Can Rheumatoid Arthritis Cause Dizziness? Learn the Hidden Dangers

Have you ever wondered, can rheumatoid arthritis cause dizziness? Honestly, as a Rheumatology Nurse Practitioner, I’ve had so many patients over the years bring this up during visits — and I get it. When you’re dealing with a chronic illness like RA, anything out of the ordinary can feel alarming. Sometimes, the dizziness creeps in so subtly that it’s easy to overlook, while other times it hits like a wave. Let’s dive deeper into how rheumatoid arthritis (RA) can make you feel off-balance — and what’s really going on behind the scenes.

Understanding Rheumatoid Arthritis: It’s More Than Just Joints

When people hear “rheumatoid arthritis,” most immediately think about swollen hands, stiff knees, and achy joints — and that’s not wrong! But what a lot of folks don’t realize is that RA is a systemic autoimmune disease. That means it doesn’t just hang out in your joints causing trouble; it can potentially affect your whole body — including your heart, lungs, blood vessels, eyes, and yes, even your balance and brain function.

From my experience working with hundreds of RA patients, many don’t expect symptoms like fatigue, lightheadedness, or dizziness to be part of their story. Yet, they’re surprisingly common once you dig a little deeper. It’s not always a straightforward “RA causes dizziness” situation either — often, it’s a bit more complicated.

So, Can Rheumatoid Arthritis Cause Dizziness?

The short answer is: yes, but indirectly. RA itself might not spin you around the room, but it triggers a cascade of effects that certainly can make you feel dizzy, faint, or even disoriented. Based on clinical observations and patient stories, several underlying culprits come into play:

1. Anemia of Chronic Disease

One major player is anemia. Chronic inflammation from RA can interfere with your body’s ability to produce healthy red blood cells. This means less oxygen gets delivered to your brain and muscles — and guess what one of the first symptoms of low oxygen is? Yup, dizziness.

• Feeling lightheaded when standing up
• General fatigue that doesn’t improve with rest
• Shortness of breath, even with mild exertion

I can’t count the number of times I’ve ordered labs for a patient who casually mentioned “just feeling a bit off” — and boom, low hemoglobin pops up on the report.

2. Medication Side Effects

Let’s be real: the meds we use to fight RA can sometimes be a double-edged sword. Disease-modifying antirheumatic drugs (DMARDs), biologics, steroids — they can all come with side effects that include dizziness. Not to mention, many patients are also on blood pressure meds or pain medications, which can compound the problem.

1. Prednisone — can spike blood sugar and blood pressure unpredictably
2. Methotrexate — sometimes triggers nausea and weakness
3. NSAIDs — can cause gastrointestinal bleeding leading to anemia

I’ve had patients say, “I thought it was just the weather,” when it turned out to be a medication adjustment issue. It’s so important to keep track of any new or worsening symptoms when meds change!

3. Autonomic Nervous System Dysfunction

This one’s a little more complex. Some people with RA develop issues with their autonomic nervous system — the part of your body that controls things like heart rate and blood pressure without you thinking about it. When this system misfires, it can cause sudden drops in blood pressure (a condition called orthostatic hypotension), which leads straight to dizziness or even fainting spells.

Signs you might be dealing with autonomic dysfunction:

• Feeling woozy when standing up too quickly
• Cold hands and feet due to poor circulation
• Heart palpitations or “fluttering” feelings

It’s rare, but I’ve personally helped a few patients navigate this tricky situation with a combo of medication tweaks, hydration strategies, and sometimes referrals to cardiology specialists.

How Inflammation Impacts Blood Flow and Brain Function

Inflammation isn’t just about swelling joints — it’s like a wildfire running through your body. When inflammation levels are high, blood vessels can stiffen, thicken, or even narrow, reducing blood flow to important areas like the brain. That decreased circulation can absolutely trigger dizzy spells.

In some severe cases, chronic inflammation can even lead to vasculitis — inflammation of the blood vessels themselves — further impairing circulation. Thankfully, vasculitis is less common in RA, but when it does happen, it can create serious dizziness and other neurological symptoms.

From my personal clinical experience, patients tend to describe this dizziness differently than what you’d get from, say, dehydration. It’s more of a “foggy,” “off-balance,” or “floating” feeling rather than a spinning vertigo sensation.

