Fatigue & Lightheadedness: When to Be Concerned

Understand the common causes of fatigue with dizziness—and when it’s time to dig deeper.

Feeling tired is one thing—but when fatigue is paired with lightheadedness or dizziness, it’s often a signal from the body that something deeper is going on. If you’ve ever stood up and felt the room spin, or felt drained and woozy during your menstrual cycle, you’re not alone. These symptoms are common, but they’re not normal—and they can point to important imbalances in your health.

Understanding Fatigue with Dizziness

Fatigue and dizziness are closely related. They often stem from the same root causes: issues with blood flow, nutrient status, hydration, and hormonal balance. Let’s explore the most common culprits.

1. Iron Deficiency from Heavy Menstrual Cycles

For menstruating women, or men who are weight lifting, iron deficiency is one of the top causes of both fatigue and dizziness. Blood loss from heavy periods depletes iron stores over time. Without enough iron, your body struggles to deliver oxygen to your brain and muscles, leading to exhaustion and a lightheaded sensation—especially when standing or exerting yourself.

Testing is key. A simple blood test can check for:

• Complete Blood Count (CBC) – to look for anemia

• Iron and Ferritin levels – ferritin reflects stored iron, and low levels often precede anemia

• Percent Iron Saturation – helps identify how much iron is actually being used by the body

• Pregnancy Test – first trimester high progesterone can cause fatigue and nausea is common for some women

Even with “normal” results, levels may be suboptimal and worth addressing proactively.  Iron supplementation may be needed but should never be taken unless your blood levels are actually low.  You can always be proactive by increasing iron containing foods such as organic grass fed red meat, lamb, collard greens, spinach, and raisins.

2. Adrenal Fatigue and Low Cortisol

Chronic stress can wear down your adrenal glands, eventually leading to adrenal fatigue—a state of low cortisol output. Cortisol is essential for maintaining blood pressure and helping your body respond to position changes.  If you feel dizzy when moving from sitting to standing or bending over to upright, your adrenal response may be sluggish. This is called orthostatic hypotension, and it can make you feel foggy, unstable, or faint.

To assess this, we recommend:

• Saliva cortisol testing (4-point throughout the day) – to identify imbalances in your daily cortisol rhythm

 

3. Dehydration and Electrolyte Imbalance

Dehydration can also cause fatigue and dizziness, especially in warmer climates or during menstruation. Low fluid volume makes it harder for your heart to circulate blood to your brain efficiently.

Recommendations:

• Drink half your body weight in ounces of water daily

• Add trace minerals from ancient seabeds

• Include a pinch of sea salt in your water to help retain hydration

You can also test hydration status with a basic urinalysis, which shows concentration and overall hydration markers.

4. Gut, Hormones, and Chronic Conditions

Other contributing factors include:

• Poor nutrient absorption

• Thyroid dysfunction

• Sex hormone imbalances (low estrogen or progesterone)

• Chronic infections (such as mono or post-viral fatigue)

• Mitochondrial dysfunction

• POTS (Postural Orthostatic Tachycardia Syndrome), which causes elevated heart rate and dizziness when standing

POTS is complex, and while naturopathic care can support it with hydration, nervous system support, and root cause treatment, it often requires a more comprehensive plan.

When to Be Concerned About Fatigue and Lightheadedness

While occasional dizziness with fatigue can be explained by common imbalances, there are times when more urgent care is needed:

See a neurologist immediately if:

• Dizziness is constant or worsening

• You are vomiting and experience nausea

• You experience loss of balance, hearing changes, or ringing in the ears (could be Meniere’s disease)

• You have vertigo that does not resolve

• You faint or nearly faint regularly

Persistent symptoms may indicate a neurological issue or more serious cardiovascular or endocrine dysfunction that needs further evaluation.

You Deserve Real Answers

If you’re feeling tired and dizzy, your body is trying to tell you something. Don’t settle for “normal labs” or temporary fixes. With comprehensive testing and a naturopathic approach, we can uncover the root cause and create a personalized plan to restore your energy, stability, and well-being.