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Lately, sometimes when I get up from squatting or some other position I get dizzy; I thought I was going to pass out yesterday at a store when I'd squatted down to look at something, then stood up. This is not something that happened before I went primal.

My blood pressure has always been low-to-normal, between 100/60 and 120/80.

The sensation passes within 20-30 seconds but it's pretty disorienting. Otherwise I feel fine.

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I have been experiencing this a bit as well. It isn't the typical light-headedness I have felt in the past when tired or hungry, but a little more disconcerting. I almost fell last night, catching myself at the last moment. I'll have to try some of Melissa's suggestions. – Rick Apr 4 2010 at 14:19
@42 -- just wondering, are you a fan of Hitchhiker's Guide to the Galaxy? :) – Patrik Apr 4 2010 at 19:56
Patrik: yes :-) – 42 Apr 6 2010 at 1:14

3 Answers

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It's called Orthostatic Hypotension. Normally, when you rise from a seated, squatted or prone position your blood vessels constrict to adjust for the change in resistance caused by gravity. If they didn't then as soon as you stood up all of your blood would pool to your feet and you would pass out. That is what you are experiencing except on a smaller scale. The good news is that this is likely to be a temporary side effect of positive changes occurring within your body due to your diet such as your insulin levels coming down, hence less sodium being retained by the kidneys (many people don't realize that insulin causes sodium retention) which along with lower blood sugar decreases blood volume, and less sympathetic tone (less adrenaline). It's a pretty common phenomenon when people start low-carb diets. Eventually you will adjust but in the meantime you need to make a conscious effort to stay well-hydrated, consume some sea-salt every day even if you don't want to, and remember to rise from a seated, squatted or prone position slowly so your body has more time to adjust to the drop in blood pressure.

While it is always possible, I think it is unlikely that you would simultaneously develop some other hypotensive disorder just after starting paleo or primal type eating. It's just too much of a coincidence.

You didn't mention if you are taking any blood pressure medications or diuretics. If you are then you will need to have the dosage decreased or possibly have the medication eliminated from your regimen altogether.

If the dizziness hits you and you feel like you are going to black out then you should of course sit down if possible. If you are game and want a more proactive approach then you can also try (at your own risk) bearing down like you were lifting a heavy weight (Valsalva Maneuver) which will increase your intrathoracic pressure, elicit a little epinephrine increasing your cardiac output and help pump more blood back up to your brain. It is similar to what fighter pilots do in heavy Gs to keep themselves from blacking out. Don't hold it very long (more than a couple of seconds) or it could have the opposite effect and make you pass out.

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Great answer thanks! I had recently made a change that resulted in improvements across the board, but this one strange phenomenon. Good to know that I'm on the right track at least! – Rick Apr 4 2010 at 15:44
Whoa, thanks for the info! Interesting about the Valsava maneuver... I've done that for years to clear my ears when flying. I'll try that if it happens again, which it did again today while I was working on my car. I don't take any prescription meds now. Stopped Aciphex last week after 7-8 years on PPIs. – 42 Apr 4 2010 at 22:41
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I started having this problem last year and was diagnosed with hypotension. It runs in the family. Mine is still present, but it seems to have gotten better though:

  • Seaweed and Celtic Sea Salt consumption. I wasn't consuming any salt at all for some time. My food is now much tastier :) Seaweed provides iodine, which is important for thyroid health.
  • Not fasting too much and making sure to get enough calories. IF is great for some people, but it really lowered my blood pressure too much I think.
  • Exercise in the morning to get things pumping seems to help get the blood pumping
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OK, I guess low blood pressure is a likely suspect. I have done some IF e.g. light breakfast & no lunch but it didn't seem to bother me much. This episode yesterday was 2-3 hours after a huge bacon (uncured!) and eggs (pastured! giant!) late b'fast. But salt tends to make my heart race, so I don't use much of it, if any. Bacon is generally too salty for me so I've been buying low-sodium bacon. I have some dulse (seaweed) but hate the taste and can't figure out how to hide it in other things... – 42 Apr 4 2010 at 13:37
@Melissa, Just to clarify: exercise in the morning seems to reduce blood pressure later (ie. causes hypotension), or seems to reduce (improve) the actual hypotension? Thanks – archaea Apr 4 2010 at 13:52
Ah, just clarified. Yeah, I wasn't a salt fan either and I don't like bacon much...only use it in tiny amounts on salads and as flavoring, but I really like some of the artisan clay salts. If you don't like the taste of seaweed, get some kelp supplements or boil some kombu along with your stock. – Bread-Eating Beelzebub Apr 4 2010 at 14:38
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Another thing I find is that ketosis seems to make my problem worse, so I have to admit I eat about 75-100 grams of carbs a day. A few days ago I ate zero carb unintentionally and my blood pressure was very low. – Bread-Eating Beelzebub Apr 4 2010 at 14:41
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same thing happen to me after squating....been taking pre workout supplements and not getting enough water into my body i was dehydrating......1 week and im feeling much better after drinking the recomended water intake...

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