You’ll be doing everything right, and then all of the sudden you start to feel really bad.
Give in to it. Lie down. Don’t try to push through it. If you do, you’ll make your symptoms worse.
Randy Thompson, MD
Orthostatic Intolerance Spectrum Symptoms
Only about 40% of people with dysautonomia actually pass out, but 99% have overwhelming fatigue. Most patients have daily symptoms that they learn to live with and episodes where the symptoms be- come overwhelming and they need to lie down. Lying down relieves orthostatic stress and improves symptoms in orthostatic intolerance. Most patients have many symptoms beyond lightheadedness. Take a look and see if any of these other symptoms are familiar to you.
Common Symptoms Reported by Patients with Orthostatic Intolerance
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Lightheadedness |
Fainting |
Fatigue |
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Brain Fog/ Mental Clouding |
Difficulty Finding Words |
Short Term Memory Loss |
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Sensory-Hypersensitivities (e.g. light, sound, motion, touch) |
Parasthesias (pin's and needles feeling) |
Numbness of Hands and Feet |
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Coat Hanger Pain in Neck and Shoulders |
Migraine Headaches |
Other Headaches |
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Exercise Intolerance |
Heat Intolerance |
Abnormal Sweating |
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Temperature Dysregulation |
Abdominal Pain |
Nausea |
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Vomiting |
Constipation |
Diarrhea |
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Gastroparesis (Gastrointestinal tract stops moving) |
Palpitations
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Chest Pain |
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Difficulty Breathing |
Anxiety or Depression |
Difficulty With Depth Perception |
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Tinnitus (Ear ringing) |
Flushing (dry, red, hot face or upper body) |
Cyanosis in Feet (blueish/purple color change) |
Plans Will Change
You’ll make plans to go out with friends and, just before it’s time to go, you start to feel bad. Since your episodes will start with symptoms of feeling bad, it’s important for you to pay attention to your body. What kind of “bad feeling” or first symptoms do you experience? It’s important to note differences like those between being tired and being fatigued. Your symptoms may vary, but after time you may begin to recognize a helpful pattern. Once you realize that you are starting to become symptomatic, give in to it. Lie down and rest. The relief of orthostatic (upright) stress will improve your symptoms.
Once you get into an episode, it may be helpful to load up on fluids and salt. Drinking 32 oz. of cool liquids quickly, along with eating a salty snack, may help speed your recovery. Most important is to pay attention to your body and, when you start to feel bad, change your plans and recover before your symptoms worsen.
Brain Fog—A Difficult Symptom for Most People to Understand
Brain fog, or mental clouding, occurs when there is not an ideal amount of blood flow to the cerebral cortex (not a dangerously low level but a smaller than normal amount). This lower blood flow causes difficulties with concentrating, finding words, laying down short-term memory tracks, and other symptoms. Don’t worry, you are not losing IQ points. It is a temporary symptom that can improve when you reduce stress and get good rest.
It is important to note that sitting upright is an orthostatic position which may cause you to experience symptoms. It is helpful to determine how long you can stand and/or sit upright before experiencing symptoms, so that you can be prepared and plan activities appropriately.
