When You're Often Dizzy and Foggy-Headed but the Tests Are Normal

You're often dizzy, and your head feels foggy, as if in a mist.

People like this worry about a serious illness, so they get a brain scan and ear tests. Usually the results are normal. It's not anemia, and the blood pressure is more or less fine. And so they come away having been told it's "stress."

In these cases, before suspecting the brain itself, I first look at the body's environment that regulates blood flow to the brain. Dizziness and fogginess often don't mean the brain is broken; more often they are a signal that the amount of blood arriving at the brain is fluctuating from moment to moment.

Carbon dioxide regulates cerebral blood flow

It may sound surprising, but one of the most sensitive regulators of blood flow to the brain is the carbon dioxide in the blood. There has to be a suitable amount of carbon dioxide for the cerebral blood vessels to stay open. But when you're tense or anxious, or when you habitually breathe a little too much, carbon dioxide gets blown off, and when carbon dioxide drops, the cerebral blood vessels constrict.

When the cerebral blood vessels narrow, the blood going to the brain decreases. The results are dizziness, a foggy head, a feeling of blurred vision, and a faintness as though you're about to collapse. It's not because of a lack of oxygen. Rather, there's plenty of oxygen, but the vessels have narrowed so that oxygen can't be carried through.

Up to this point it is established physiology. That hypocapnia constricts the cerebral blood vessels and reduces cerebral blood flow is a well-known fact.

From here on is my interpretation. I see this kind of dizziness and fogginess not as a "problem of the brain" but as the result of the axis of breathing being shaken and spreading into circulation. When the breath is a little disturbed, the body's chemical balance tilts, and that tilt carries over into cerebral blood flow. That's why examining only the brain doesn't yield an answer.

So what do I do?

I watch these people's breathing carefully. Many of them actually try to take a big breath in when they feel dizzy. But that big breath blows off even more carbon dioxide and worsens the dizziness. It's a loop of anxiety → excessive breathing → dizziness → greater anxiety.

So I bring the breath back toward being slow and shallow, settling it down. When you break this loop, the frequency and intensity of the dizziness decrease. Helping to lower the body's tension and the on-edge state of the autonomic nervous system even in the hours away from the exam room — this is the place that herbal medicine takes on.

Cases where you should go to a hospital first

With dizziness there are things that must be ruled out first. If severe spinning dizziness comes with vomiting, or is accompanied by paralysis of one arm or leg, slurred speech, a severe headache, or double vision, or if you have a sudden fainting collapse, you must get emergency care without delay. Problems with the vestibular organ of the ear, arrhythmia, low blood pressure, anemia, and blood sugar problems can also cause dizziness. These must be checked first.

I don't say that all dizziness is because of breathing. Still less do I mean that you should skip the tests.

Finally

To someone who has long been told "the tests are normal but I keep feeling dizzy and foggy," I want to say that it isn't only a problem of the mind. The body's environment is tilting from moment to moment, and the dizziness is a signal announcing that tilt. Together, we'll work to restore that environment, not the brain.