Recommended lifestyle changes in those with orthostatic intolerance

We saw this interesting graphic — and list of ten tips — in a blog post about orthostatic intolerance.  The blog post addresses dysautonomia and POTS (postural orthostatic tachycardia syndrome).  Some (not all!) of the ten tips apply to those dealing with multiple system atrophy and Lewy body dementia.

The tips are:

1.  Avoid alcohol.

2.  Avoid heat or sun or humid environments.

3.  Avoid heavy meals and eat six small meals a day, if possible.

4.  Learn how to do leg crossing and other resistance maneuvers when one gets symptoms in the standing position.

5.  Begin a graded exercise program under the direction of your physician.

6.  Drink ample fluid, 48-64 ounces a day often adding solute into the fluid, or taking extra salt up to 6-8 grams a day.

7.  Drink a bottle of water, 8-16 ounces before even arising in the morning and just dangle the legs over the bed.

8.  Elevate the head of the bet at night with pillows or with a wedge block.  This will avoid a nocturnal diuresis and will prevent one from waking up more dehydrated.

9.  The patient should wear abdominal binders and compression stockings.  We like to start with compression stockings 20-30 mm below the knees and then increase to 30-40 mm if necessary.  Oftentimes, we will go waist high and oftentimes we will add an abdominal binder, or use only an abdominal binder if individuals have too much sensitivity to compression and are hypervigilant to compression at the lower extremities.

10.  An antioxidant cocktail, which should contain Alpha Lipoic Acid at a minimum of 600 mg per day, and prefer up to 1800 mg per day.  Also, a nitric oxide-producing compound, which contains beet root extract of at least 500 mg per day is useful in individuals who have significant exercise intolerance with chronic fatigue, or have testing which shows microcirculation abnormalities with nitric oxide production.

The ten tips are captured somewhat in this image:

Read the full blog post here

What is Orthostatic Intolerance?
by Franklin Cardiovascular Associates, PA (Sicklerville, NJ)
August 13, 2019

Certainly speak with your physician (ideally, a cardiologist or neurologist) in advance about these tips!  Don’t take medical advice from a blog post.

Robin