Dizziness and vertigo (hilo): what causes it, what helps, and when it is an emergency

People say hilo (nahihilo) for different feelings, and telling them apart helps find the cause:

• Lightheaded: faint, woozy or weak, as if you might pass out.
• Vertigo: you or the room seems to spin or move, even when you are still. It usually comes from the inner ear, which controls balance.
• Off-balance: unsteady on your feet, as if you might fall.

Note how long each spell lasts and what brings it on: this helps the doctor.

Most dizziness comes from something common:

• Standing up too fast, when blood pressure drops for a moment
• Not drinking enough, especially in hot weather, with fever, or after vomiting or diarrhea (pagtatae)
• Heat exhaustion after time under the sun
• Skipping meals, and low blood sugar in people on insulin or some diabetes medicines (see our diabetes symptoms guide)
• A cold, flu or ear infection (see our flu guide)
• Migraine (see our headache guide), stress or anxiety, and anaemia (kulang sa dugo)
• Medicines, such as some for blood pressure, the heart, anxiety or pain, and water pills
• Alcohol, and motion sickness on boats or buses

Less often, dizziness is a sign of a stroke, a heart problem or bleeding inside the body. These usually come with other signs, such as chest pain, a racing heart, weakness or trouble speaking. See When dizziness is an emergency.

Inner-ear problems are the most common cause of vertigo.

• BPPV (benign paroxysmal positional vertigo) is the most common. Tiny calcium crystals in the inner ear come loose. Spinning lasts seconds to minutes and starts when you move your head, such as rolling over in bed or looking up.
• Labyrinthitis and vestibular neuritis are swelling in the inner ear, usually after a cold or flu. Spinning, nausea and unsteadiness start suddenly. Labyrinthitis can also affect hearing. It usually eases after a few days, and balance returns over 2 to 6 weeks.
• Ménière's disease is rare. Attacks last from a few minutes up to a day, with ringing, ear pressure and hearing loss.
• Migraine and some medicines can also cause vertigo.

BPPV is very treatable. A doctor or therapist can do the Epley manoeuvre, a set of head movements that moves the crystals back into place. Have a trained health worker do it or teach it to you.

• Sit or lie down right away until it passes. If you feel faint, lie down and raise your legs.
• Get up slowly. Sit on the edge of the bed for a while before you stand, and hold on to something.
• Drink water in small sips. After vomiting or diarrhea, ask the pharmacist about oral rehydration salts (ORS).
• Skip coffee, alcohol and cigarettes.
• For vertigo, lie still in a quiet, dark room, and put screens away.
• Move your head slowly. Squat instead of bending over, and don't stretch your neck to reach high shelves.
• If you have diabetes and feel shaky and sweaty, check your sugar if you can and follow your low-sugar plan, such as a sweet drink if you can swallow safely.

Nahihilo at nasusuka? Keep still, sip fluids little and often, and avoid strong smells.

Stay safe. While dizzy, don't drive, ride a motorcycle, climb a ladder or tree, or use machinery. After vertigo, wait about a week after it stops.

Unsure what is behind your hilo? Ask our AI symptoms guide at any hour.

People often ask for a gamot sa hilo tablet, but no single pill works for all dizziness. Treatment depends on the cause.

• Anti-dizziness and anti-sickness medicines, some of them antihistamines, ease spinning and nausea for a short time. For labyrinthitis, doctors give them only for a few days, because longer use can slow recovery. For BPPV they often don't work well; the Epley manoeuvre works better.
• Betahistine is a medicine doctors prescribe for Ménière's disease. Take it only if a doctor prescribes it, and don't stop it without asking them.
• Antibiotics don't help most labyrinthitis, which a virus causes.
• Don't stop your regular medicines, such as for blood pressure, on your own. Ask your doctor.

For any botika medicine, follow the label or ask the pharmacist. Ask a doctor first if you are pregnant or breastfeeding, or for a child. You can also ask our medicines guide.