Other Hidden Causes of Dizziness in Rheumatoid Arthritis Patients

Now, while we’ve touched on the big culprits, there are a few lesser-known issues that I always keep in mind when someone with RA tells me they’re feeling dizzy. RA is such a complex beast — and sometimes the unexpected things are what trip us up the most.

1. Inner Ear Involvement (Vestibular Issues)

Believe it or not, RA can sometimes mess with your inner ear — the part of your body responsible for balance. Chronic inflammation can impact blood flow to the inner ear structures, and in rare cases, even trigger conditions like vestibular neuritis or labyrinthitis. Both can cause dizziness, vertigo, and a feeling like the world is tilting sideways.

Here’s what to watch for:

• A spinning sensation (even when you’re sitting still)
• Feeling like you’re pulled to one side
• Sudden loss of balance when walking

I’ve had a few patients who swore they were “just tired” until it turned out to be an inner ear problem. We worked together with ENT specialists to get the right diagnosis — and it made all the difference in their treatment plans.

2. Dehydration and Electrolyte Imbalance

Here’s one that’s super simple but super sneaky. People with RA often take medications that can dehydrate them (like diuretics, or even corticosteroids). Add that to low appetite from chronic pain or nausea, and you’ve got a recipe for dizziness right there.

1. Dry mouth
2. Dark yellow urine
3. Rapid heartbeat or feeling faint after standing

Sometimes, all it takes is a gentle reminder for my patients to up their water intake, add an electrolyte drink now and then, or tweak their meds — and poof, the dizziness improves significantly.

What It Feels Like: Real Patient Stories About RA and Dizziness

Nothing beats real-world experience, right? Over the years, I’ve heard so many different ways people describe the dizziness linked with rheumatoid arthritis. Some common phrases I hear in clinic:

• “It feels like my head’s in the clouds.”
• “Sometimes it’s like the ground moves when I stand up.”
• “I get these random head rushes, like all the blood drains from my brain.”

One of my patients, Sarah, told me, “I thought I was going crazy! I expected joint pain with RA, not feeling like I was on a roller coaster every time I stood up.” It took a little detective work, but we eventually traced her symptoms back to anemia and a slight autonomic nervous system dysfunction. With a few adjustments to her treatment plan, she’s feeling much steadier these days.

Another patient, Miguel, experienced dizziness every afternoon around the same time. We discovered that it coincided with when his blood pressure would dip — linked to his RA meds wearing off. We coordinated with his cardiologist, made a small timing adjustment, and voila — his symptoms dramatically reduced.

When Should You Be Concerned About Dizziness with Rheumatoid Arthritis?

Okay, so dizziness isn’t always a five-alarm fire, but there are definitely times you shouldn’t just brush it off. As a general rule, if dizziness is:

• Severe and sudden in onset
• Associated with chest pain, shortness of breath, or palpitations
• Causing frequent falls or near-falls
• Accompanied by neurological symptoms like vision changes or slurred speech

Please seek immediate medical attention. Dizziness can sometimes be a sign of more serious problems like stroke, heart issues, or severe anemia — all of which need fast intervention.

In my clinic, I always tell my patients: you know your body better than anyone else. If something feels “off,” trust that feeling. It’s always better to ask and be reassured than to wait until something escalates.

Steps You Can Take Today to Manage Dizziness from Rheumatoid Arthritis

Managing dizziness often starts with identifying the root cause — and as we’ve seen, there are plenty of possibilities. Here’s what I often recommend based on my clinical practice:

1. Stay hydrated: Water is your best friend. Electrolyte-rich drinks help too, especially if you’re on diuretics or sweating a lot.
2. Monitor your medications: Keep a symptom diary when you start a new med or adjust dosages.
3. Check your blood work: Ask your provider to monitor for anemia, electrolyte levels, and inflammation markers regularly.
4. Get up slowly: If you’re prone to orthostatic hypotension, avoid jumping up from a seated position too fast.
5. Eat balanced meals: Even small snacks help keep blood sugar stable, which can prevent dizziness dips.

And honestly, don’t underestimate the power of simple lifestyle tweaks. I’ve had patients make small changes — like adding more salty snacks if they’re prone to low blood pressure — and it’s made a huge difference in their day-to-day life.

Can Lifestyle Changes Help Reduce Dizziness from Rheumatoid Arthritis?

Absolutely — and honestly, this is one of my favorite parts of working with RA patients. It’s empowering to show people that even small changes can make a huge impact, especially when it comes to symptoms like dizziness. Over the years, I’ve seen firsthand how lifestyle adjustments can boost energy levels, improve balance, and even reduce flare-ups.

