Why You Still Feel Dizzy (Even After “Normal” Tests) | The Real Causes of Chronic Dizziness

Dizziness is one of the most common symptoms people struggle with… and one of the most misunderstood.

If you’ve been told everything looks “normal,” yet you still feel off, this episode explains why.

Instead of chasing a single cause, we break down a more accurate framework — looking at how dizziness can come from metabolic issues, inflammation, the immune system, vascular changes, the neck, and ultimately how the brain processes it all. 

You’ll learn:

•  Why “normal labs” don’t always mean normal function 
•  Why treatments work for some people but not others 
•  The overlooked role of the brain, vision, and vestibular system 
•  And why there’s no one-size-fits-all fix 

If you’re tired of guessing and want to understand what’s actually driving your symptoms, this episode will give you a completely different lens to look through.

https://peakbrainandbody.com

Transcript

There's going to be a framework that is super important that everyone understands when we look at dizziness. Because when I look at all the different patients that I see, no matter what they're coming in with, dizziness constitute ranks as a top four or top five symptom that they're coming with. And my patients, they've been all over the place. They've seen sometimes cardiologists, they've seen neurologists, they've seen EMTs, maybe they've done vestibular physical therapy or other physical therapy, chiropractic, you know, really there's a laundry list of things that people are trying to do help them with their dizziness in general we do really really well with dizziness but we've got to step back and have an appreciation of what really is dizziness what drives it and everything from that arena because if you understand these concepts that i'm sharing with you today your provider you'll be able to better help the patients if you are someone who's dealing with dizziness and you're trying to get help this also is going to help you finally get going in the proper direction because what comes out is there's not a magic bullet for dizziness there's not hey this is the one thing everyone does and they're going to feel great i wish i could tell you that's the truth but the reality is if someone tries to say look this is the thing for everyone honestly for me that just immediately qualifies them what I want to share with you is the framework so this is a blog post I did about a year ago or so and it's one of the most popular YouTube videos that I've made up to this point with lots of people who've watched it And I'm going to go through this framework when we look at dizziness. Now, ultimately, when we look at dizziness, I always do consider dizziness a neurological-based issue. Because without your brain, there is no such thing as dizziness. Now, when we break it down, we would have dizziness from a truly neurological perspective. We also have dizziness from the inflammatory or immune system, like dizziness. We have dizziness from a metabolic, we have dizziness from a musculoskeletal, and we have dizziness from a vascular perspective. I'm going to start with the metabolic side and we're gonna wrap our way around to better understand this. Once again, Q&A. It is about you. So if you do have questions, feel free to ask questions and I will absolutely do the best I can to answer it. While there's not questions being asked, we're going to have a focus on this. So look at dizziness. No matter what you have that may be contributing to your dizziness, I really need you to lean out a little bit. It is very easy to get focused and be like, oh, wow, I have anemia. Maybe that's why I have dizziness. And you may be right, or you may be completely wrong, or you could actually be partially right. And one of the reasons why people aren't getting better is we're often trying to find the one thing like, oh, well, if I have that, that's my dizziness. Nothing else matters. In reality, maybe it's because I see people who've been to other clinics, but I rarely see someone where it's as simple as this is the one thing for you. I know it exists, but it's not the overwhelming majority. So when we look at metabolic rates, dizziness is a neurological issue. If you have things that impact the functionality of your brain cells, then you will end up with dizziness. So what are some of those things that impact the function and the rate at which all they function? So you think about a productivity lever, okay? There are things that are gonna make your brain cells less productive. There are things that cause way too much productivity. So for example, anemia. anemia, not having enough iron or not as common, but you can have B vitamin B- twelve induced anemia. This can cause dizziness. How do we measure it? Well, it's not just a CBC. The amount of people I see with normal CBC, where they look at the red blood cells, and yet when you do a ferritin, which is your body stored form iron and it's super low, there's a ton of them. So You got to make sure anemia is not at play. If you have anemia, you're not going to deliver as much blood from oxygen in the tissues, so they cannot perform appropriately. Hopefully, it can contribute to dizziness. Thyroid. Having a low thyroid, otherwise known as hypothyroid, with the most common type being Hashimoto's, which is autoimmune, this can contribute to dizziness. But on the other side, if you see anxiety plus dizziness, can be due to hyperthyroid now this can be manifest under lab work your tsh is going to be low free t-three free t-four are going to be lab high okay definitely a very serious issue of the president i don't want you to think that overly common because it's not but it does happen so we've got to be aware and then lastly