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Emergency? Call 911

Symptoms

Dizziness: causes, what to do and when to call 911

Is this an emergency?

This is not an emergency service. Call 911 or go to the nearest emergency room if you have:

  • Sudden dizziness or loss of balance with vision changes, a drooping face, weakness in an arm or leg, or trouble speaking (possible stroke)
  • Fainting, or nearly fainting, with chest pain or palpitations
  • An irregular or very fast heartbeat, or shortness of breath
  • A blow to the head
  • High fever with a stiff neck, or seizures

Warning signs: when to go to the ER

Dizziness usually comes from something passing, such as standing up too fast, dehydration, heat, low blood sugar or an inner-ear problem. But call 911 right away if the dizziness starts suddenly with loss of balance, vision changes, a drooping face, arm weakness or trouble speaking: these can be signs of a stroke. If dizzy spells keep coming back, the doctor assesses you by video.

Other names: Lightheadedness, Feeling dizzy

Can we help by telehealth?YesWe can help by telehealth.
US$79Doctor visit

Possible causes

  • Vertigo (inner ear)

    The room spins, often when you move your head

  • Low blood pressure on standing

    Dizzy when you stand up fast, more common in older adults

  • Dehydration

    After vomiting, diarrhea or heavy sweating

  • Heat

    Dizziness with sweating, weakness and headache in the heat

  • Low blood sugar

    Dizzy with shakiness and sweating, especially on diabetes medicines

  • Seasickness

    Nausea and dizziness on a boat or cruise

  • Stroke

    Sudden dizziness with a drooping face, weakness or trouble speaking: call 911

Dizziness with stroke signs: call 911 (BE FAST)

Sudden dizziness or loss of balance can be a sign of a stroke. The CDC teaches BE FAST. If you notice any of these signs in yourself or someone else, do not wait for a video visit: call 911 right away and note the time the symptoms started.

  • B – Balance loss: is the person suddenly dizzy or off balance?
  • E – Eye (vision) changes: do they have trouble seeing normally?
  • F – Face: ask them to smile. Does one side of the face droop?
  • A – Arms: ask them to raise both arms. Does one arm drift down?
  • S – Speech: ask them to repeat a simple phrase. Is the speech slurred or strange?
  • T – Time: call 911 right away. Every minute counts.

No warning signs? Talk to the doctor by video

If you have none of the warning signs on this page, the doctor can evaluate you by video and tell you whether you need to be seen in person.

For problems that are not emergencies. In an emergency, call 911.

What is dizziness?

"Dizzy" describes two different feelings, and telling them apart helps the doctor find the cause:

  • Lightheadedness, or feeling you might faint: usually because less blood reaches the brain for a moment, for example when you stand up fast.
  • Feeling that you or the room is spinning (vertigo): usually from the inner ear, often with nausea. See vertigo.

If you get dizzy on a boat or a cruise, see seasickness.

Why am I dizzy? The most common causes

The table on this page sums up the causes. The most common are:

  • Standing up too fast, especially in older adults: blood pressure drops suddenly. See low blood pressure.
  • Dehydration from vomiting, diarrhea, sweating or not drinking enough. See dehydration.
  • Puerto Rico heat: dizziness with sweating, weakness and headache can be heat exhaustion. See heat exhaustion and heat stroke.
  • Low blood sugar, especially if you use insulin or other diabetes medicines: dizziness with shakiness, sweating and a racing heart.
  • A virus, such as a cold or the flu, or an inner-ear problem.
  • Medicines, for example for blood pressure.

How we help with dizziness by video

You see Dr. Diana Nieves Castro, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish: she knows which dizziness can be handled at home and which needs the ER. We evaluate, diagnose and treat. The doctor asks what the dizziness feels like, when it happens, how long it lasts, what medicines you take and whether you have diabetes, high blood pressure or heart problems.

If needed, we give you a lab order for a lab near you, for example to check for anemia or your blood sugar. If appropriate, the doctor prescribes and we send your prescription to your pharmacy, or reviews with you a medicine that may be making you dizzy. If you need a test we do not order or a specialist, we refer you. For dizziness that is not an emergency, we offer non-emergency urgent care by video.

Your doctor

Dr. Diana Nieves Castro, MD

General practice physician

Several years of emergency-department experience.

Founding Executive Director of The Health Initiative.

Meet the doctor

Your visit in 3 steps

Request a visit online 24/7 — we confirm your time by email or text.

  1. Request your visit.

    Book a visit and choose "Doctor visit". You pay by card when you request it.

  2. See the doctor by video.

    We send you a secure video link. It works on your phone, tablet or computer. Sit down while you talk with her.

  3. Get your plan.

    A lab order if needed; if appropriate, the doctor prescribes and we send your prescription to your pharmacy.

What the visit costs

A doctor visit costs US$79, the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. A doctor’s note is included. We do not bill insurance; the lab and the pharmacy charge separately. See all prices.

What to do when you feel dizzy

If there are no emergency signs:

  • Sit or lie down right away so you do not fall.
  • Get up slowly: sit on the edge of the bed for a moment first, then stand.
  • If the room is spinning, keep still and avoid bright lights and screens.
  • Drink water if you have been sweating, vomiting or had diarrhea, and get into shade or air conditioning if you are in the heat.
  • If you have diabetes and think your sugar is low, check it if you can and eat or drink something sugary, such as juice.
  • Do not drive or climb stairs or ladders until it passes.

When dizziness is an emergency

Besides the stroke signs (BE FAST), call 911 or go to the emergency room if dizziness comes with any of these signs. See when to go to the ER.

  • Fainting, or nearly fainting, with chest pain or palpitations
  • An irregular or very fast heartbeat, or shortness of breath
  • A blow to the head
  • High fever with a stiff neck
  • Seizures
  • Low blood sugar that does not improve after eating or drinking something sugary

Frequently asked questions

Why do I get dizzy when I stand up?

When you stand up fast, your blood pressure can drop for a moment and less blood reaches the brain. It is more common in older adults, with dehydration or with some medicines. Get up slowly and see a doctor if it happens often.

What is the difference between dizziness and vertigo?

With lightheadedness you feel you might faint. With vertigo you feel that you or the room is spinning, and it usually comes from the inner ear.

When is dizziness a sign of a stroke?

When it starts suddenly with loss of balance, vision changes, a drooping face, weakness in an arm or leg, or trouble speaking. Call 911 right away and note the time.

What should I do about frequent dizzy spells?

Write down when they happen, how long they last and what you were doing, and see a doctor. The doctor looks for the cause by video and, if needed, gives you a lab order for a lab near you.

About this page

Author: The Health Initiative

Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)

Disclosure: Founding Executive Director of The Health Initiative

Published: 2026-10-02 · Updated: 2026-10-02