Here are a few real-world strategies that I often recommend in the clinic:

• Gentle exercise: Activities like yoga, tai chi, and walking can improve circulation and help your body regulate blood pressure better. Plus, movement naturally combats stiffness and boosts mood!
• Mindful hydration: Aiming for 6–8 glasses of water a day (more if it’s hot or you’re active) can fend off dehydration-related dizziness.
• Anti-inflammatory diet: Omega-3s, leafy greens, and antioxidant-rich foods aren’t just trendy — they really can help lower systemic inflammation. Less inflammation, less dizziness risk.
• Stress management: Chronic stress can worsen inflammation and throw off your autonomic nervous system, making dizziness worse. Deep breathing, meditation, or simply taking time for hobbies you love can make a world of difference.

One patient of mine, Tom, started a simple morning stretching routine and swapped out some processed foods for more veggies and fish. Within three months, he reported fewer dizzy spells and better overall energy. It’s not magic — it’s just giving your body the support it needs to thrive.

When Dizziness Might Mean It’s Time to Reassess Your Rheumatoid Arthritis Management

Sometimes, persistent dizziness is a nudge from your body that your RA treatment plan needs a little tweaking. And that’s totally okay. In fact, it’s expected — rheumatoid arthritis is a moving target, and what worked a year ago might not be the best fit today.

If you’re finding that your dizziness:

• Has gotten worse over time
• Is interfering with daily activities
• Is not improving despite hydration, diet, and medication tweaks

Then it’s probably time for a sit-down with your rheumatology provider. Sometimes we’ll need to:

1. Reevaluate your medication doses or switch treatments
2. Refer you to a specialist, like a cardiologist or neurologist
3. Run additional labs or imaging studies to rule out other causes

In my practice, I always encourage patients to bring a symptom journal to their appointments. Jotting down when dizziness happens, what you were doing, how long it lasted, and any other symptoms you noticed can give your care team priceless clues to help tailor your treatment.

What To Ask Your Rheumatologist If You’re Experiencing Dizziness

Walking into your appointment armed with the right questions can really fast-track getting the help you need. Based on years of working closely with RA patients, here are some smart questions you might consider:

• “Could my RA medications be causing or contributing to my dizziness?”
• “Should we check for anemia or electrolyte imbalances?”
• “Would a referral to cardiology or neurology be appropriate?”
• “What lifestyle changes might help reduce my dizziness?”
• “Are there any RA complications, like vasculitis, that could explain this?”

And honestly, don’t be shy about asking your provider to slow down and explain their thought process. A good healthcare team is there to partner with you — not just prescribe and dash.

Final Thoughts on Can Rheumatoid Arthritis Cause Dizziness?

By now, it’s probably pretty clear: the answer to can rheumatoid arthritis cause dizziness is yes, absolutely — but often indirectly. It’s rarely just one simple cause; more often, it’s a tangled web of inflammation, medication effects, secondary conditions like anemia, and even lifestyle factors.

Through attentive management, good communication with your healthcare team, and smart lifestyle habits, you can get a handle on this frustrating symptom. I’ve seen it happen again and again — patients who once feared they’d never feel “steady” again have gone on to lead vibrant, active lives.

So if you’re feeling dizzy and living with RA, don’t brush it off. Listen to your body, reach out for support, and know that you’re not alone on this journey. You’ve got this — and we’re right here with you.

References

• National Institutes of Health
• Health.com
• Mayo Clinic
• Arthritis Foundation

Disclaimer

This article is intended for informational purposes only and should not be taken as professional medical advice. Always consult with your rheumatologist, primary care physician, or qualified healthcare provider regarding your symptoms, treatment options, and any health-related decisions. Every individual’s health situation is unique, and personalized medical care is essential.

Tarra Nugroho

Tarra Nugroho is a dedicated Nurse Practitioner with a strong foundation in family and preventive care. She brings both compassion and clinical expertise to her practice, focusing on patient-centered care and health education. As a contributor to Healthusias.com, Tarra translates medical knowledge into clear, empowering articles on topics like women’s health, chronic disease management, and lifestyle medicine. Her mission is simple: help people feel seen, heard, and informed—both in the clinic and through the content she creates. When she’s not caring for patients, Tarra enjoys weekend hikes, plant-based cooking, and curling up with a good health podcast.