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We humans are constantly working against an invisible force: gravity. Naturally, it is weakest when we are lying down, more so when we are sitting, and more pronounced when we are standing.
As a rule, we ignore this force. But this is not true for everyone. Sometimes gravity can also cause discomfort: Palpitations, shortness of breath, dizziness or exhaustion.
How does this happen? What is to be done?
Most people hardly think about getting up. They simply get up, day after day, dozens or hundreds of times.
Yet what our circulatory system has to do is impressive. 85% of the blood is always in the veins. When we stand up, another 10% or half a liter is added within seconds. It "sinks" into the veins of the legs and abdomen. If no countermeasures were taken here, the blood pressure would immediately drop by 50 mmHg. Instead of 120 mmHg systolic (the upper value) only 70 mmHg. This is no longer sufficient for cerebral perfusion.
So countermeasures are urgently needed. When the pressure receptors or also Bart receptors in the carotid artery or the carotid artery signal a drop in pressure, threefold countermeasures are taken:
This regulation work is called orthostasis reaction (orthostasis = standing upright) and is in everyday life one of the performances that the cardiovascular regulation most often demands and also constantly trains through the frequent change of standing up/sitting/lying down.
The whole runs with the healthy one within seconds fully automatically. Particularly sporty active people do not spend any thought on it. But if you have been lying in bed for a few days and then suddenly get up, you already feel a certain "deconditioning". The circulation must first adapt again.
Likewise, many medications/drugs have an influence on the circulation. If you've had too much to drink, you'll feel dizzy when you get up from a round of wine: your circulatory system has already been affected by the alcohol.
In a large number of people, the regulation of the circulatory system is frequently or permanently disturbed, and in some there is a real condition that can severely impair the quality of life. Some patients only get slightly dizzy or have a little heart palpitations, then it's all over again. But there may also be severe symptoms: visual disturbances, sweating, shortness of breath, rapid heartbeat and anxiety, even blackness before the eyes and unconsciousness, the affected person falls down.
As mentioned, it often takes a short moment for the blood pressure to be perfectly regulated during the transition from lying to standing. During this time, the upper - systolic - value may drop briefly, while the pulse and the lower - diastolic - value increase slightly.
The symptoms are relatively similar even though the causes can be very different.
The main symptoms are a "strange feeling in the head", dizziness, malaise, dizziness, swaying, nausea, sweating, restlessness, palpitations, palpitations, numbness in the arms and legs, cold hands and feet, pain in the shoulders, neck or back of the head, visual disturbances, "tunnel vision", blurred vision, hearing disturbances (hearing everything as if from a distance), ringing in the ears, exhaustion, feeling/fear of "keeling over" or falling/fainting.
Disorders of circulatory regulation are often called different names and are also classified differently. Here, three main forms are to be distinguished:
In orthostatic hypotension (low blood pressure) or orthostatic intolerance, there is a drop in systolic of more than 20 mmHg within three minutes. The lower, diastolic value drops slightly less by more than 10 mmHg or more. The heart rate increases.
As a result, there is drowsiness, dizziness, neck pain, which is often called "coat hanger pain", "turning black" before the eyes,
These complaints are very common and increase with age. At retirement age, 25% of all people are affected to varying degrees.
The more frequently they occur, the greater the fear of going out of the house or moving around outdoors, for example, naturally increases. This can lead to social withdrawal, which unfortunately also leads to a loss of fitness and thus more complaints.
Different degrees of severity are distinguished.
The following conditions, among others, often cause a drop in blood pressure when standing up:
The following medications often cause a drop in blood pressure (among others):
If in doubt, always check the package insert to see if such side effects are known!
Especially young women or women of childbearing age (but also younger men) suffer from the following disorder. When they stand up, their blood pressure remains completely constant, but their heart rate abruptly increases by 30 beats or more.
As soon as they lie down again, the spook is over. In addition to dizziness, palpitations and drowsiness, they often experience shortness of breath, feelings of anxiety and panic or even panic attacks.
Postural tachycardia syndrome (POTS) is often coupled with numerous other, often serious complaints. Therefore, we have designed a special page for this, which again goes into great detail about the problem.
Dizziness, that means a disorientation in space. There is hardly anything that is as unsettling and causes fear, even panic, as this sensation.
For some types of dizziness there are clear findings, e.g. an impairment of the inner ear. An example would be benign positional vertigo, the most common type of vertigo.
But sometimes there are no physical findings at all. Often it is more a feeling of dizziness, a feeling like being drunk or having absorbent cotton in the head. Usually it is coupled with strong exhaustion, sleep disturbances and numerous further complaints. Then the insecurity is twofold: Once by the discomfort and then still by the lack of clarity, what then causes this discomfort.
These pages are about dizziness with and without physical findings. What is it? How does it occur? What to do about it?
About half of all physical complaints with which people consult their family doctor have no organic cause. These are so-called functional complaints. If nothing physical is present, the psyche is usually suspected as the cause. But often neither psychotherapies nor psychopharmaceuticals lead to the desired success. What then? Do those affected not want to get better? Are they imagining the complaints?
While the acute hyperventilation syndrome is a highly acute complaint (shortness of breath, anxiety, palpitations, dizziness, panic), the chronic hyperventilation syndrome is often overlooked. It usually manifests itself only indirectly and often only after years of symptoms. However, the consequences for the quality of life are sometimes even more serious and often lead to severe impairments, even to retirement.
It often begins after a gastrointestinal infection or after taking antibiotics. Suddenly, digestion becomes sensitive. Food is less well tolerated, it stings and bloats, there is diarrhea and/or constipation, many foods are no longer tolerated.
We humans are constantly working against an invisible force: gravity. Naturally, it is weakest when we are lying down, more so when we are sitting, and more pronounced when we are standing.
As a rule, we ignore this force. But this is not true for everyone. Sometimes gravity can also cause discomfort: Palpitations, shortness of breath, dizziness or exhaustion.
How does this happen? What can be done?
Dr. med. Thomas Weiss
P 6, 26
68161 Mannheim
Office hours:
Mo. – Do.: 9.00 – 16.00 h
Fr: 9.00 – 15.00 h
Phone: +49 621 460 860 60
Mail: info@weiss.de