1. INTRODUCTION
Fatigue is described as an extreme physical and mental tiredness that does not go away with rest or sleep. Dizziness can refer to light headedness, unsteadiness, or vertigo. Both symptoms result from a number of health states and conditions, only some of which are serious. Here, we look at five common causes of dizziness and fatigue. We also discuss associated symptoms, and what can be done to help.

2. WHAT CAUSES DIZZINESS AND FATIGUE?
Dizziness and fatigue may be caused by hypoglycemia, concussion, or iron-deficiency anemia (IDA). A wide variety of conditions can cause both dizziness and fatigue. Below are five of the most common causes of both symptoms.

a. Chronic Fatigue Syndrome (CFS)
As indicated in the name, fatigue is the main symptom of CFS, and it can be so severe that it creates difficulty in performing everyday tasks. The condition is also known as myalgic encephalomyelitis (a disease characterized by profound fatigue, sleep abnormalities, pain and other symptoms that are made worse by exertion).
In addition to fatigue and dizziness, a person with CFS may experience:
· sleep problems
· muscle or joint pains
· headaches
· a sore throat
· difficulty thinking, remembering, or concentrating
· a fast or irregular heartbeat
The symptoms may be mild, moderate, or severe, and tend to worsen after exercise.

b. Hypoglycemia (low blood sugar)
Hypoglycemia happens when the level of glucose in the blood drops below normal levels. It is also known as low blood glucose or low blood sugar.
The condition commonly occurs in cases of insulin-dependent diabetes. People with this long-term condition do not properly process glucose, the body’s main energy source, and they require supplementation with insulin.
Symptoms of mild to moderate hypoglycemia can vary from person to person. They tend to come on quickly and may include fatigue and dizziness.
People with hypoglycemia can also experience any combination of the following symptoms:
· being shaky or jittery
· excessive sweating
· hunger
· headache
· blurred vision
· confusion
· poor coordination
· trouble concentrating
· weakness
· a fast or irregular heartbeat
People with severe hypoglycemia may be unable to eat or drink. They may experience seizures or convulsions and can even lose consciousness.
Severe hypoglycemia is dangerous and needs to be managed right away.

c. Iron-deficiency anemia (IDA)
Iron deficiency anemia is a condition where there are too few red blood cells in the body due to a shortage of iron. The body uses iron to produce red blood cells, which transport oxygen around the body, maintaining healthy cells and tissues. And so without enough iron, there may be too few healthy red blood cells to carry sufficient oxygen to satisfy the body’s needs, leading to IDA. This may cause dizziness and fatigue.

Other symptoms can include:
· pale or yellow skin
· shortness of breath or chest pain
· rapid heartbeat
· a pounding or “whooshing” noise in the ears
· brittle nails or hair loss
· Those most at risk of IDA are:
· vegetarians or vegans
· people who are pregnant
· people who have heavy periods
· others who have lost a lot of blood
Underlying health conditions, such as peptic ulcer disease, celiac disease and inflammatory bowel disease, can also increase the risk of developing IDA.

d. Concussion
A concussion is a temporary brain injury, caused by a knock to the head. The injury can last a few days or weeks. Symptoms of concussion may include headache, confusion, dizziness, fatigue, and nausea.

Symptoms usually appear within a few minutes of the impact, and can include:
· dizziness and fatigue
· headache
· nausea or vomiting
· confusion
· memory loss
· balance problems
· mood swings
· blurred or doubled vision

e. Migraine
A migraine is a type of throbbing, pounding headache that can last anywhere from a few hours to several days. Migraines can diminish a person’s ability to perform daily activities.
They are often accompanied by symptoms such as:
· feeling sensitive to light and sound
· nausea and vomiting
· A person may experience an “aura” immediately before their migraine begins.
· This can refer to:
· seeing flashes or spots of light
· a feeling of pins and needles in the face or arms
· trouble thinking and speaking

3. WHEN TO SEE A DOCTOR
Anyone who experiences repeated episodes of dizziness and fatigue should speak to a doctor. This is particularly true if a person suspects that they have a chronic illness, such as CFS or diabetes mellitus. These require long-term management.
The symptoms below may indicate concussion. Immediately seek medical attention if any of the following are present after a head injury:
· unconsciousness
· memory problems
· a headache that will not go away
· continual vomiting
· changes in behavior

4. TREATMENT AND PREVENTION
An increase of iron-rich food, such as broccoli, in the diet may help to prevent IDA.
Treatment options depend on the cause of the symptoms.

In the event of CFS, there is no cure or approved treatment, though some symptoms may be manageable. Specialists tend to recommend habits that help to manage sleep problems. These can include having a regular bedtime, and removing TVs and computers from the bedroom. Gradual increases in exercise can also help with fatigue. A doctor may recommend wearing support stockings, which can help with dizziness and light-headedness. And because the cause of CFS is unknown, there is no known prevention.

In people with diabetes mellitus, mild to moderate hypoglycemia is managed by consuming glucose. People can do this in many ways. Some may consume four glucose tablets or a tube of gel. Others may prefer half a cup of fruit juice, or a tablespoon of sugar, honey, or corn syrup.
If a person with diabetes mellitus frequently needs to consume extra glucose, this shows that their condition is not being appropriately managed. Changes should be made to the dosage of insulin or other medications.

Severe hypoglycemia requires hospital treatment. People with diabetes mellitus are advised to eat regular meals and check their blood glucose levels frequently, to avoid hypoglycemia.

A doctor manages IDA by increasing the person’s intake of iron, usually with supplements. To prevent IDA, a diet rich in iron is recommended. Good sources of iron include:
· meat
· fish
· legumes
· leafy green vegetables, such as broccoli, spinach and kale

Anyone with a concussion should get plenty of rest, and avoid mentally taxing activities and alcohol. Acetaminophen is recommended, to manage associated headaches.
The best treatments for migraines vary from person to person. Some find relief by using over-the-counter painkillers, such as aspirin or ibuprofen. Others may prefer anti-nausea medications. Prescription medications are also available. Avoiding the factors that trigger migraines can help prevent their occurrence. These triggers also vary but can include stress, certain foods, and sleeping too much or too little.

5. OUTLOOK
Dizziness and fatigue are common symptoms of a range of conditions. In most cases, the underlying cause can be managed, either at home or by a healthcare provider.
If the cause of simultaneous dizziness and fatigue is unknown, it may be a good idea to consult a doctor.

Culled from Medicine News Today (MNT)