You Have Felt It Before
October is National Audiology Awareness Month.
Perhaps as a child you played Pin the Tail on the Donkey. You were willingly blindfolded and spun around until disoriented before attempting to walk towards a board and attach a paper donkey tail. The unavoidable misplacement amused onlookers. 
In the game, the participant usually regains equilibrium shortly after the veil is removed. If you can imagine remaining in that state of disorientation without the blindfold then you have entered the tortuous world of chronic vertigo sufferers.
Vertigo Dries Up Social Interaction
Disequilibrium can bemuse vertigo sufferers for hours, days or longer, often accompanied by nausea, photophobia, and hyperacusis (sonophobia). This means they are sensitive to light and sound. It interferes with individual fitness routine and social interaction. Some describe it as a never-ending roller-coaster descent. Others say that it feels like a hangover without the alcohol.  Either way, it’s not fun and games.
A sudden change in position may trigger vertigo. The “good” kind lasts less than a minute. For others, there’s an aura, or tell-tale sign, portending an unproductive day. Medical literature distinguishes between migraines, dizziness, and vertigo. “Dizzy” may be defined as a feeling of faintness or lightheadedness.
However, symptoms can overlap. A patient may experience migrainous vertigo (vertiginous migraine), for example.  Those debilitated by vertigo often deplete financial resources in hopes of emerging from their social drought of hibernation.
Weeding Out The Source of Vertigo
Many professional tests can be performed to diagnose vertigo. If trauma has been involved or unexplained dizziness occurs, particularly in association with other symptoms like diarrhea, impaired vision, depreciated hearing or memory loss, a doctor’s diagnosis is prudent. Generally, physicians perform an MRI to rule out tumors. This may be ordered in conjunction with a referral to an otolaryngologist (Ear, Nose & Throat doctor) for further evaluation and testing.
A very common cause of vertigo that worsens with a change in position is dehydration.
During a patient consultation, questions often focus on when symptoms first began, what current medications are being taken, whether vision is blurred, if there is any pain associated with the disequilibrium, does (s)he feel faint, how much alcohol is consumed daily, whether the patient feels (s)he is moving or encircled by the environment.  The questions, alone, could make one’s head spin. An often overlooked question is: “How much water do you drink daily?”
Though it may not be the motivation of most healthcare providers, counseling, pain medication, psychiatric visits, vestibular and auditory tests can be monetized. With the potential for a life-threatenting ailment, insurance companies pay up. And the compensation keeps doctors in business. Chronic sufferers may wonder if this care diverts attention away from such a simple, natural solution. Is a such an inexpensive remedy as water even plausible?
Getting To The Root of The Problem
Putting chemical fertilizer on a lawn with insufficient water will do more damage than good. Similarly, treating vertigo symptoms with prescription medication does not remedy the root problem when the cause is dehydration.
It is theorized that unnecessary drugs may contribute towards toxicity (another cause of vertigo) since the body’s water conservation effort results in retention of a higher concentration of chemicals.
Any condition that affects the brain can trigger vertigo.  One way to remember the causes of vertigo beyond vestibular dysfunction or dehydration is to use the popular English vowels mnemonic AEIOU TIPS:
According to Joshua Gowin, PhD, brain cells require a delicate balance between water and various elements to operate, and when too much water is lost, that balance is disrupted. Brain cells lose efficiency.  A very common cause of vertigo that worsens with a change in position is dehydration.
Dehydration often follows vomiting or diarrhea. Vertigo frequently causes nausea and vomiting, so it may be hard to distinguish inner ear problems from dehydration.  Nevertheless, such a distinction is key to ascertaining proper care.
An article in the Journal of the American Medical Association by A.D. Weinberg, MD, et al. concludes: “In patients identified as being at risk for possible dehydration, an interdisciplinary care plan with regard to prevention of clinically significant dehydration is critical if maximum benefit is to result.” 
If someone has been dehydrated for an extended time, the thirst mechanism shuts down.
Many negative symptoms associated with a hangover are caused by dehydration—headaches, fatigue, and dry mouth.  How can vertigo cause dehydration when an individual doesn’t feel thirsty? If someone has been dehydrated for an extended time, the thirst mechanism shuts down.
The feeling of thirst is absent until the mouth is literally dry or the body is about two glasses low. It’s a strange phenomenon, but if one begins regularly drinking water, the thirst mechanism returns.  A quick test for dehydration is to lightly pinch and pull up your skin and see if it stays standing up in a tent. 
Immerse Yourself In Water
Obviously, water does not cure every case of vertigo. As discussed earlier, there can be physiological causes or even environmental toxins.  But it is good to monitor water intake since the average person expells 90 ounces (2.66 liters) of water daily through urine and perspiration. Aim to drink about half your body weight (pounds) in ounces.
At 150 pounds (68 kg), the human body requires about 75 ounces (2.22 liters) of water throughout the day to remain hydrated. Fluid requirements increase at higher altitudes and during physical exertion.  Generally, the limit for the largest person is sixteen 8-ounce (250 mL) glasses per day.
People with nephrotic syndrome can have extreme thirst due to kidney dysfunction. A doctor trained in the field of nephrology is called a nephrologist. This medical specialist should advise patients with liver anomalies on diet and fluid intake.
When someone has been dehydrated for an extended time, the thirst mechanism shuts down.
If you are not in the habit of drinking much water, you may need to remind yourself by associating water consumption with regular activities. Have an individual glass of water first thing in the morning. Have another before and after each meal. Keep a bottle on your desk at work and take one with you during workouts. Offset each caffeinated beverage with an equal amount of pure water. 
Recommended Daily Water Intake By Body Weight
|Body Weight||130 lbs|
|Daily Water||65 fl. oz.|
|75 fl. oz.|
|90 fl. oz.|
|100 fl. oz.|
It takes time to thoroughly rehydrate cells throughout your body, so do not expect immediate results. But if you have other symptoms of dehydration like dry skin and hair, dark or infrequent urine, then you should evaluate your water intake even in the absence of vertigo.
Drinking water also helps remove toxins that may cause equilibrium problems. If your dehydration is serious, you may need to see a doctor to get treated with intravenous (IV) fluids. Though you may have tried everything but the kitchen sink, a simple cure for this ailment may be purified water. 
Water is not a cure-all for vertigo. Rather, symptoms of dehydration include vertigo. Hydrate yourself to eliminate dehydration as a possible cause. The Epley maneuver may bring relief to those with with benign paroxysmal positional vertigo (BPPV). If these home remedies are not effective, see a health care professional. Check references below for more vertigo information.
This article has been updated since original published version at ClinicalPosters.com on August 22, 2012.