Can immunotherapy cause dizziness?

Yes, dizziness can occur with immunotherapy, and it may have several causes ranging from mild, self-limited issues to treatable immune-related side effects affecting hormone glands (thyroid, pituitary, adrenal). ^[1] Dizziness has also been documented as an adverse reaction with certain checkpoint inhibitors such as nivolumab, including postural dizziness (feeling light‑headed when standing). ^{[2] [3]}

Why dizziness can happen on immunotherapy

• Immune-related hormone (endocrine) problems: Immunotherapy can inflame hormone glands, especially the thyroid, pituitary (hypophysitis), and adrenal glands, leading to symptoms such as tiredness, headache, weight changes, and dizziness or fainting. ^[1] These endocrine side effects are recognized and require blood tests and targeted treatment. ^[4]
• Adrenal or pituitary inflammation: Early symptoms of hypophysitis/adrenal insufficiency may include dizziness, headache, nausea, severe fatigue, confusion, and low blood pressure; proper evaluation and treatment are recommended in guidelines. ^{[5] [6]}
• Direct drug side effect: Postural dizziness and vertigo have been reported with agents like nivolumab in prescribing information. ^{[2] [3]}

Red flags that need urgent medical attention

• New or worsening dizziness with fainting, severe headache, confusion, chest pain, shortness of breath, or low blood pressure symptoms (e.g., feeling like you might pass out). These can signal endocrine emergencies like adrenal crisis or other serious adverse events and should be assessed promptly. ^{[5] [6]}
• Dizziness plus extreme fatigue, persistent headache, weight changes, feeling unusually cold, mood changes, or hair loss may point to thyroid, pituitary, or adrenal issues that need labs and treatment. ^{[1] [4]}

How to cope safely at home

• Rise slowly: When moving from lying to sitting or standing, do it gradually to reduce postural drops in blood pressure and light‑headedness. ^[7]
• Hydration and salt (as advised): Staying well hydrated can help maintain blood pressure; some people benefit from modest salt intake if not restricted for other conditions ask your care team what’s right for you. ^[8]
• Fall prevention: Use handrails, avoid rushing, keep floors clear, and wear supportive, non‑slip footwear to reduce fall risk if you feel light‑headed. ^[9]
• Energy management: Fatigue commonly accompanies treatment; pacing activities and scheduling rest can reduce dizziness related to exhaustion. ^[8]
• Avoid driving or operating machinery when dizzy: Safety first until symptoms are controlled. ^[8]

When to contact your oncology team

• If dizziness is persistent, worsening, or interfering with daily activities, your team may check labs for endocrine problems (e.g., morning cortisol, thyroid function) and other causes, and they may temporarily hold treatment while evaluating. ^[6]
• If an endocrine problem is confirmed, treatment might include hormone replacement (for example, thyroid hormone or physiologic-dose steroids), which often improves dizziness. ^{[5] [6]}
• Medication guidance and scheduling: Some side effects improve with symptom‑targeted treatment or adjustments to therapy timing; discuss changes only with your team. ^[8]

Practical checklist for your next visit

• Track episodes: Note timing, triggers (standing up, after infusions), associated symptoms (headache, nausea, palpitations), and severity. ^[8]
• Bring a current medication and supplement list: Some drugs can worsen dizziness or blood pressure control; your team will review for interactions. ^[8]
• Ask about labs: Clarify whether you need thyroid tests, morning cortisol, ACTH, electrolytes, and pituitary hormones if symptoms suggest endocrine involvement. ^[6]

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Summary

• Dizziness can occur with immunotherapy and may be related to immune effects on hormone glands or to the medicine itself. ^{[1] [2]}
• Safety steps at home and early communication with your care team can help prevent falls and speed diagnosis and treatment. ^[8]
• Prompt evaluation is important when dizziness is paired with fainting, severe headache, confusion, or signs of low blood pressure. ^{[5] [6]}