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Orthostatic Hypotension

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Old 07-14-2007, 06:27 AM   #1
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Wowwwweeee HB User
Orthostatic Hypotension

Hi Board,

I hope everyone is coping well.

My head symptoms have been intense for the "low sugar, low blood pressure" feelings of feeling "off", foggyheaded, fatigued (not like me at ALL), and weak/breathless, fainty.

I saw my cardiologist yesterday, who diagnosed me with Orthostatic Hypotension. My BP is on the healthy low side to begin with (90/70), but upon standing, drops considerably with an increased heart rate. I am also symptomatic upon kneeling, squatting, oh gee, generally moving in any way.

I have been prescribed salt tablets, and was told to drink plenty of fluids (for hydration).

Although my cardio does NOT feel that my other head symptoms are related, in reading a little more about OH, I found the following (brief excerpts are included, with Mod's permission, but I am unable to provide the direct link):

"Syndromes with orthostatic dizziness or lightheadedness, not associated with low blood pressure include:

1. Positional orthostatic tachycardia (POT) syndrome. Here,
the pulse races on standing.
2. Low CSF pressure syndrome
3. Primary orthostatic tremor
4. Positional vertigo (i.e. BPPV)

In addition,

"Syndromes with orthostatic hypotension that may be diagnosed include: Unknown type:
1. Orthostatic intolerance in chronic fatigue syndrome (this mainly seems to be a syndrome of adolescents)
2. Orthostatic intolerance associated with basilar migraine
3. Delayed orthostatic hypotension. Possibly due to fatigue of autonomic system over 3-20 minutes.

And finally,

"Vestibular disorders may interact with blood pressure and heart rate control. The vestibular system is one source of information about uprightness (the otoliths), there are some effects of vestibular stimulation on the heart, and there are some patients who have a combination of autonomic and vestibular symptoms."


- xo

Last edited by Wowwwweeee; 07-14-2007 at 06:32 AM.

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Old 07-14-2007, 06:44 AM   #2
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Re: Orthostatic Hypotension

Hi Wow,

Interesting dx by the doc but isn't your dizzy problem strictly migraine-based? You've posted in the past that amitriptyilne cleared up all of your head symptoms within a few days ... that you felt your old self etc but that in the end ami gave you side effects that were bad news. Have you pursued other migraine meds for this? If you can find another one without nasty SEs, you're home free.

Cheers ... Scott

Old 07-14-2007, 06:55 AM   #3
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Cool Re: Orthostatic Hypotension


I understand that you are dealing with a migraine diagnosis - how GREAT that you now know.

The general consensus is that I am dealing with MAV. And yes, the Ami was GREAT for me in that three days after being on it, my symptoms cleared up 100%. And then yes, I experienced some impacting side-effects that made it necessary for me to go off of it. Within a few months, my symptoms were back.

I saw a new neuro last month who feels that my symptoms are a result of an acute inner ear issue coupled with a migraine variant.

She prescribed Topomax - which she stated seems to work well on the vertigo part of migraine issues - but although I have the samples and the prescription, I haven't done anything with it. I am, quite honestly, too afraid to try it.

She knew that it would take great effort on my part to work up to even trying half a dose, and was fine with that. But she said that at some point, it would be good for me to try SOMETHING because she felt that if I could find a good way to alleviate my headache, the other head symptoms would probably be more manageable.

Thanks for responding - but I knew you would! xo

Last edited by Wowwwweeee; 07-14-2007 at 06:56 AM.

Old 07-14-2007, 03:29 PM   #4
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firechick HB User
Re: Orthostatic Hypotension

This is just crazy, I just posted this morning to Scott that one symptom I have had since BPPV came on 2 years ago is some major lightheadedness when going from kneeling to standing etc and when I blow my nose or cough too hard...and last week through discussion with Scott I have realized that I have a migraine issue with my BPPV it's all being diagnosed now, so long after my first viral labs infection...weid.
THanks Wowwee for your info, very interesting. My BP is on the low side to begin with and my doctor said not to hold back with the salt. Did your Dr say this is a permanent problem or one that will go away?

Old 07-14-2007, 05:52 PM   #5
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Cool Re: Orthostatic Hypotension

Hey 'Chick,

I hope this finds you doing well.

My cardio alluded to me that OH is a permanent condition. Remember, it's NOT an illness, but rather, just the way you are "made". It is what it is. Regarding symptoms as it pertains to this type of diganosis, they can fluctuate depending on things like your level of hydration, as well as hot weather.

