Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Dizziness Post Showering?
Question: When I got out of the shower this am I got dizzy, felt weak and unsteady, my ears were ringing, was seeing "stars" and thought I was going to pass out. I sat down and put my head between my knees. My bowels emptied. The feeling passed eventually. I haven't felt like that since I had toxoplasmosis at age 17. Now 63, female.
Brief Answer:
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
I think that the most probable cause for your symptoms is an excessive drop in blood pressure leading to a syncope.
You already seem to have one risk factor for having episodes of drops of blood pressure which is your medication, drugs like Amitriptyline and Duloxetin have orthostatic hypotension as a side effect, in particular amitriptyline. In this episode the shower became an additional factor, the hot water leads to dilation of peripheral vessels in the surface with lowering of blood pressure and as more blood is pooled there less blood was available for other organs included the brain. So the combination of the hot water and medications predisposes to such episodes.
One single episode may not need any intervention. However I would check for other possible factors in particular heart arrhythmia which could also lead to insufficient blood supply. For that I would start with a simple EKG, and if the episode is repeated longer EKG monitoring would be recommended (it can be done through a portable device for 24 hours or longer). Some routine blood tests like blood count, sugar, electrolyte panel etc may also be considered to screen for anemia, infections or metabolic alterations.
I remain at your disposal for other questions.
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
I think that the most probable cause for your symptoms is an excessive drop in blood pressure leading to a syncope.
You already seem to have one risk factor for having episodes of drops of blood pressure which is your medication, drugs like Amitriptyline and Duloxetin have orthostatic hypotension as a side effect, in particular amitriptyline. In this episode the shower became an additional factor, the hot water leads to dilation of peripheral vessels in the surface with lowering of blood pressure and as more blood is pooled there less blood was available for other organs included the brain. So the combination of the hot water and medications predisposes to such episodes.
One single episode may not need any intervention. However I would check for other possible factors in particular heart arrhythmia which could also lead to insufficient blood supply. For that I would start with a simple EKG, and if the episode is repeated longer EKG monitoring would be recommended (it can be done through a portable device for 24 hours or longer). Some routine blood tests like blood count, sugar, electrolyte panel etc may also be considered to screen for anemia, infections or metabolic alterations.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. I did go to the urgent care clinic. They took BP sitting, standing, and laying, drew blood, did an EKG and a urine test. Nothing was abnormal other than the urine showing dehydration (I hadn't had much to eat or drink all day.) The PA and the MD on call considered the amitriptyline as the culprit but didn't think that was it. I had only began using the amitriptyline again for 4 nights preceding this mornings event. I will follow up with my primary care doctor as recommended by them and try to use less hot water in the shower. They are sending some of the blood out for lab analysis which will return in a couple of days. I saw my gastro doctor earlier in the day and told him of the event. He was quite concerned and recommended I get to primary care asap.
Thanks again for sharing your knowledge.
Thanks again for sharing your knowledge.
Brief Answer:
Read below
Detailed Answer:
Thank you for the update. It is good that you have been checked. Dehydration can be a further contributor as well in lowering blood pressure. Amitriptyline as I said may play a role as well, it doesn't have to be necessarily only one factor alone. It can be the combination of several causes of low blood pressure such as hot water, dehydration and amitriptyline combined which add up to lead to that episode of extremely low pressure. It shouldn't be serious though, just try to stay hydrated and avoid other pressure lowering factors in the future.
Let me know if I can further assist you
Read below
Detailed Answer:
Thank you for the update. It is good that you have been checked. Dehydration can be a further contributor as well in lowering blood pressure. Amitriptyline as I said may play a role as well, it doesn't have to be necessarily only one factor alone. It can be the combination of several causes of low blood pressure such as hot water, dehydration and amitriptyline combined which add up to lead to that episode of extremely low pressure. It shouldn't be serious though, just try to stay hydrated and avoid other pressure lowering factors in the future.
Let me know if I can further assist you
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
