish a regular sleep pattern where you’ll go to bed every night at the same time and wake up every morning at the same time as well. Getting eight to nine hours of sleep is ideal
- Avoid moving suddenly when feeling dizzy or lightheaded
- Remove tripping hazards in your home to reduce the risk of falling when you’re dizzy or experiencing vertigo
- Make sure you do not drive a car or operate heavy machinery when feeling dizzy
- Other things you can do: eat a well-balanced diet, manage stress, reduce salt intake, take antihistamines if your dizziness comes with nausea, rest in a cool place
Dizziness is not a health condition on its own, but a symptom of many diseases and health problems we experience. Unfortunately, dizziness is not extensively studied, which can prevent doctors and patients from understanding why it happens or how to avoid it properly. Thyroid conditions can contribute to dizziness and lightheadedness because hormones produced by this gland have a major influence on cardiovascular function and blood flow. Hypothyroidism and hyperthyroidism can lead to low or high blood pressure, and changes in blood pressure make us dizzy. It’s also worth mentioning that thyroid autoimmunity is linked to vestibular dysfunctions which can also induce dizziness.
[ii] Wedro B. Dizziness (dizzy). MedicineNet. Retrieved from: https://www.medicinenet.com/dizziness_dizzy/article.htm
[iii] Low blood pressure – when blood pressure is too low. American Heart Association. Retrieved from: https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/low-blood-pressure-when-blood-pressure-is-too-low
[iv] Udovcic, M., Pena, R. H., Patham, B., Tabatabai, L., & Kansara, A. (2017). Hypothyroidism and the Heart. Methodist DeBakey cardiovascular journal, 13(2), 55–59. doi:10.14797/mdcj-13-2-55. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5512679/
[v] Berta E, Lengyel I, Halmi S, et al. (2019). Hypertension in thyroid disorders. Frontiers in Endocrinology, 10:482. Doi: 10.3389/fendo.2019.00482. Retrieved from: https://www.frontiersin.org/articles/10.3389/fendo.2019.00482/full#h8
[vi] Santosh, U. P., & Rao, M. S. (2016). Incidence of Hypothyroidism in Meniere’s Disease. Journal of clinical and diagnostic research: JCDR, 10(5), MC01–MC3. doi:10.7860/JCDR/2016/17587.7759. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4948427/
[vii] Chiarella G, Russo D, Monzani F, et al. (2017). Hashimoto thyroiditis and vestibular dysfunction. Endocrine Practice, 23(7):863-8. Doi: 10.4158/EP161635.RA. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/28534686
[viii] Fayyaz, B., & Upreti, S. (2018). Autoimmune inner ear disease is secondary to Hashimoto’s thyroiditis: a case report. Journal of community hospital internal medicine perspectives, 8(4), 227–229. doi:10.1080/20009666.2018.1503917. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116174/
[ix] Prisant LM, Gujral JS, Mulloy AL et al. (2007). Hyperthyroidism: a secondary cause of isolated systolic hypertension. The Journal of Clinical Hypertension, 8(8):596-9. Doi: 10.1111/j.1524-6175.2006.05180.x. Retrieved from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1524-6175.2006.05180.x
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