I deal with these symptoms usually 4-5 days per month, but lately, it's been almost constant. However, our days here have been sweltering hot (I'm in New York), and my cardio stated that this could be a factor in why I have been feeling symptoms more.

Also, eating in general lowers your BP, so it's best to eat small meals throughout the day instead of large meals.

I am also having similiar symptoms when I get the urge to move my bowels. Maybe you have heard of people feeling fainty when they push their bowels - but my symptoms are upon onset of urge. My cardio explained to me that this is most likely a vagal nerve response, and can be low BP related as well.

My cardio said that he would rather see patients dealing with OH than with high BP, because although these types of symptoms are scary and can lead some people to pass out from it, it's healthier than dealing with the opposite ends of things - meaning high BP.

He also said that this is a very common condition, one that he sees in a wide variety of ages.

It was explained to me that my system is in good working order, just super sensitive, hence the physical sensations associated with OH. People with higher BP can also have OH, however, because their BP is higher to begin with, symptoms may not be as noticeable.

I was told to keep my salt intake up with Salt Tablets (2-4 grams per day), and well as plenty of fluids. Note that a person can over-do it on the salt, and actually cause themselves to have high BP, so it's something to be aware of.

My cardio stated too, that I don't have to go crazy with drinking fluids. He stated that although it's important to drink, beverages like V-8 are also a good choice because the salt content is high. Also, processed food like chicken soup is good for the same reason.

So, it's good to have something to drink every hour, stay away from excess heat (that includes hot showers), up your salt intake, and when moving from a sitting/kneeling/lying position to a standing one, try to either do some stretching first or at least clench your calf muscles a few times - this starts the blood pumping, which helps alleviate the fainty feeling.

Well wishes for a nice evening. xo

Old 07-15-2007, 03:00 PM   #6
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Re: Orthostatic Hypotension

Hi Wowwwwweeeee

Just curious. Are you thin for your height?

I have bouts with heart palpitations and dizziness upon standing and I think it's because I got too thin due to all of this terrible ear anxiety.

I think I have poor autonomic tone and have been gaining weight lately as a countermeasure against the dreaded symptoms.

Great post - thanks for sharing!

Old 07-16-2007, 06:31 AM   #7
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Re: Orthostatic Hypotension

Hi Wowwwweeee,

I'm am so happy you are getting to the bottom of some of your problems. I had mentioned in one of my earlier posts to you about feeling dizzier when standing with your low blood pressure. I read about this about a year and a half ago when I read about one of the Wiggles (the one in the yellow shirt) came down with this at the age of 33. He had to quit the show. He had a lot of our head symptoms and I do believe they are contributing to some of your problems. Migraine may still be a factor with you, but I do believe if you can get this under control a little you would feel a little better.

I'm curious though as your doctor said this doesn't go away, but I read that it can go away when I was researching about the Wiggles guy. I'll have to try and find some of that information when I get a chance and see what I can dig up. I guess above all, it sounds like it can be controlled which is a good thing.

I'm so happy you are getting to the bottom of this. I noticed a big change in making sure I eat little small meals during the day versuses the bigger ones. It can affect your system in so many ways including lowering your bp. It also stirs up your CNS by releasing too much sugar too quickly into your system when you eat bigger meals.

Keep pushing and try to eat those small meals and keep hydrated. I hope you see some improvements soon. I'm always thinking of you.


PS - Keep pushing for answers and never give up. You are headed on the right track now to helping yourself.

Last edited by gloria2936; 07-16-2007 at 06:32 AM.

Old 07-26-2007, 07:10 AM   #8
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Re: Orthostatic Hypotension

I am one of the ones that has high BP and still suffers from the OH. Its kind of tough to understand because its a bit of a contradiction. Howver my symptoms are just as bad. I find the better shape I get in the better I feel. They say that getting your legs strong is a factor.

As you mentioned, the heat is a huge factor with me.

Old 07-26-2007, 12:15 PM   #9
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realbelle HB User
Re: Orthostatic Hypotension

HI, so glad you posted this. I started doing all that this past month. It seems like when I move--it feels like I get very light-headed abd then feels like I am going to faint. I did notice drinking water seems to help. Worse, if I am down on the floor and trying to get up. Was wondering what on earth is happening now!!! Thanks, Belle

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