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Upside Down And Inside Out: Why Are You Feeling Dizzy While Standing Up?

Dr. Zulfiqar Ali Kango

3 min read

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Known as Orthostatic Hypo-tension (OH), this phenomenon occurs as a result of gravity pulling all of the blood towards the legs and trunk due to suddenly standing up from a sitting or lying position. This drop in blood pressure prompts the nervous system to constrict the blood vessels and increase heart rate (the number of times a heart beats per minute) to approximately an extra 10 beats per minute, in order to force the blood back towards the heart, brain and other vital organs and stabilize blood pressure. If you suspect you have OH, this article might help in clarifying your doubts about feeling dizzy. 

The Types

Divided into 2 types; Acute Orthostatic Hypo-tension is occasional, causes short spans of feeling dizzy, and is easily treatable as it results from common factors such as dehydration or prolonged bed rest. Chronic Orthostatic Hypo-tension, on the other hand, occurs more often for prolonged periods of time and is usually caused by an underlying condition that is determined by further testing.

The Symptoms

Generally lasting for less than a few minutes, the common symptoms of OH, in addition to feeling dizzy and lightheadedness, are:

  • Blurry vision
  • Weakness
  • Confusion
  • Fainting
  • Imbalance resulting in falling

The latter two are symptoms of chronic OH.

The Causes

The following factors may contribute towards lowering blood pressure:

  • Dehydration

Mild dehydration caused by either fever, vomiting, severe diarrhea, Hypovolemia (decrease in blood volume), excessive sweating, or reduced fluid intake all contribute towards lowering blood pressure, which results in weakness, dizziness, and fatigue-all symptoms of OH.

  • Heart Problems

Bradycardia (an abnormally low heart rate), heart valve malfunctions, a previous heart attack or heart failure cause OH by decreasing the heart’s ability to pump blood efficiently, and interfering with the rapid body response required to pump more blood.

  • Hormonal Dysfunction

While diabetes damages the nerves that transfer blood pressure regulating signals throughout the body, thyroid conditions, low blood sugar and under-performance of the adrenal gland are also major causes of OH.

  • Nervous System Malfunction

Commonly found in sufferers of long-term OH, drug abuse and certain nervous disorders such as Parkinson’s disease, multiple system atrophy and Lewy body dementia damage the nervous system, hence interfering with regulation of blood pressure.

  • Loss of Blood

Blood loss causes a reduction of red blood cells that take circulate oxygen in the body. This may lead to the symptoms of OH. The bleeding can be a lot at once or short discharges. The steady blood loss might be temporarily resolved with the body replacing the lost red blood cells with water. However, the symptoms will soon kick-in with light-headedness accompanied probably by chest pain, shortening of breath, or general weakness.  

Other factors include medications that have OH as a side-effect. Psychiatric prescriptions are an example. These may include MAO inhibitors, nortriptyline, tricyclic antidepressants, and phenothiazine. 

Who Can Get It?

Since the heart’s ability to efficiently pump blood decreases with age, people over 65 are most likely to develop OH. The risk is also higher for pregnant women and people suffering from various heart diseases-and use medication to treat these conditions. Moreover, prolonged bedrest, high temperatures (that cause dehydration) and using blood pressure medication are all major risk factors for OH.

Hidden Dangers

People diagnosed with chronic Orthostatic Hypo-tension may also be in danger of developing the following conditions:

  • Atherosclerosis

The vigorous blood-pumping action performed periodically in sufferers of OH may harden the arteries over time, forcing the heart to pump harder and eventually result in heart failure.

  • Stroke

OH-induced blood pressure imbalance reduces blood supply to the brain, which, if continued, can magnify the risk of stroke.

  • Cardiovascular Diseases

Chronic OH is commonly linked to increased chances of developing heart problems such as chest pain, heart rhythm problems and heart failure in later years.

The Treatment

Mild or occasional dizziness can be controlled with the following daily adjustments:

  • Rise slowly and carefully after sitting, eating or lying down
  • Exercise regularly and avoid standing or sitting in one place for too long to evade blood pooling in the legs
  • Remain hydrated throughout the day
  • For people without heart problems, increasing dietary salt can help increase water retention and minimize dehydration
  • Eat smaller and more frequent meals if overeating is the cause of dizziness.

When Not To Worry

Dizziness that lasts for only a few seconds after standing is a not a cause for concern, as it commonly occurs after strenuous exercise, and can also result from taking blood pressure regulating medicines, dehydration, a normally low blood pressure, a flu or standing up after eating a heavy meal.

When To Worry

Consult with your doctor if the above-mentioned symptoms, along with fainting and falling due to imbalance, occur every time you stand up and last for 3 minutes or more. Difficulty in walking, poor coordination and balance and a bloody or black, tar-like stool alongside these symptoms require immediate medical attention.

Feeling dizzy shouldn’t be a problem. While simple lifestyle modifications can usually remedy the occasional dizziness, serious or chronic Orthostatic Hypo-tension can also be treated using specialized prescription medication. Book an appointment with a top Cardiologist in Islamabad, Multan and Karachi through oladoc.com. Or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your cardiac issues.

Disclaimer: The contents of this article are intended to raise awareness about common health issues and should not be viewed as sound medical advice for your specific condition. You should always consult with a licensed medical practitioner prior to following any suggestions outlined in this article or adopting any treatment protocol based on the contents of this article.

Dr. Zulfiqar Ali Kango - Author Dr. Zulfiqar Ali Kango is a cardiologist and diabetes specialist based in Islamabad. He advises patients on cardiac issues, diabetes, and a number of medical conditions. You can seek appointment with him via oladoc.com.
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