Detecting and Helping Your Own Orthostatic Intolerance
    Orthostatic Stress is normal.  It happens every time you stand up. Some degree of orthostatic intolerance is also very common.  You may experience this is you are sometimes dizzy or lightheaded for an instant when you stand up suddenly after sitting or lying down.  Many people have mild orthostatic symptoms chronically or  occasionally (such as after standing for an unusually long time on a very hot day).  If you feel you may have chronic orthostatic intolerance, but not so badly you need a doctor, the following directions may help you help yourself.  Some of these suggestions can also be useful if you are under treatment for this condition but are not getting behavioral advice from your physician.
    To figure out for yourself if you have COI, stand up for ten minutes while leaning your upper back or shoulders lightly against a wall. Keep your hands by your sides. Don't listen to music, watch television, or talk with anyone. When you start, take a look at your hands and ankles and feet (do this test barefoot). Don't fidget.

    If doing this is boring and has no particular bad effect on you, you don't have COI. But if it brings on symptoms you often experience in your daily life, you do have some degree of orthostatic problem. You can probably confirm this by looking at your hands and feet. If they haven't mottled or gone purple probably you do not have COI. If they have, there is something wrong. This might be serious enough to seek treatment for, or maybe not. Subclinical orthostatic intolerance (not requiring treatment) is pretty common and you can handle it yourself.

    A high fluid, high salt diet can help a lot. And forget that stuff about salt being bad for you. That's turned out to be a medical myth, except for a few people (not all) with high blood pressure.  For further information, click here.  Some cases of orthostatic intolerance are caused by excessively low salt diets and go away when those are normalized.

    Sit with your feet up. When I have COI patients sitting in my office to talk with me I put a chair in front of them and make them keep their feet on it. Often they are amazed how much calmer and more clear-headed they feel after five or more minutes in this position.

    Other helpful postures are sitting Indian style, on your legs, or in a yoga position (legs crossed). Just because you are sitting on a chair or sofa doesn't mean you can't use these postures. It also help to sit balled up, your legs pulled up in front of you, so that the upper legs press on your belly and chest.

    Improving aerobic conditioning is helpful to people with COI. This must be done carefully. I tell people to start by walking at a moderate pace until they are almost beginning to get tired. Pushing beyond that and getting tired will lead to post-exertional fatigue, making things worse instead of better. So stop well before you reach your limit. Do the same the next day, and the next, and the next. The aim is to be able to walk a mile in 20 minutes several times a week. After that you could jog a little, or work toward walking a mile in 15 minutes (a brisk pace). If you are able to keep working like this, very slowly improving conditioning, the COI will improve too.  But don't force yourself, that will cause more harm than good.

    Some people try to treat their own COI with licorice root, which is available through health food and vitamin stores. You should not do this. Licorice root does often help COI, but it is a dangerously powerful drug and should not be taken without supervision from a physician.

    People with COI usually tolerate heat very poorly. Take cool showers and cool baths. Avoid outdoor heat in the summer and direct sunlight except on cold days.

    If following this advice lets you control your symptoms well enough that you can lead a normally active and enjoyable life, you don't need to see a doctor about them.  But if symptoms persist, get worse, or force you to live uncomfortably or with a reduced activity level, you need medical help.

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