orthostatic intolerance

Posted by Cort Johnson

(In what has become easily the best documented interaction of any patient with Dr. Dan Peterson, Corrine returns to see him for visit #4. Check out Corrines other blogs here as she brings up you close and personal with one of the most respected ME/CFS physicians in the US. Check out the beginning of the Corinne-Dr. Peterson Chronicles here)

 

Let me begin with a summary of my first three visits with Dr. P.

 

June 2009: I traveled by RV (my husband drove) because I was partially bedridden and wanted to “stop and smell the roses” along the way.… Read More
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Central Nervous System Stimulants

Stimulants  are sometimes used to treat orthostatic intolerance in chronic fatigue syndrome because of their ability to increase blood flows. Stimulants do this by increasing blood pressure, the heart rate, and constricting the blood vessels. Many are similar in chemical structure to the neurohormone norepinephrine, which plays a key role in constricting the blood vessels when we stand.

In the past amphetamines were used to treat many disorders including asthma and other respiratory diseases, obesity, neurological disorders, etc. but their potential for abuse and addiction has restricted their use to just a few conditions such as attention deficit disorder.… Read More

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Dr. Peter Rowe of the Pediatric Network at Johns Hopkins provides the most extensive overview of the different drugs used to treat orthostatic intolerance in chronic fatigue syndrome (ME/CFS). He makes several general points:

  • Few treatment trials have assessed most of these drugs effectiveness in ME/CFS
  • Finding the right drug or combination of drugs to treat this problem may take some time and requires persistence and the willingness to experiment on the part of the physician and the patient.
  • Because several of these drugs can cause serious side effects such as increased blood pressure and altered electrolyte levels careful monitoring is needed.
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FOOD

Eat Small Meals More Frequently

Eating large meals causes large amounts of blood to be shunted to the gut (and away from the heart and brain) causing sluggishness and fatigue. The National Dysautonomia Foundation (NDF) suggests flexing your feet back and forth while you’re eating to stimulate the muscle pump in the legs. Do not eat in a high chair since doing so accentuates blood flows into your legs.

Starchy and High Sugar Foods

 Stay away from starchy and high sugar foods (yes, all the good stuff!) since they tend to worsen symptoms

Salt

“The reduction in salt, which is a good idea for most people, may push OT symptomatic people into having symptoms of OT” Dr.

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