Stroke. Sudden dizziness can be a stroke sign. Remember BE FAST:

• Balance: sudden dizziness or trouble walking
• Eyes: sudden vision loss or double vision
• Face: one side droops
• Arms: weakness or numbness in an arm or leg
• Speech: slurred or strange
• Time: call 911 or go to the nearest emergency room now

Clot-busting treatment works only within hours, so don't wait to see if it passes, even if the signs stop. Don't drive yourself.

Heart. Get emergency help for dizziness with chest pain, a cold sweat, shortness of breath, or a racing or irregular heartbeat.

Heat. Dizziness with heavy sweating, headache, cramps and thirst after time in the heat suggests heat exhaustion. Move to a cool, shady place, remove extra clothing, drink water or ORS, and cool the skin with water and a fan. If not better within 30 minutes, or if the skin is hot and dry, or there is confusion or a seizure, it may be heatstroke: call 911.

Kulang sa dugo? Anaemia can cause dizziness with tiredness and pale skin, but so can many other things. Only a blood test (CBC) shows anaemia. Don't start iron pills on your own: the cause, such as heavy periods or a bleeding ulcer, must be found too.

High blood? Most people with high blood pressure feel nothing, and dizziness on standing can mean pressure that is too low. Measure it: see how to check your blood pressure at home and the normal blood pressure chart. A reading of 180/120 or more with dizziness, severe headache or chest pain needs care right away (see our high blood pressure guide).

Bawal na pagkain sa vertigo? There is no food list everyone must avoid. Regular meals, enough water, and less alcohol and coffee help. For Ménière's disease, doctors may suggest less salt and caffeine.

Hilot and oils. A gentle massage or a menthol oil may feel soothing but won't fix inner-ear or blood pressure problems. Avoid strong pulling, twisting or stretching of the neck.

Stress. Anxiety is a real cause of dizziness. If worry or panic feels like too much, or you think of harming yourself, reach the NCMH crisis line any time at 1553 (mobile: 0917 899 8727 or 0919 057 1553).

• Older adults get dizzy on standing more often, and a fall can break a hip. Use night lights, railings and, if needed, a walking stick.
• In pregnancy, lower blood pressure can cause lightheadedness. Mention it at your prenatal check-ups and ask your doctor or midwife before taking any medicine. If you are or might be pregnant, sudden sharp belly pain with feeling very dizzy, fainting or looking very pale is an emergency: call 911.
• Children who seem dizzy or unsteady need a doctor's check, especially after a fall or a bump on the head. Ask a doctor before giving any medicine.

The doctor will check your blood pressure, ears, eyes and balance, and may order an ECG (heart tracing), blood tests or a hearing test.

• Barangay health station, RHU or city health center: start here for dizziness that keeps coming back. Find a health center or read how the public health system works.
• PhilHealth YAKAP: as of July 2025, registered members get free check-ups, lab tests their YAKAP doctor orders, and GAMOT-list medicines up to ₱20,000 a year. Private YAKAP clinics may charge up to ₱900 a year. The Konsulta lab list YAKAP builds on includes CBC, fasting blood sugar and ECG. See our PhilHealth YAKAP guide.
• Stroke care: PhilHealth pays accredited hospitals a set case rate for acute stroke care in a basic (ward) bed (Circular 2023-0021). You may pay extra if you upgrade the room, choose your own doctor, or need medicines outside the Philippine National Formulary. A Malasakit Center can help with the rest.
• Private clinics and ENT doctors charge for visits and tests, so ask the price first.

Want to talk it through? Book a call with a nurse.

• Drink enough water, more in hot weather.
• Change position slowly, and sit a minute before standing up from bed.
• Eat regular meals, smaller ones if big meals make you lightheaded.
• Avoid the midday sun in the hot season, and limit alcohol.
• Know your numbers. High blood pressure is the biggest risk factor for stroke. A yearly check-up checks your blood pressure and blood sugar.