Great, training -> orthostatic hypotension

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Great, training -> orthostatic hypotension

Postby sogood » Mon Mar 02, 2009 8:54 pm

Just wondering how many here also get orthostatic hypotension for days after solid training sessions? The classic symptom being dizziness/visual blackouts on standing quickly from sitting or lying positions.

I've been noticing this problem for some time now and have put it to fluid shifts within the body. Did a little Medline search today and found out this is actually a documented phenomenon. However, there appear to be conflicting reports of endurance exercise exacerbating or minimising the problem. