_edited.png)
Vertigo and Dizziness
Dizziness is a mismatch between what your eyes, inner ears, and body report to the brain. We find which signal is off and retrain how the brain integrates them.
What you may be noticing
The room spins when you roll over in bed. Or nothing spins, yet you feel like you are on a boat. Grocery aisles, scrolling, and busy patterns make you queasy. You hold the wall in the shower and avoid looking up. You may feel anxious simply because the ground no longer feels trustworthy.
Why it is rarely one thing
Dizziness is not one condition. It is a word for several very different experiences: spinning vertigo, lightheadedness, imbalance, and a floating or rocking sensation. Each points to a different system.
Balance is a team effort. Your inner ear senses motion, your eyes report the horizon, and the nerves in your neck and feet report position. The brainstem and cerebellum compare these reports many times every second. When one report is wrong, or when the brain cannot compare them well, the result is dizziness.
That is why so many people are given a medication that dulls the symptom yet never retrains the system. Suppressing the signal can help in an acute attack. Recalibrating it, precisely and in the right order, is what restores steady footing.
Patterns we look for
- Benign paroxysmal positional vertigo (BPPV), from displaced crystals in the inner ear canals.
- Vestibular hypofunction, in which one inner ear responds less than the other after a virus or injury.
- Vestibular migraine, a common and under-recognized cause of episodic dizziness.
- Cervicogenic dizziness from upper neck injury or tension, and blood flow sensitivity with neck extension.
- Persistent postural-perceptual dizziness (PPPD), in which the brain stays on high alert after an initial dizzy event.
- Histamine and mast cell activity, especially when antihistamines are the only thing that helps.
- Autonomic balance and blood pressure regulation on standing.
- Blood sugar, iron, B12, and thyroid status.
- Inflammation, including post-viral and mold-related effects on the ears and sinuses.
- Visual dependence, in which the brain over-relies on vision for balance.
How I evaluate it
A comprehensive functional neurological exam is essential here. It includes detailed eye movement testing, positional testing for BPPV, head impulse testing, balance on different surfaces with eyes open and closed, cerebellar testing, a cervical exam, and autonomic measurements from lying to standing. When dizziness appears with head extension, I assess neck mechanics and vascular safety before any vestibular loading.
Functional labs may include a complete blood count, ferritin, B12, a thyroid panel, fasting glucose and insulin, and inflammatory markers. An audiology evaluation is added when hearing is involved.
Call emergency services for sudden dizziness with weakness, numbness, facial droop, slurred speech, double vision, severe headache, or trouble walking. These can be signs of stroke.
How we address it
- Treat the mechanical cause first: canal repositioning maneuvers for BPPV.
- Stabilize the autonomic system. If you are dizzy with exertion, your exercises begin seated or supported.
- Retrain the vestibular system with gaze stabilization, habituation, and balance progressions matched to the canal and direction your exam identifies. Optokinetic and rotational input are used only when your findings call for them, and symptoms stay mild and settle quickly.
- Remove upstream drivers: migraine triggers, histamine load, blood sugar swings, inflammation, and nutrient gaps.
- Rebalance vision, inner ear, and body sense to reduce visual dependence, and calm the limbic response so your brain stops treating motion as danger.
Your brain is remarkably adaptable. Given precise practice, it recalibrates. It steadies. It trusts the ground again.
Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.