Orthostatic Hypotension: Anything I'm missing? page

[TornadoGirl]

I mentioned this in someone else's thread about blood pressure, but I wanted to see if anyone has any suggestions/ideas specific to my situation. A few years back, I started a diet called Fat Flush, which starts with a very strict phase one of meat, eggs, non-starchy veg., two low glycemic fruits, a half gallon of water mixed with one cup of pure cranberry juice, and a cup of lemon water, and no-added salt. As you can imagine, the first thing that happens is you drop a massive amount of fluid weight during this two weeks. While I lost lots of weight over the four months I religiously adhered to this program, I started feeling very faint when I would rise from squatting to standing or do yoga or even get really excited or startled. I'm talking grabbing the wall when rising from a seated or lying down yoga position. Once I took my blood pressure during one of these episodes (which had been borderline high before beginning this) and it didn't register on my bp machine, presumably because it was too low. During these episodes my heart rate increases, I'm assuming to get some blood flowing to my brain so I don't pass out?

I mentioned this to a nurse when getting my cholesterol checked and she told me to add salt, which did help. I also started supplementing with calcium and magnesium, which seemed to help.

A couple of years prior to the above, I had a cardiac workup after having premature ventricular contractions (PVCs). One thing they noticed right away is my blood levels of magnesium were low. Now I read that blood levels usually aren't low when tissue levels are, so I'm guessing I was really deficient. I had a stress test, an EKG, and a sonogram at the time. The only "problem" uncovered other than the low mag was high cholesterol which I've almost always had but I've always had a good ratio with very high levels of HDL (up to 90).

When beginning the Primal Blueprint a month ago, I did not stop eating dairy specifically to keep my calcium intake higher. I also have done a pretty good job of supplementing calcium and magnesium and just started D3 drops (10,000 iu). Even so, I have had symptoms of the orthostatic hypotension and restless legs at times with PB. I know that my salt intake is lower with less processed food so I do salt my food more with Celtic sea salt. This does seem to help some.

Interestingly, I have less symptoms of orthostatic hypotension on the SAD. This is pretty frustrating to eat healthy foods and feel worse in some ways. My theory here is that the SAD masks the OH because my blood pressure stays higher and it doesn't dip as low upon standing, etc. I'm also wondering if this could be related to Sjogren's disease, which I have. I never really thought about it until now and did a quick search.

In my latest research on OH, I have noticed a link to alcohol consumption. I have cut down on my red wine since starting PB, but I will try to track whether that has an impact. Last night I had two glasses of Merlot and a particularly bad episode of OH this morning while running around the house cleaning with lots of stooping and bending. Blood pressure was all of the map as was my pulse which climbed to 125 after bending over and raising up.

One problem I may still be experiencing is a hydrochloric acid deficiency which may be interfering with absorption of minerals. I did a test a year or two ago and found my body was making little to no HCL. I'm going to check that again.

Sorry for the novel, but if anyone has any thoughts I'd love to hear them. If I don't tease this out soon, I will find a new doc who is less prescription happy to help me because it really does interfere with living an active life.

[jammies]

How much sea salt are you getting during the day? Any chance you are dehydrated? Do you know if you have any issues with adrenal function - this can result in orthostatic hypotension.

Any ear problems? Also, do you know if you have corrected your mineral problems with your supplement?

All questions, no answers - sorry!

[TornadoGirl]

Questions are good, thanks for your help and interest. I'm not really sure how much sea salt I'm getting. I salt dishes I cook to taste and if something doesn't have salt I grind a little and sprinkle it on (like a salad or eggs). How much do I need? I'm pretty sure I have had adrenal problems in the past and now to a lesser extent. No ear problems.

I am afraid I'm still having problems with mineral absorption so that is probably something to look into more thoroughly. I don't think I'm absorbing the calcium I'm using right now. I have used Garden of Life in the past with pretty good results.

[jammies]

I like magnesium oil, I rub it on my skin once or twice a day and find it helps with leg cramps (along with potassium) as well as sleep, with no GI upset. I think Cillikat uses a slow release magnesium that you might find helpful. Magnesium can cause a small decrease in blood pressure though, so I would proceed slowly with this.

My physician had me take 1/2 teaspoon good quality sea salt in a full glass of water twice a day. I found this helpful, and actually am going to start it again today.

I don't want to be nosy, but are you on any prescription meds that could be contributing?

Also, don't have blinders on about this being diet related for sure. This could be secondary to any number of conditions, and I think it would be wise to stay under the care of a good internist while figuring things out.

Best wishes.

ETA: Forgot to ask about potassium. Do you know if your potassium levels are okay?

[TornadoGirl]

I don't know about potassium, and I'm not on any prescriptions. I don't think it is diet related, really, just that the condition is masked by unhealthy eating probably because of getting excess sodium which raises my blood pressure. Just a theory though. Something makes this better on the SAD and worse with healthy, low carb eating, ironically enough. I think I have had this all of my life when I think back to how I felt during PE in school and other times.

