Orthostatic Intolerance

Colorful blurry image to represent dizziness and fainting
Image: Colorful blurry image to represent dizziness and fainting
Home » Symptom Management » Orthostatic Intolerance

Dizziness / Lightheadedness

There are ways to manage dizziness, lightheadedness, orthostatic intolerance. The following is a collection of strategies used by the patient community. As always, please consult your doctor before making any lifestyle changes.

Dizziness & lightheadedness typically experienced when up-right (sitting or standing) is known as orthostatic intolerance.

It is important to be evaluated by a medical professional if you are experiencing this symptom. Primary care physicians can evaluate their patients with a simple 10 minute standing test.

Defined Syndromes of Chronic Orthostatic Intolerance (OI)

  • Orthostatic Hypotension: A BP reduction of at least 20mm Hg systolic or 10mm Hg diastolic within the first 3 minutes of upright posture.
  • Postural Orthostatic Tachycardia Syndrome (POTS): the reproduction of orthostatic symptoms with a +30 bpm increase in HR, from supine to 10 min upright, or an increase in HR of greater than/equal to 120 bpm. Age 12-19 heart rate increase must be +40 bpm.
  • Neurally Mediated Hypotension/Syncope (NMH/S): synonymous with vasovagal syncope, neurocardiogenic syncope.

    (Freeman R et al., Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome.  Clin Auton Res. 2011 Apr;21(2):69-72.)

Symptom Management

It is extremely important to seek accurate diagnosis by a doctor for your dizziness. Dysautonomia specialist are preferred.

Management techniques that are commonly suggested for Dysautonomia have been largely adopted by the Long Covid community.

Compression gear

Electrolyte drinks

Heat avoidance

Shower chairs

Mobility aids

Heart rate monitors

Blood pressure monitors

Avoid standing for long periods

Research on Dysautonomia and Orthostatic Intolerance in Long Covid

Long Covid Families continually adds to our collection of research and resources via AirTable

Published: December 21, 2021

Orthostatic intolerance in adults with long COVID was not [just] associated with postural orthostatic tachycardia syndrome

Published: March 7, 2021

Is postural orthostatic tachycardia syndrome (POTS) a central nervous system disorder?

Published: March 22, 2021
Persistent Antiphospholipid Antibodies, Mast Cell Activation Syndrome, Postural Orthostatic Tachycardia Syndrome and Post-COVID Syndrome: 1 Year On

Published: March 19, 2021
Long-COVID postural tachycardia syndrome: an American Autonomic Society statement

Published: January 21, 2021
Autonomic dysfunction in ‘long COVID’: rationale, physiology and management strategies

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