Falling down when standing up

(Olivier) #1

Hi
I am in ketosis for at least a week, probably more than I started to experience blood pressure falling when I get up. This weekend I felt on the ground.
I was talking with my sister then suddenly I lost focus and the topic of the discussion.
A second later I was sitting on the floor.
Is it something known with keto or just a lack of electrolytes and maybe too few calories?
The weekend was extremely hot, so much we had to stay inside the house.

(Olivier) #2

Forgot to mention I made intensive workout in the morning (pumping foil)

(Bob M) #3

It COULD be electrolytes, so some salt at least would be advisable. But I would probably see a doctor too if it happens more than once.

#4

Electrolytes, not enough calories (don’t skimp on calories on Keto!!!) and heat can all contribute to this. Fix these things and if it happens again, do see a doc.

(Olivier) #5

Thanks to the both of you :wink:

(Joey) #7

You are describing postural hypotension - i.e., low pressure leading to light-headedness upon rising up and heading off too quickly.

Yes, low electrolytes and hydration can definitely exacerbate this condition, so manage that carefully as your body adjusts to life without carbs.

Having said that, I’ve continued to have this condition for years. I need to be mindful of getting up from bed or after sitting a chair for a while.

But it’s a blessing of good health.

The trick is twofold:

  1. Stand up gently then wait a few moments before marching off somewhere, and …

  2. Thank your lucky stars you don’t suffer from hypertension - since it’s high blood pressure which can be deadly.

It’s only unhealthy if you crash-land somewhere because you didn’t respect your body’s need for a brief chance to pump blood where it needs to go. Just hold off for a brief bit after rising and before walking off, steadying yourself for a moment first.

Meanwhile, manage the minimal risks and enjoy the longevity it promotes. :vulcan_salute:

(Robin) #8

Don’t assume this is keto related. I would seek out a cardiologist.

(You've tried everything else; why not try bacon?) #9

Mostly lack of salt, and consequent hypovolaemia. Eat salty foods and put more salt on your food, and drink enough water to quench your thirst.

H(OWEVER: if you are taking a blood-pressure medication, see your doctor about lowering the dosage, or even discontinuing it. The same for any diabetes medications you may be taking.

As long as salt tastes good, your body can use it. If it starts to taste unpleasant, you’ve consumed enough for a while.

Don’t overdo the water, but be sure you get enough. Use your thirst as a guide, and you’ll drink what you need.

(Edith) #10

I agree with @PaulL. Keto does help lower blood pressure and not enough salt does as well. If you are on a blood pressure lowering medication, you definitely need to see your doctor so he or she can help you lower your dosage.

With that being said, since you are only into keto for a week, I would go with needing to increase your sodium intake. One loses a lot of water the first few weeks of keto and with that water loss comes electrolyte loss. I have to supplement an extra teaspoon or two every day on top of what comes in my food. I add it to my water, I will just put some in my mouth and swallow it down with some water, and I heavily salt my food. If you are exercising and sweating you may need even more salt.

(Joey) #11

Can someone please confirm this connection for me - i.e., between not enough salt and low blood pressure?

I was under the impression that the well-publicized concern that salt increases blood pressure - giving birth to the low-salt diet craze - was flawed with respect to those with normally functioning kidneys. And that the admonishment to reduce salt was therefore not appropriate for most folks.

Certainly, restricting carbs produces lower blood pressure than SAD eating, but I thought that was due to lower water retention - not lack of salt.

While salt + hydration do go hand-in-hand, by telling folks to eat more salt in order to reduce hypotension, aren’t we confusing matters rather than providing science-based guidance?

Keeping an open mind here :man_shrugging:

(Edith) #12

Well, I can only go by me, but like you mentioned, salt helps us hold onto water. If I don’t get enough salt, I don’t retain enough water. If I don’t retain enough water, my blood pressure drops.

This guy can ramble on a bit, but I found this episode interesting. He is very science based. If I recall correctly, he does mention using salt to help with hypotension.

(Peter - Don't Fear the Fat ) #13

It’s a good question. I’ve been sceptical too. My mother is always reminded to add salt by her Dr because of Low BP.
The theory is more salt, more water in the blood, extra volume, extra pressure.

According to these guys. It’s their only specifically!

(You've tried everything else; why not try bacon?) #14

I think I’ve got this right. Let me try to lay it out:

First, it’s not a direct connexion. The postural hypotension is caused by low blood volume, not low blood pressure. A change in posture affects the amount of volume needed to continue to supply adequate oxygen to the brain. So the heart has to work harder because of the lowered blood volume, and there is that interval of dizziness until the body adjusts.

Second, it is true that alt promotes water retention, which means that low salt causes the blood system to become hypovolaemic, as part of the body’s effort to keep the pressure and salinity of the blood at a constant level. Because of the efforts of the renin-aldosterone-angiotensin pathway, the effect of salt intake on blood pressure is minuscule to non-existent in most people. Even in those rare people who are salt-sensitive hypotensives, the effect of salt intake on blood pressure is modest.

Jeff Volek apparently noticed this effect in one of his studies. At first, the athletes in the study would have a hard time performing, and their hearts would be working unusually hard. Stephen Phinney, when consulted, diagnosed hypovolaemia and suggested giving them a cup of broth forty-five minutes before the tests began, and that brought their blood volume back up, while keeping the salinity and pressure of their blood constant. The athletes could then undergo the strain of the tests with no problems.

Pure water wouldn’t have helped nearly as much, and salt alone would have been less than useless. The liquid in the broth provided the volume, and the salt provided enough sodium to keep the blood isotonic.

(Betsy) #15

There are other things that can help orthostatic hypotension besides raising salt intake.

One thing that helps some people is thiamine.

" Vitamin B1 (thiamin): Thiamin deficiency is rare, but the symptoms mimic POTS . In a retrospective study of 65 patients (Blitshteyn, 2017), 4 were found to have low (but not truly deficient) thiamin. When they supplemented with 100 mg/day, 1 patient saw quick and dramatic improvement in POTS."

B5 can help, too, because it helps the body make acetylcholine.

What helps me the most is a combination of Butcher’s Broom herb and l-tyrosine.

(Joey) #16

Now this actually makes sense. Salt alone = useless. H20 alone = same.
But put them together and you get the volume combined with the ability to retain it.

Okay, need to integrate this further into my understanding going forward…

FWIW, I drink a giant flask of salt water daily (teaspoon of sea salt + teaspoon of Mg citrate). I’m quite well hydrated. Yet I still enjoy low blood pressure and postural hypotension. :man_shrugging:

(You've tried everything else; why not try bacon?) #17

Dizziness when standing up can also be caused by certain crystals in the inner ear moving out of their normal place. Read up on the Epley manoeuvre to get them back into place.

I very proudly shared my knowledge of this trick with some friends, who are my age, or a bit older. To my chagrin, they knew all about the Epley manoeuvre and had been doing it for years!

(Allie) #18

Answered your own question.