[Dragonfly]

Last night I had two glasses of Merlot and a particularly bad episode of OH this morning while running around the house cleaning with lots of stooping and bending.

You may be dehydrated. The alcohol was a flag for me.

Also- what kind of exercise do you do?
Before going primal and starting the PB Fitness workout, I used to have dizzy spells when getting up from sitting or squatting. I have been a regular walker all my life, but hadn't done any hard lifting in over a year. After about a month of twice weekly PB Fitness workouts, I no longer get dizzy--plus I can squat with ease...

[cillakat]

Potassium, Magnesium, Calcium and Sodium intake are all about ratios.

While adding salt appears to help your issues, it's unlikely that salt is absolutely necessary as in an evolutionary environment, we simply wouldn't have had access to 'added' salt. Salty foods (ie produce, blood etc) but not salt alone.

I suspect that in spite of a nutrient dense diet, some of your mineral needs aren't being met. Increasing sodium increases potassium needs. Increasing calcium increases magnesium needs. Given the fact that serum magnesium was low to begin with, you're right in assuming tissue levels were likely even lower

http://en.wikipedia.org/wiki/Prematu...ar_contraction

note the two following possible causes of PVC

• Magnesium and potassium deficiency;[2]
• Calcium excess;[2]

Tracking magnesium and calcium intake for a few days may be helpful in order to see if continuing to supplement calcium is wise. It appears that perhaps more magnesium and potassium may be in order.

If the dizziness truly is due to orthostatic hypotension, then supplementing salt for a time is wise - or at least not suddenly reducing sodium intake but rather doing so slowly, over time.

10,000 IU vitamin D is excessive for most individuals. The goal is to get blood levels between 40 and 80 depending on whom one asks. I tend to think Cannell (vitamin D council) is correct in his "55-65 ng/mL" recommendation as that is a level typically achievable by significant midday sun exposure. The upper end of the recommendations--ie 80 ng/mL-- is nearly impossible to achieve via sun exposure - it's only seen in fair skinned lifeguards (and even then, rarely) who are spending all day in the sun....a combination that would never happen in any environment of evolutionary adaptation (EEA).

Grizz will no doubt chime in saying that William Davis (heartscan) recommends 70-80 ng/mL. William Davis is a cardiologist, not a D specialist or researcher and if we regard Davis as the last word on all matters health and nutritional, then we would all be avoiding butter, lard and fatty meat as well.

Best,
Katherine
PS a $65 vitamin D test is available from grassrootshealth.net as part of their D Action Study. Please consider joining as this is looking like the largest compilation of D data ever--anywhere. Every major (and some minor) D researcher is on board and this really stands a chance at changing the face of public health wrt vitamin D recommendations.

[TornadoGirl]

Back when I first experienced the PVCs I was breastfeeding at the time. I wondered if that was part of being low in magnesium, but I have had other issues like fibromyalgia and ADD symptoms that have been stable over a long period of time that are linked to magnesium deficiency.

I am definitely going to monitor things like alcohol intake more closely, but I have cut down and rarely have the two glasses of wine like I did last night. Usually more like a half of a glass and not every night. I also drink a lot of water due to the Sjogren's disease and it's accompanying dry mouth and dry everything basically. I have noticed more thirst since starting PB.

Interestingly, some of the symptoms of Sjogren's and potassium deficiency are the same. I am going to also monitor my potassium intake more closely. It seems like anything that makes me "pee" more seems to exacerbate the orthostatic symptoms I'm talking about. A new diet, increasing water intake, drinking a lot of green tea, etc. I think, for some reason, I flush minerals out of my body more than other people and/or hover on the brink of deficiencies all the time.

I am definitely going to test my vitamin D levels. I would be amazed if I weren't low at this point. My plan had been to cut down to 5 or 6K IU after a bit of the 10K.

Thanks for the input. I really appreciate your help and suggestions.

[cillakat]

We have a lot in common.

I also drink a lot of water due to the Sjogren's disease and it's accompanying dry mouth and dry everything basically.

btdt....you may want to have a look at my journal.

have noticed more thirst since starting PB.

Yes, it'll resolve as you adapt. It's temporary. For me it lasted about 8 weeks.

[TornadoGirl]

Katherine, I have started reading your journal and noticed our similar health history. I tried to leave you a message there this morning but a computer blip occurred and I lost it. I was reading your potassium doc and was interested to see that it said that potassium and mag are relaxers. I knew mag was but didn't realize potassium. I have very tight, stiff, often knotted muscles. They are better now with magnesium supplementation and exercise. I'm sure my cleaner diet is helping as well. I still have pain but not as much. I'm thinking some potassium rich broths might be in order.

Dragonfly, my exercise pre-primal was mostly walking for the last few months which I will continue. I was also doing some light weights with high reps. I'm changing to the full body exercises and plan on doing more weight less reps. I also want to work up to the sprinting.