#27 April Edition: Can Allergies Cause Dizziness?

Hi Everyone,

Spring is here, and for a lot of people that means sneezing, congestion, itchy eyes… and sometimes feeling a little off.

One question I hear quite a bit is: can seasonal allergies make you dizzy?

The answer is yes.

Seasonal allergies do not usually cause true spinning vertigo, but they can make you feel dizzy, foggy, off balance, heavy-headed, or full in the ears.

This is usually because allergic rhinitis can cause nasal congestion, sinus pressure, ear fullness, muffled hearing, and Eustachian tube dysfunction (Bernstein et al., 2024). When pressure around the middle ear is not regulating properly, it can leave people feeling off or unsteady.

Not all dizziness is the same

One of the biggest reasons this gets confusing is that people use the word dizzy to describe a lot of different sensations.

Sometimes they mean:

• lightheaded

• foggy

• off balance

• heavy-headed

• spinning

With allergies, it is usually more of a blocked, pressure-filled, off-balance feeling rather than true vertigo (Bernstein et al., 2024).

What is more likely to cause vertigo?

If you feel like the room is spinning, that is a different conversation.

A cold or ear infection is more likely (but not the only reason) to trigger true vertigo because of irritation or inflammation involving the inner ear.

Then there is BPPV, one of the most common causes of vertigo. This happens when tiny crystals in the inner ear move into the wrong place. It usually causes brief spinning episodes, especially when lying down, rolling in bed, or looking up.

So yes, allergies can make you feel dizzy. But true vertigo is different and usually suggests something more than seasonal allergies alone.

The good news is that BPPV is usually very treatable. With the right manoeuvre, many people improve in just 1–2 sessions. As a physio, it is one of those things that is really rewarding to treat because people can feel so much better so quickly.

A physio tip after vertigo

Even after the spinning settles, your balance system can still feel a little off for a few days.

Simple balance exercises can help some people feel steadier after a vertigo episode, especially once the main spinning has settled.

That might look like:

• standing on one leg for 30 seconds

• standing with your feet together and eyes closed, trying to maintain your balance safely 30 seconds

• repeating these a few times through the day

These are simple ways to help your system rebuild confidence again.

Of course, make sure you are somewhere safe and stable when you practise these.

Why this matters

Most vertigo is not dangerous, and many cases do come from the inner ear.

But not all vertigo is harmless. Research shows that a small but important number of acute vertigo presentations are caused by more serious problems, including stroke (Tarnutzer et al., 2023; Shah et al., 2022; Ohle et al., 2020).

That is why severe vertigo should never just be brushed off as allergies.

When to get checked urgently

Seek urgent medical attention if you have:

• sudden hearing loss

• severe imbalance or trouble walking

• double vision

• slurred speech

• weakness

• numbness

• a new severe headache

If you have sudden hearing loss, go straight to the ER or urgent care that same day.

That is very different from the muffled or blocked feeling that can happen with congestion.

Takeaway

Seasonal allergies can absolutely make you feel dizzy, especially when congestion, sinus pressure, and ear fullness are part of the picture.

But true vertigo is different.

A cold or ear infection is more likely to cause vertigo through inner-ear involvement, and BPPV is another common cause of spinning dizziness.

Sometimes “dizzy” is just congestion and pressure.

Sometimes it is something that deserves a closer look.

Hope everyone has a physically active spring.

Kosta Ikonomou

References

Bernstein, J., Bernstein, J., Makol, R., & Ward, S. (2024). Allergic Rhinitis: A Review. JAMA, 331(10), 866–877.

Tarnutzer, A., Gold, D., Wang, Z., Robinson, K., Kattah, J., Mantokoudis, G., Tehrani, A., Zee, D., Edlow, J., & Newman-Toker, D. (2023). Impact of Clinician Training Background and Stroke Location on Bedside Diagnostic Test Accuracy in the Acute Vestibular Syndrome – A Meta-Analysis. Annals of Neurology, 94.

Ohle, R., Montpellier, R., Marchadier, V., Wharton, A., McIsaac, S., Anderson, M., & Savage, D. (2020). Can Emergency Physicians Accurately Rule Out a Central Cause of Vertigo Using the HINTS Examination? Academic Emergency Medicine, 27, 887–896.

Shah, V., Silva, O., Farah, W., Seisa, M., Balla, A., Christensen, A., Farah, M., Hasan, B., Bellolio, F., & Murad, H. (2022). Diagnostic accuracy of neuroimaging in emergency department patients with acute vertigo or dizziness. Academic Emergency Medicine, 30, 517–530.