blood sugar so if You have an impaired blood sugar response. Blood sugar is too low. That can make you be dizzy. Also too high. So quick synopsis on metabolic anemia, right? It's too low of iron. You only have issue. Thyroid up or down gives you issues. Blood sugar up or down. Now, when we're looking at thyroid, we should consider that A lot of people, depending on the provider, sometimes they're trying to overly optimize thyroid. And I get people who come in and they've been over-prescribed to thyroid medications, trying to make up energy and brain form and everything else. That can contribute to anxiety, feelings, and disease as well. So this is one of the metabolic sides. These are foundational things that should be checked. So anemia, anemia, thyroid, blood sugar, glucose, C-peptide, insulin, A-one-C is gonna give us a good idea of what is happening there. Now, before I go on a musculoskeletal, it is important to realize that dizziness and stability, so your ability to be stable is based upon proper neurological input. So if your brain gets good information from your eyes, your vestibular system, and your muscles in your joint, you therefore will be stable. So you can have dysfunction in those that leads to it, which we'll cover in a bit, or you can have things in the body that makes those areas weak. And that's one of the big things with metabolic. Next, when we look at musculoskeletal. Now, I really am tempted to put musculoskeletal just right underneath neurological and just leave it there. The reason why I'm not going to do that quite yet is most people, they still see musculoskeletal as a distinct thing. But when we're looking at our voluntary muscles and we look at these intrinsic muscles of our neck and our spine that can contribute to dizziness and headaches and other things like that, those are underneath direct control of the nervous system. And so a improper functioning nervous system would be why your musculoskeletal system isn't going to respond in the right way. So if we look at cervical spine related issues, people often, right? They're like, oh, dizziness. Here's what's called cervicogenic dizziness. It's going to be neck issues leading to your dizziness. And this is where if you're in different groups online, people are like, oh, but I did chiropractic. And, you know, they adjusted my neck. My dizziness is so much better. Same thing. I did acupuncture. So much better. I did physical therapy. So much better. And then you get this other big group. I did it and I don't feel any better at all. You get a small percentage. It made me worse. You get others. No changes. Others, I mean, it helped a little bit for like a couple hours or a day, and then it's as if they did nothing. So musculoskeletal, and what I normally tell people to do is, look, if you want to try any of those therapies for three to four weeks to see how you do, that makes a lot of sense, right? As long as we know that nothing crazy is going on, which we'll kind of cover in the other one, but as long as nothing's crazy going on, bad starting place. Where it becomes a not a bad starting place to this is a bad decision. It's when you're doing it for six months and the evidence is you are not getting better. Because in my experience, even though I don't do regular chiropractic, I don't adjust people. Those who respond, they respond fairly fast for people. It's not something where it's a super delayed process that takes a long time. Before we continue, just a friendly reminder, if you do have questions, feel free, put them in the chat. I will absolutely go through and answer them to the best I can. Next, vascular issues. Vascular issues are one of the big things. So outside of metabolic issues that most providers are going to look at, Vascular is the next one that people are going to look at. They're typically going to say, is your blood pressure going too low, right? Are you going AD over fifty, right? That could cause it. Hypertension on the other side can make you feel dizzy too if your blood pressure is getting way too high. Heart rate, way too low. also kind of or heart rate which i didn't put too high you know that's still going to make you feel off anything that impacts your ability to deliver blood flow and oxygen to your brain is going to therefore contribute to business now if this is an issue it needs to be looked at right we especially see this in people over the age of sixty those on what's called polypharmacy there are multiple pharmaceutical medications often including blood pressure medications, you're getting interactions, and this leads to changes in blood pressure. They're often at risk of falling whenever they're laying or sitting to standing because their brain isn't able to adjust basically the pressure gauge and the way it's shut. It's like, oh, hold up. Lost some pressure. Tighten it up. Let's make sure we get more. So this is important to know. It's also okay to make sure, you know, some people do have issues with connectivity of their heart. Some people do have valvular issues that need to be addressed, right? Super important. Get it checked, especially as we get older, probably more likely to have that compared to when we're younger. And this is why, once again, right, we're not looking at the one thing. We're saying, how do these tie in? Because if you have metabolic issues, most of the musculoskeletal issues, that's going to be more complex. And you have to go through each step of the therapy to see how well you're going to do. Versus, hey, we've checked this, checked that, checked that. We know these are all okay. And we've really isolated it. Now you can proceed with confidence. Again, if you have questions, feel free, let me know. And we're going to move on to inflammation. We kind of