[20F] Experiencing postprandial dizziness with tunnel vision

Patient Description

A 20-year-old female reports experiencing dizziness immediately after eating, accompanied by tunnel vision. These episodes have been occurring for a few years and are described as feeling lightweight with darkening vision and some confusion, lasting about 30 seconds. The dizziness is rated as moderately severe (6-7/10) and occurs randomly with various foods such as bagels, white bread, spaghetti, and flour tortillas. The patient notes sweaty hands during episodes and shakiness afterward, but no hunger. Blood pressure is consistently around 90. There is no history of endocrine disorders, recent weight changes, or medication use. The patient has no known allergies or family history of diabetes or endocrine disorders. Eating smaller, more frequent meals may help alleviate symptoms.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Postprandial Hypotension: This condition occurs when blood pressure drops significantly after eating. It can cause dizziness, lightheadedness, and even fainting. It happens because blood flow increases to the digestive tract, which can reduce blood flow to other parts of the body. Monitoring your blood pressure during these episodes can help confirm this.

  2. Reactive Hypoglycemia: This is a condition where blood sugar levels drop after eating, leading to symptoms like dizziness, shakiness, and sweating. It can occur if your body produces too much insulin in response to a meal, especially one high in carbohydrates.

  3. Vasovagal Response: This is a reflex that can cause a sudden drop in heart rate and blood pressure, leading to dizziness and fainting. It can be triggered by eating in some individuals.

Typical treatments or testing for these conditions might include monitoring your blood pressure and blood sugar levels, dietary adjustments, and possibly further evaluation by a healthcare provider to rule out other causes.

What you can do

  1. Dietary Adjustments: Since eating smaller, more frequent meals seems to help, continue with this approach. Try to include a balance of protein, healthy fats, and complex carbohydrates to maintain stable blood sugar levels.

  2. Stay Hydrated: Ensure you are drinking enough water throughout the day, as dehydration can exacerbate dizziness.

  3. Monitor Symptoms: Keep a journal of your symptoms, including what you eat and when the dizziness occurs. This can help identify any patterns or triggers. You can use MDandMe to track your symptoms and share this information with your healthcare provider.

  4. Consult a Healthcare Provider: It's important to discuss these symptoms with a healthcare professional who can provide a formal diagnosis and recommend appropriate tests or treatments.

What you should look out for

  • Seek Medical Attention: If your symptoms worsen, become more frequent, or if you experience additional symptoms like chest pain, severe headache, or loss of consciousness, seek medical attention promptly.

  • Monitor for Other Symptoms: Pay attention to any new symptoms that may arise, such as changes in vision, heart palpitations, or significant changes in weight, and report these to your healthcare provider.

Remember, while this information can be helpful, it's important to consult with a healthcare professional for a comprehensive evaluation and personalized advice.

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2 mo ago

People Also Ask


What is postprandial hypotension and how can it be managed?

Postprandial hypotension is a condition where blood pressure drops significantly after eating, leading to dizziness and lightheadedness. It can be managed by eating smaller, more frequent meals, staying hydrated, and monitoring blood pressure during episodes.


What are the symptoms and causes of reactive hypoglycemia?

Reactive hypoglycemia occurs when blood sugar levels drop after eating, causing symptoms like dizziness, shakiness, and sweating. It can be caused by the body producing too much insulin in response to a high-carbohydrate meal.


How does a vasovagal response cause dizziness after eating?

A vasovagal response is a reflex that can cause a sudden drop in heart rate and blood pressure, leading to dizziness and fainting. It can be triggered by eating in some individuals, especially if the meal is large or stressful.


What dietary changes can help manage dizziness after meals?

To manage dizziness after meals, try eating smaller, more frequent meals that include a balance of protein, healthy fats, and complex carbohydrates. This can help maintain stable blood sugar levels and prevent sudden drops in blood pressure.


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