This letter originally appeared in Dr. Hoffman's column on allHealth.com. |
Q: I have been having really bad nose bleeds with dizziness and a headache with them. Should I seek medical help immediately or wait?
A: Some people are exquisitely sensitive to blood loss. It is not uncommon, for example, for someone to pass out the first time he/she donates blood.
On the other hand, if the blood loss is fast enough and large enough, the symptoms you describe would occur with anyone. The physiology behind this is quite simple. One of the main functions of blood is to transport oxygen (bound to an iron-containing protein called hemoglobin) to every tissue in the body. Well, almost every tissue the dead stuff, nails and hair, doesnt need oxygen!
Your most important organ is your brain. Your body would rather shut down blood flow to any other organ or extremity than allow your brain to die from lack of oxygen. Thats why patients in shock have cold, clammy extremities. You can live without an arm or leg, but not without your brain.
But it takes a bit of time for the body to accommodate this drop in blood volume. If the blood loss is rapid enough, the brain will be oxygen-starved until the appropriate blood flow is reestablished. Lightheadedness/dizziness and headache would not be uncommon symptoms in this situation.
So, what your symptoms suggest to me is that when you say "bad nose bleeds" you mean "BAD, BAD nose bleeds!" Gushers, to use the appropriate medical terminology. Does this require urgent medical attention? YOU BET!
As if life-threatening nose gushers werent bad enough, I can think of a number of other, much rarer problems in which nasal bleeding could coincide with odd neurological symptoms such as dizziness and headache. Certain brain tumors could present in this fashion. I am not trying to alarm you, but there is certainly a small chance of this. Nevertheless, the main reason to seek immediate medical attention is the fact that your nose bleeds are severe enough to cause neurological symptoms. While uncommon, it is possible to bleed to death from a bloody nose.
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