Guest Author - Jim Lowrance
Orthostatic Hypotension (OH) is also referred to as Orthostatic Intolerance and in its simplest form, simply means that you get dizzy upon standing up from a seated or lying down (supine) position. This phenomenon is the “dysautonomia” category, which is a form of involuntary nervous system dysfunction. When this part of our nervous system has mild to severe imbalances in it, due to disease processes in the body, things that normally function properly in our bodies, such as blood pressure and heart rate, are slightly off-balance. In the case of Orthostatic Hypotension, blood pressure does not rise as it is normally supposed to, with positional changes of the body from seated/lying down to standing but instead it drops slightly and results in the symptoms of OH.
The symptoms of OH include; dizziness that lasts a few seconds, a feeling like you are about to black out, a pressure sensation in the neck, head and chest, temporary rapid heart rate (tachycardia) and a temporary change in vision. These symptoms are a result of the drop in blood pressure and they subside once the body adjusts to the change in position and blood pressure returns to normal.
Some people have a more severe form of OH or Orthostatic Intolerance and their blood pressure remains dis-regulated even after their body should normally have had time to adjust to positional changes. This more severe type is referred to as Postural Orthostatic Tachycardia Syndrome (POTS). People with this severe type of dysautonomia are sometimes medically treated for this condition while milder forms of orthostatic hypotension do not need treatment.
The diseases and conditions that can cause Orthostatic Hypotension are endocrine disorders and syndromes that have an affect on adrenal function, such as Fibromalgia, Post Traumatic Stress Disorder and Chronic Fatigue Syndrome. A common heart murmur called Mitral Valve Prolapse can also cause dysautonomia symptoms, including OH and when it does, it is referred to as “Mitral Valve Prolapse-Syndrome”. Other health disorders such as anemia, hypovolemia (low blood volume) and dehydration can cause OH and certain types of medications can potentially cause it as well, including drugs for hypertension and certain types of antidepressants. Many thyroid patients also complain of suffering symptoms of Orthostatic Hypotension, especially those with Grave’s Disease but patients with hypothyroidism can also experience it. Many people, who experience OH, have no known distinguishable cause for it.
The treatment for OH is usually simple lifestyle changes, when it is mild to moderate, including exercise and eating healthy, making sure there is ample salt in the diet and drinking plenty of water which all help to keep low blood pressure episodes from happening (hypotension). When drug therapy for OH is used, it may include “Fludrocortisone” (Florinef), a mineral corticosteroid used to help regulate blood pressure, Midodrine (alpha-1 adrenergic agonist), Methylphenidate (amphetamine) and Ephedrine (adrenaline). These drug treatments are not recommended or prescribed however, when lifestyle and diet changes are able to control OH.