started with the main things people are looking at. I'm not seeing overly missed. Unfortunately, I do see anemia way more than it should be. Very sad because it's a pretty cheap blood test. But the right side isn't missed at all. and over, you know, a ton, even though it is missing. What side is missed a lot? Everything on the left, especially when we're looking at inflammation. We talked about the beginning of dizziness. Your balance is made up of all the sensory input, your vision, your vestibular, and proprioceptive information coming from your muscles and your joints. When your brain receives the information right, you can say, cool, here's what I've got. And then you do things that allows you to be stable. Everything we've already talked about impacts the functionality of those systems. Inflammation is a really big impact as well. So you have people who eat certain foods. Yeah, man, every time I have this, I feel off. That can be due to a couple different reasons. One's going to be just an inflammatory response. Two is excess histamine production. Histamine can cause disease as well. Okay. And also it can impact neurological function. Infections. Infections are a really big deal. So you get infections from two different types. You have infections from a, I had flu, I had pneumonia, I had COVID, etc., That goes in and it impacts me, leaving it meningitis. Okay. That impacts them as well. These are things that can go cause inflammation in the body that then goes through the blood brain barrier and impacts the functionality of the brain. On the other side, you can also need infections that hit your vestibular system. This is what's going to be like vestibular neuronitis or labyrinthitis if you have hearing issues. So you do get infections that can absolutely do it. Sometimes people get that infection treated, they resolve, okay. Other time you have a cleanup that they still have to work through. Allergies, allergies are really big as well. Inflation tube dysfunction, so if you're unable to drain, clear it appropriately. Mass cell histamine-based responses, really big. deal as well and you're really just trying to correlate and say what are the patterns that we see better the patterns the more likely the results you want the less patterns the less likely right so if you say hey you've got dizziness yeah every time i have my menstrual cycle i do worse i was like okay so possible anemia also inflammation and then you know what when i get when there's seasonal allergies i also do okay there's that And then when I have certain foods, okay, there's that, right? So you've got to say, what are the things that if it happens is going to increase the likelihood you have disease? And that starts letting us figure out what are the pieces of this person's puzzle? I kind of view it like whenever you watch any of the TV shows or movies where they're going through a crime and they've got everything up on a board on the wall. They've got pins and strings trying to tie everything together. So you're like, okay, how's this working together? That's what I do with people to try to say, how's it tied together? And then what matters more up front? And while usually we're going to be right on what we think, there's times where it's like, wow, priority number one actually wasn't priority number one. It should have been priority number two or three. There was something else first that should have been, you know, dealt with. Because ultimately you don't know until you start treating a little bit. Mold is another big thing. The amount of people dealing with mold-related issues. Currently, I'm in Florida, outside of Tampa. Lots and lots and lots of these houses have mold, even brand new houses, because whenever they build these houses, they're not waiting for everything to dry up if it rains. They just keep working as if nothing happened. A lot of these old schools that our kids are in all have mold. Treated more than enough teachers. who were exposed to mold. And that's not just here in Florida, but that's back when I lived in Idaho. So mold is not one of those things that's, well, it's just this part of the country. Mold has become a growing issue because our immune system is not as strong and resilient as it used to be in the past. The same reason why we need to get allergies. Allergies are much more prominent now than they were thirty years ago. Outhood allergies are worse, eczema, all of that stuff. is worse. And all these things that drive immune response is going to ultimately impact neurological function. How I divide this is I'll do their neurological testing and I actually keep them from past their neurological testing, even though they feel different. But it's their immune response that's causing it. And for me, even though it's technological and neurological, one and i don't mean to put on here that triple pd so basically you have this persistent you know postural perception of dizziness they're like oh man and you do their testing like you know you kind of ace your eye movements raise your balance like there's things i can't find and for people traditionally they're using psychiatric meds there's a little bit of research using transcranial magnetic simulation therapy for and anxiety helps as well. But we do think about what's happening in the immune system. It just requires patience because having someone neurologically when they don't have anything that's going to ruin it tends to go pretty well and people are seeing the improvement that you expect. When they don't, you've got to step back and say, what is it here? Normally inflammatory, but isn't it metabolic or vascular as well that we're not catching? So at this point in time, we've reviewed four different layers of things that can contribute to