OpenHealth Q&A

Experiencing Lightheadedness for Two Months | Male, 30

Sex: Male Age: 30 Years Current Medication: Hydroxyzine 50mg (for over a decade) prescribed for insomnia. Concern: I've been dealing with episodes of lightheadedness for approximately two months now, fluctuating from mild to moderate severity, with a couple of instances being quite severe. I have a follow-up appointment with my physician on Tuesday, and I'm seeking clarity on whether any of my test results might explain this persistent issue. Additionally, if this condition isn't a matter that warrants further investigation, I would greatly appreciate any recommendations for tests or treatments that I can discuss with my doctor to help manage the symptoms. Among the tests I underwent was a blood glucose level assessment which returned a result of 94 mg/dL, taken an hour and a half post-breakfast. Given that my mother has type 2 diabetes, she advised that such a reading isn’t typical unless fasting. To gather more data, I enlisted her assistance in testing my levels at home across different days. Below are the results of those tests (note that fasting occurred on a different day from subsequent tests): - 15 Minutes after Lunch: 84 mg/dL - 1 Hour after Lunch: 95 mg/dL - 2 Hours 30 Minutes after Lunch: 98 mg/dL - 1.5 Hours after Dinner: 99 mg/dL - Fasting for 8 Hours: 88 mg/dL Could these glucose readings possibly be the reason for my lightheadedness? Is there a particular reason my levels remain under 100 mg/dL? Are the standard post-meal glucose ranges of 140-170 mg/dL applicable only to diabetics, or should they be a concern for those without diabetes as well? With my glucose levels appearing stable, I take it as a sign that my pancreas is functioning adequately, but I’m uncertain if that’s the correct interpretation. In case my blood sugar levels turn out not to be the underlying issue, here are results from other tests conducted (not all of which were related to my lightheadedness, but we conducted a series of lab tests): - White Blood Cell Count (WBC): 6.0 (normal) - Red Blood Cell Count (RBC): 5.93 (moderately high) - Hemoglobin: 16.9 (normal) - Hematocrit: 51.4 (high) - MCV: 87 (normal) - MCH: 28.5 (normal) - MCHC: 32.9 (normal) - RDW: 12 (normal) - Platelets: 247 (normal) - Absolute Neutrophils: 3.3 (normal) - Absolute Lymphocytes: 2.1 (normal) - Absolute Monocytes: 0.4 (normal) - Absolute Eosinophils: 0.1 (normal) - Absolute Basophils: 0 (normal) - Immature Granulocytes: 0.0 (normal) - Glucose Level: 94 (normal) - Blood Urea Nitrogen (BUN): 16 (normal) - BUN/Creatinine Ratio: 15 (normal) - Sodium: 144 (normal) - Potassium: 4.6 (normal) - Chloride: 106 (normal) - Total Carbon Dioxide: 21 (normal) - Calcium: 9.6 (normal) - Total Protein: 7.2 (normal) - Albumin: 4.6 (normal) - Total Globulin: 2.6 (normal) - Total Bilirubin: 0.4 (normal) - Alkaline Phosphatase: 100 (normal) - AST (SGOT): 23 (normal) - ALT (SGPT): 47 (moderately high) - Total Iron Binding Capacity (TIBC): 340 (normal) - Unsaturated Iron Binding Capacity (UIBC): 258 (normal) - Iron Level: 82 (normal) - Iron Saturation: 24 (normal) - TSH with Free T4: TSH 1.050 | GGT 45 (results not marked) - Ferritin: 153 (normal) Diet: I maintain a consistent diet, with all meals prepared from scratch, avoiding fast food. Here’s a summary of what I typically eat: - **Breakfast**: 2 scrambled eggs on buttered whole wheat toast with a slice of pepperjack cheese. - **Lunch**: A salad containing red leaf lettuce, arugula, grilled chicken, seasoned black beans, peppers, tomatoes, assorted nuts, dried cranberries, shredded pepperjack cheese, green onions, and I dress it with half a squeezed lime; I pair it with either half a cup of brown rice or a slice of toast as a carbohydrate source. - **Dinner**: A protein bowl with shredded chicken, black beans, a cup of mixed vegetables (corn, green beans, carrots, peas), tomatoes, onions, and green onions, served over half a cup of brown rice, with added pepperjack cheese and topped with arugula/red leaf lettuce. - **Evening Snack**: 1 cup of yogurt, and I have 2 slices of whole wheat toast during the night. Given my dietary habits and test outcomes, what would be the best path forward to address my lightheadedness? Should I explore my glucose levels further? Are there additional tests to consider discussing with my doctor to find potential answers? What type of specialist would be best suited to consult regarding this issue?

Answers (1)

9/10/2025, 9:10:57 PM

OpenHealth AI

It sounds like your episodes of lightheadedness have been concerning and ongoing. Given your specific health details, let's unpack this step by step, considering your symptoms, test results, and dietary habits.

Main Points:

1. Lightheadedness can stem from various factors, including blood sugar fluctuations, hydration issues, or blood pressure changes.
2. Your glucose readings are within a normal range and likely are not the direct cause of your symptoms.
3. Some aspects in your blood test results may warrant further exploration.

Explanation:

Lightheadedness can arise from multiple causes, including low blood pressure, dehydration, or even side effects from medications like hydroxyzine. It's essential to assess and monitor any potential triggers.

Your glucose readings (all below 100 mg/dL) fall within the normal range for fasting and postprandial (after meal) states for someone without diabetes. The ranges you refer to for post-meal glucose apply more to individuals with diabetes and would not be a concern for someone with normal glucose tolerance.

The moderately high red blood cell count (RBC) and hematocrit may indicate dehydration, as they can increase when the body lacks sufficient fluids. Staying well-hydrated can help mitigate this effect.

Next Steps:

1. Hydration: Increase your water intake throughout the day. Aim for at least 8 to 10 glasses daily, especially if you engage in physical activity or live in a hot environment.

2. Monitor Symptoms: Keep track of when your lightheadedness occurs, including any triggers (such as after meals, standing up quickly, or specific activities). This information can be valuable for your doctor.

3. Discuss Medication: Since you’ve been on hydroxyzine for a long time, ask your physician if your medication could be contributing to your lightheadedness. They might consider adjusting the dosage or switching to a different medication for insomnia if necessary.

4. Review Blood Pressure: Since lightheadedness can be related to blood pressure, it might be beneficial to check your blood pressure regularly at home over the next few days.

5. Additional Tests: Discuss the possibility of further tests to assess hydration status, such as blood tests for electrolytes, as well as a complete blood count (CBC) to further investigate your elevated RBC count if symptoms persist.

6. Specialist Referral: If symptoms continue, it may be beneficial to discuss with your physician the option of seeing an endocrinologist to evaluate any potential metabolic issues, or a neurologist if the lightheadedness has neurological implications.

7. Healthy Eating: Maintain your nutritious diet, but consider reducing caffeine or alcohol intake, as they can sometimes contribute to dehydration or fluctuations in blood pressure.

Keep a note of these points and share them with your physician during your upcoming appointment. This will foster a productive dialogue about the potential next steps in diagnosing and managing your lightheadedness. Your proactive approach is commendable, and together with your doctor, you can work towards finding relief.