Internal Medicine

Dizziness and alcohol

introduction

dizziness can occur from alcohol consumption. A distinction is made between Dizziness while consuming alcoholthat arises from acute alcohol overload and dizziness that as a long-term consequence of chronic alcohol consumption occurs. The causes of these two forms of dizziness are different, but each can be traced back to alcohol consumption.

On the other hand, there are also patients who suffer from dizziness and an improvement in their symptoms with light alcohol consumption feel. Often these people are affected by a phobic postural vertigowhich is psychogenic and occurs particularly in stressful situations.

causes

Alcohol can cause dizziness through a variety of mechanisms. Balance is largely controlled by the inner ear. There the semicircular canals are particularly important, of which humans have three on each side. In the semicircular canals there is a liquid that moves along with the rotation of the head and thus stimulates special sensory cells. The brain then processes this stimulus as a sensation of position. The fluid in the semicircular canals and the mass in which the sensory cells are located (so-called Cupula), are in a certain weight ratio to each other, so that the generation and transmission of stimuli can proceed correctly. However, alcohol changes this ratio. The alcohol gets into the inner ear and causes the cupula with the sensory cells to become lighter, since alcohol is lighter than water. The weight ratio between fluid and cupula shifts. The cupula can now be excited much more easily, which causes dizziness in the brain when the head changes position.

The cerebellum, which is particularly important for coordination, is also disturbed by alcohol consumption (see: cerebellar damage). This often results in an unsteady gait (sway).

Chronic alcohol consumption ultimately leads to permanent damage to the nerve tracts of the brain. One example is Wernicke's encephalopathy as a result of chronic alcohol consumption. There is a lack of vitamin B1, which ultimately leads to a decrease in various brain structures (Atrophye). Those affected suffer from unsteadiness to walk and stand and develop various psychological syndromes. The nerve tracts in the body are also damaged by chronic alcohol consumption. A so-called polyneuropathy can occur, which leads to a loss of sensations, for example in the legs. The spinal tract is also affected. As a result, the sense of position is also disturbed and unsteady gait and stance as well as dizziness can occur.

Dizziness the next day

Dizziness can also occur the day after consuming alcoholic beverages. This is mostly due to the loss of fluids caused by the alcohol.
Alcohol inhibits the release of the antidiuretic hormone in the body, which actually causes orally ingested fluids in the kidneys to remain in the body's circulation. If this hormone is missing, the kidneys excrete more water with the urine - water is thus withdrawn from the body.

Symptoms of dehydration include low blood pressure and the resulting dizziness. In addition, dizziness can be triggered by alcohol through other mechanisms the next day. The alcohol has not yet been completely broken down and there are still residual amounts in the blood. These influence parts of the central nervous system that make a decisive contribution to maintaining balance: This includes the cerebellum, which is responsible for coordinating movement sequences, and the inner ear, which, as a sensory organ, perceives the position of the body.

To relieve the dizziness, the generous consumption of water, tea or diluted fruit juices helps to initially remedy the lack of fluids. In addition, care should be taken to ensure a sufficient supply of vitamins, as these are also consumed when alcohol is broken down. Fatty food should be avoided the day after (excessive) alcohol consumption in order to relieve the liver, which still breaks down residual amounts of alcohol.

Alcohol improves dizziness

However, without pre-existing alcohol consumption, if a patient suffers from dizziness and improves this is even more likely through alcohol consumption, so is usually a phobic vertigo in front. This clinical picture is and is not uncommon psychogenic. Nausea and vomiting usually do not occur.

The phobic vertigo expresses itself mainly through Subjectively felt unsteadiness of walking and standing and fluctuations caused by it. Often times it occurs suddenly Fear of fallingwithout actually falling. The symptoms appear especially in stressful situations on and concern mostly depressed patients. By light alcohol consumption as well as exercise, patients experience a improvement their complaints. To prevent chronification, a Behavior therapy be considered.

Also at People with alcohol addiction dizziness can occur, which becomes better with alcohol consumption. More often these people suffer from Tremors or psychosiswhich can also be suppressed by resuming consumption. In such cases, alcohol withdrawal is essential.

Concomitant symptoms

Alcohol consumption can lead to both vertigo and vertigo. With vertigo, the person concerned has the feeling that the environment is rotating around him. In the case of vertigo, there is above all an unsteady stance and gait, as the person has the feeling that the ground is not firm, but rather sways back and forth.

However, vertigo is most common due to alcohol consumption. Dizziness is not infrequently accompanied by other symptoms, such as nausea or headache. These can persist the day after drinking alcohol.

Tremors and dizziness

Tremors and dizziness can occur together with alcohol consumption. Occasional drinkers who are not addicted to alcohol can experience tremors while intoxicated when the cerebellum is impaired. This manifests itself primarily through an unsteady gait and stance (walking in a snake, swaying), but also through a so-called intention tremor. Purposeful movements, for example when reaching for a bottle, result in trembling movements that often miss the target.

If you consume alcohol at parties where you move around a lot, for example when dancing, dehydration, i.e. a loss of fluid, occurs particularly quickly. Alcohol itself has a dehydrating effect; in connection with physical activity, the affected person loses fluids even faster. It can also lead to hypoglycaemia. Dehydration and hypoglycaemia can also cause tremors, just as they can cause palpitations after alcohol.

