Treating Orthostatic Intolerance in CFS: Diet


Diet1Eat 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


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

Many people with chronic fatigue syndrome increase their salt take. Increasing yoursalt (with your doctor’s permission) and fluid intake can increase your blood volume – which is low in many chronic fatigue syndrome (ME/CFS) patients) Doing so can increase blood flows to your heart and brain, enabling you to stand more easily and think more clearly when you stand.

Increasing salt intake will only work, though, if you increase your fluid intake as well for (see below). Increasing salt intake should be done slowly and is often achieved simply by eating saltier foods. Some ME/CFS and POTS patients who already had low salt intake have had dramatic improvements by increasing their salt intake. Do not increase your salt intake, however, if you have high blood pressure.

Be on the Lookout for Hypersensitivities to Foods
Dr. Peter Rowe reports that food hypersensitivities, particularly to dairy, should be checked if the following symptoms occur: upper abdominal pain, gastroesophageal reflux, and appetite disturbance (filling up too quickly, picky appetite), sometimes with recurrent mouth ulcers, headaches, sinusitis, and either constipation or diarrhea.


You guys are about a litre short in blood volume, ok? If I’m sitting at five litres, you’re sitting at four. So, you’re really, really sensitive to blood volume changes. If you’re a little dry, you crash. Dr. Nancy Klimas

Fluids For CFSDr. Rowe suggests that patients who make a serious (i.e. consistent) effort at increasing their fluid intake will benefit the most. He recommends drinking a glass of liquid every two hours with a goal of drinking at least two liters of water a day (approximately half a gallon). Particularly when its hot be careful that you’re well hydrated. If you’re trying to increase both blood volume and salt tomato juice is an excellent choice.

  • Vitalyte – Dr. Cheney recommends Vitalyte, an electrolyte enhancer, to increase blood volume.
  • Caffeine may help some patients and harm others. Its diuretic properties suggest it should be avoided in patients with low blood volume.
  • Alcohol opens the blood vessels – just the opposite of that OI patients want to have happen – therefore stay away from alcohol.

(This and all sections of the Phoenix Rising website are compiled by a layman. They are not a substitute for a physician and are for informational uses only. Please discuss any treatments in these pages with your physician.)

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