Chances are you’ve experienced this event at least once in your life. I see it fairly often in patients, to varying degrees.

According to Mayo Clinic; “Orthostatic hypotension — also called postural hypotension — is a form of low blood pressure that happens when you stand up from sitting or lying down. Orthostatic hypotension can make you feel dizzy or lightheaded, and maybe even faint.”

Mayo Clinic goes on to mention the cause(s) of orthostatic (or postural) hypotension as follows: “When you stand up, gravity causes blood to pool in your legs. This decreases blood pressure because there’s less blood circulating back to your heart to pump. Normally, special cells (baroreceptors) next to your heart and neck arteries sense this lower blood pressure and counteract it by triggering your heart to beat faster and pump more blood, which stabilizes blood pressure. In addition, these cells cause blood vessels to narrow, which increases resistance to blood flow and increases blood pressure. Orthostatic or postural hypotension occurs when something interrupts the body’s natural process of counteracting low blood pressure. Orthostatic hypotension can be caused by many different things, including: dehydration, heart problems, diabetes, and nervous system disorders.”

One more thing I want to add that Mayo Clinic mentions: “If you have mild orthostatic hypotension, you may not need treatment. Many people occasionally feel dizzy or lightheaded after standing, and it’s usually not cause for concern. The treatment for more-severe cases of orthostatic hypotension depends on what’s causing your episodes of low blood pressure.”

“Usually not a cause for concern.” “Many people occasionally feel dizzy or lightheaded after standing.” My presumption is that they say this because it is rarely a cause for “serious” (i.e.: pathological) concern. Serious concern for my patients, on the other hand, is their everyday well-being, and this is one (reliable in my experience) symptom that will spot a “brewing” problem.

From my experience (and that of my colleagues); this condition is usually a result of long-standing adrenal fatigue. It seems to occur from chronically stressed adrenal glands, and almost always has a blood sugar imbalance that accompanies it (as with most adrenal conditions). Systolic (the “top” number) blood pressure should normally rise by roughly 8mm of Hg (e.g.: 120/80 to 128/80)  in order to accommodate the change in position. Think of the adrenal gland hormone cortisol, and neurotransmitter adrenaline (epinephrine), as allowing the blood vessels to act like a G-suit (or anti-G-suit) for a jet pilot. If you’re not sure, a G-suit will constrict the pilot’s lower legs and abdomen in order to prevent blood from pooling in the lower extremities and abdomen, and prevent blood from draining away from the brain. This is used during periods of high acceleration in order to prevent the pilot from “blacking out”.

This condition is very much similar in that the dizziness ensues due to lack of an adequate blood supply to the brain. Why? When you are sitting or lying for a period of time, blood tends to “pool” along with the flow of gravity. As a result, when you stand up, the blood needs to (quickly) follow in order to avoid dizziness, light-headedness, feeling faint, or outright “blacking out”. This rise is accomplished by an increase in blood pressure, after standing.

According to Walter Schmitt, DC, DIBAK, DABCN cortisol sensitizes the blood vessels to allow for the constricting effect of adrenaline. When the vessels get constricted, blood pressure rises and should get to the brain “in time” to avoid dizziness, etc. under these circumstances.

Now, if there is not enough cortisol or adrenaline to “go around”, the blood vessels may not respond properly and cause orthostatic hypotension. If there is a lack of cortisol and/or adrenaline, you can be sure the person has undergone severe chronic stress (usu. chemical and/or emotional) and is in need of support. A practitioner shouldn’t claim that the person is low in these biochemicals just because they “fail” the test. There are advanced laboratories that can measure these levels. Regardless of the actual levels though, adrenal fatigue should be on the list of suspected problems. When the blood pressure drops from sitting or lying to standing…this indicates relatively severe adrenal stress in most cases.

This is not always the primary complaint of a patient, but I check it (by taking blood pressure after changes in position) on everyone. It simply helps me make a judgment of how well the patient’s adrenal glands are functioning, and perhaps contributing to their main health issue. There are many other in-office, functional adrenal stress tests.

This is usually a condition that can be easily resolved, assuming the patient is willing to make some lifestyle changes (usu. diet and stress levels/response). Once again, the key is often healthy blood sugar regulation. The adrenals have a large say in how blood sugar is regulated. Basically, cortisol and epinephrine will respond to blood sugar fluctuations. If blood sugar regulation is “faulty”, your adrenals most probably are as well. So, I’ll end with this. You can’t “fix” the adrenals if you don’t “fix” the blood sugar; and you can’t “fix” the blood sugar if you don’t “fix” the diet.

Good luck, and watch out for this symptom. If it happens rarely, try to think of a stressor that you encountered the day or so before. For instance: poor eating habits, emotional stress, etc.. If you find one, chances are, that stressor is more stressful than you may think.

One last thing, low blood pressure in general is not “OK”. “Low” is low. We should strive for optimal, not low and not high. Many doctors, including one I used to see told me that the lower the blood pressure, the better. He went on to say that I’d live longer with lower blood pressure. This is simply false, I’m sorry, but outright false. If that were true then why isn’t normal blood pressure considered 01/01 to 120/80? I’m obviously exaggerating, and I hope you get the point. I’ll discuss blood pressure in another article.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiologist

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