If the person concerned is a person who consumes alcohol regularly, the tremors could also be withdrawal symptoms. The brain is, so to speak, immobilized by alcohol. When there is a lack of alcohol, the receptors in the brain are overexcited and generate too many signals, which are then sent to the muscles. Tremors and other physical symptoms are the result. This tremor then usually diminishes through consumption of alcohol, as the brain no longer sends unnecessary impulses through the "calming" alcohol.

nausea

It is not uncommon for nausea and vomiting together with dizziness to occur with excessive alcohol consumption.

Several factors come together here: First of all, the body is very dehydrated, as alcohol increases the excretion of fluids. This easily results in poor circulation, which in turn leads to dizziness. In turn, dizziness can lead to nausea by activating the vomiting center in the brain stem. In addition, excessive alcohol consumption can also directly activate the vomiting center, as the concentration of toxins in the blood is also measured here. Since alcohol is actually a toxic substance, alcohol consumption can lead to nausea and vomiting in the short and long term.

Racing heart

In addition to numerous other physical complaints, alcohol can cause palpitations, which are uncomfortable for the person concerned.

One reason for this is that alcohol has a dilating effect on the blood vessels. As a result, there is suddenly more space in the blood vessels to fill with an unchanged amount of blood volume. At the same time, alcohol ensures a slight to moderate dehydration of the body, which also reduces the blood volume. As a compensation, the heart now beats faster in order to be able to distribute the insufficient blood volume in the body and to maintain a sufficient circulation.

Circulatory problems

As already described above, alcohol has an activating effect on fluid excretion. This happens by disrupting hormonal mechanisms that normally regulate urine production in the kidneys: Alcohol has a special effect on the concentration of urine, it prevents water absorption. The urine is therefore more diluted or contains a larger proportion of water than usual. This proportion of fluid is in turn missing in the blood vessels, which makes it more and more difficult for the body to maintain the circulation.

In addition, as already described above, alcohol has a vasodilating effect, which also makes it difficult to maintain an adequate circulation. Accordingly, symptoms such as dizziness after getting up too quickly or a noticeable drop in blood pressure can occur.

diagnosis

In general, dizziness that occurs after consuming alcohol does not require any special diagnostics. The relationship between alcohol consumption and the patient's complaints is usually clear. However, if the dizziness persists or occurs regardless of alcohol consumption, further diagnostics should be carried out. The organ of equilibrium in the inner ear and the cerebellum are examined for their functionality.

If it is not clear whether the dizziness is caused by alcohol or whether it is caused by other causes, further tests will be done. In order to better classify dizziness that occurs during or shortly after drinking alcohol, the alcohol content in the breath can first be measured. Special devices and self-tests for this are even freely available. Acquiring it can therefore be considered by the person concerned if there is the impression that the dizziness is triggered or promoted by alcohol consumption.

Alternatively, an attempt at elimination can be tried in order to make the connection between alcohol consumption and dizziness more likely. If dizziness no longer occurs when alcohol is not consumed, a connection can be assumed. However, you should wait a sufficiently long time to see whether dizziness occurs without consuming alcohol. That could be four weeks, for example, during which no alcohol is allowed to be drunk.

therapy

If you feel dizzy from drinking alcohol, the only thing that helps is waiting. When the alcohol has been broken down and excreted in the body, the dizziness also goes down. If you consume alcohol, you should definitely have a rich breakfast with plenty of vitamins and sufficient fluids the next day. This should help with the hangover.

Prolonged dizziness that does not show any improvement after a few days should be examined by a doctor as a precaution.

Find out more about the topic here:

Hangover after alcohol- what to do?
Vertigo therapy

How can I still sleep?

Sleeping can be very difficult with dizziness after drinking alcohol.

The feeling that the whole environment is turning keeps you awake. In addition, the dizziness is often more pronounced when lying down than when sitting or standing. If you still want to sleep, you can use a simple trick. To do this, you hang one leg out of the bed and place your foot on the floor. The body receives position information from the room and the brain can process that the leg is firmly on the floor. The subjectively perceived rotational movement of the room and the information that the leg is firmly on the floor are recognized by the brain as not matching and the dizziness is suppressed. This can make falling asleep easier.

Sometimes, however, all of this does not help - the dizziness cannot be brought under control. Then often the only thing that helps is waiting and hoping that you can still fall asleep at some point. If in doubt, it is better to stay awake and keep your eyes open so that the dizziness does not add to the nausea.

forecast

Alcohol-related dizziness usually only lasts until all of the alcohol has been metabolized and eliminated from the body. As Symptom of a hangover can he The dizziness persists the following day but usually disappears on its own. A balanced meal in the morning and sufficient amounts of water to drink quickly get the circulation going again.

prophylaxis

Dizziness is one of the typical hangover symptomsthat can occur after consuming alcohol. The best prophylaxis is a good foundation before consuming alcohol in the form of a high-carbohydrate and high-fat meal, such as pizza. Due to the fat content in the food, the alcohol is released into the blood more slowly and dizziness is much less common. A healthier alternative are, for example, oily pickled fish such as sardines. In addition, should not consuming too much alcohol at once and drinking a glass of water every now and then. This prevents fluid loss.