dizziness. Metabolic, musculoskeletal, vascular, and inflammatory. Next, the final one, urological. And remember, these all interact with each other. So please don't become too attached to one. I encourage all providers to not become too attached to any one of these. The more attached we become to something, the less people that we're going to help. And the less likely, if you're a patient, you're ever going to know who you need to because you have a provider who's attached and you become attached. So underneath neurological, we have dysautonomia or POTS, postural orthopedic tachycardia syndrome. And if you're dealing with POTS, you're probably like, wait, wait, wait, hold up. I thought that was vascular. They keep sending me to cardiology. But if you notice, a lot of cardiologists do not enjoy treating POTS. Because if it was truly cardiovascular, when they do an EKG, when they do electrophysiological testing, when they do... and things will get valves. They would find something that they could then treat. But more often than not, they're not going to. And the reason why it's dysautonomia is it's a dysfunction of the autonomic nervous system. And when the nervous system isn't functioning the way it should, you are not able to regulate your heart rate, blood pressure, temperature, sweating, and much more in the way it should be. So POTS can absolutely do it. Now, if you want a more deep dive on POTS, I do have other videos and stuff on it. Once again, this is a Q&A. So if you're here, you have that ability to ask a question. If you're listening from the back end, well, you have to go on us live to be able to ask us something specifically. Visual system. You can have what's called visual-induced dizziness. So even without moving your head, moving your body, you can have dizziness. How do we screen for this? Hey, when I'm in a car, I'm a passenger, oh man, I don't do so well. Okay, when I'm at the grocery store and it's pretty busy or I'm at church or in gathering, I'm overwhelmed. Okay, that could be from visual overstimulation or it could even be from poisoning, right, in gathering. So let's check how well your brain functions and see if that makes sense. For a lot of people, you find this and it needs to be treated. Now, when we look at dizziness, vestibular system gets all the attention, right? You get sent to an ENT, they do an MRI, which, you know, okay, let's make sure there's no tumor. Let's make sure there was no throat. But everyone thinks about vestibular system being just, oh, I've got a crystal in my inner ear. Unfortunately, that thought process is keeping a lot of people really, really sick. Let me explain to you why I say that. And it makes sense, okay? You type in vestibular system. What does it show you? It shows you the outer ear. But let's go back. So I'm trying to find a good picture here. And what we're gonna do is, so you do have a peripheral vestibular system and that's okay, or peripheral component, but that's not it, okay? You have your brainstem. All of your information from the outer or the peripheral vestibular system comes in and it relays on your vestibular nuclei, which is your central component. So you may not have a peripheral issue causing your dizziness, labyrinthitis, vestibular neuronitis, EPPV, and so forth. But if you have a central vestibular tissue, when you do a caloric, so the warm air, warm water, cold air, cold water in your ear, you can come up and be normal. But your vestibular system processes information from your outer ear, okay, or your inner ear. It processes information from your visual system, and it processes information from your cervical spine. All that comes in and used to basically provide information for what should happen. And that's why if you get your neck adjusted and your dizziness improved, usually from how the cervical spine muscles influence the vestibular system. So vestibular system, super important. just remember it really is best to not do it in isolation. Those that do it in isolation are gonna have lower success rates than those that treat it as part of a continuum. Now, things that routinely impact the vestibular system is a concussion. Having a concussion, vestibular and visual impacts are very, very common. Unfortunately, many of these concussions go undiagnosed or if you do get diagnosed, it basically gets timed out as if it's not a big deal. If there's a possibility of concussion, it needs to be treated and evaluated accordingly. As far as you're not being done especially in car accidents a lot of them are not treated their diagnosis whiplash instead it's not saying you couldn't have had a whiplash but you can have whiplash plus a concussion and it's very different doing physical therapy or chiropractic for your neck or whiplash than doing therapy for a concussion very different one's not going right what you do for your whiplash isn't going to do anything for your concussion Even if you kind of slightly improve neck pain and headache, it doesn't take care of the other things. You can have a stroke that can also cause dizziness. You can have an autoimmune disease such as multiple sclerosis, which can contribute to dizziness. As you can see, right, there's a lot of layers that contribute to dizziness. And it's why I tell people the worst thing we've done in healthcare is try to separate the body and all these little people. And ignore the fact that endocrinology is going to affect the musculoskeletal system, the vascular system, inflammatory and immune response are all going to impact neurology. And then neurology has the ability to guess what? I'm going to mess with a lot of these too. So the better we understand how things connect, the better off people are going to be and the more likely they get the results they're looking for.