It’s one thing to lose your balance and fall. But it’s especially important to keep elderly people from the hazards of a trip and fall.

The causes of balance issues could come from a number of different sources—many that don’t have a seemingly direct connection to balance or falls. Dr. Jason Rice, a primary care internist at Loyola University Health System, tells about some surprising reasons you may lose your balance and fall.

Blood pressure medication.

Some of these drugs can lead to side effects such as dizziness and lightheadedness, especially when changing positions such as standing up from a seated position. The same mechanism that allows our body to quickly adjust our blood flow after moving to a standing position from a seated or flat position can lead to a change in blood pressure, and several medications actively work to hinder this mechanism, which can lead to unsteadiness or falls when changing positions. Solution: Stand up slowly and get your bearings before walking. Staying hydrated also helps to prevent drops in blood pressure.

Blood vessel changes.

Over time the elasticity of blood vessels starts to decline and this can affect blood flow. Similar to blood pressure medication, this can cause you to become dizzy or lightheaded when changing positions, which can lead to falls. Solution: Stand up slowly and hold on to a stable surface before walking.

Low blood sugar.

Low blood sugar can cause dizziness, falls, and even loss of consciousness. This is especially true for people with diabetes. If you are taking medication to lower your blood sugar, make sure you take it with an adequate meal so your sugar doesn’t drop too low.

Declining vision.

Visual clues are an extremely important part of balance. As we age, our eyesight declines, which can lead to issues with balance. Regular visits to your primary care physician, which includes a vision assessment, is the best way to avoid this problem.