By Dr. Roshini Raj

Dizziness is one of the trickiest symptoms of all because it can be caused by a variety of things, both worrisome and not. It may just be a sign that you’re dehydrated; make sure you drink enough H2O throughout the day (which means at least eight glasses) in addition to having water on hand during your workout to replace any fluids you sweat out. It could also be that you’re overdoing it. It’s great to push yourself a little in your gym sessions, but it’s not wise to go so hard that your head whirls. Try easing off a bit during workouts—going at a slower pace or doing fewer reps—to see if that solves the problem.

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If you’re becoming dizzy even during light exercise, however, that’s a sign you need to see your doctor. Feeling the spins at the gym can be related to exercise-induced asthma. This typically causes shortness of breath or chest tightness as well, but if these symptoms are mild enough, you may not notice them. (You are working out, after all.) For that, your doctor can test your breathing strength and prescribe an inhaler to use before you hit the treadmill.

Finally, dizziness during a workout could signal an underlying heart problem, one of which is an abnormal rhythm, called an arrhythmia. There are a variety of types of arrhythmias—some make the heart beat too slowly or too fast, while others make the beats irregular. Arrhythmias can be caused by a structural problem, heart disease or even an electrolyte imbalance resulting from dehydration or poor diet. Sometimes exertion is the only time you get symptoms.

Depending on the type, arrhythmias are treated with prescription medications or surgery to implant a pacemaker. Another option is a procedure called catheter ablation, in which a series of flexible wires are inserted into your arm, upper thigh or neck and guided into your heart. Then radio waves are sent through the wires to destroy the heart tissue that may be causing the problem.

Some less serious arrhythmias can be managed with what’s known as vagal maneuvers, which are mini-exercises like coughing or holding your breath and bearing down. Done correctly, these moves can actually kick your heart back into a more regular beat.

Health’s medical editor, Roshini Rajapaksa, MD, is assistant professor of medicine at the NYU School of Medicine.

Originally published on Health.com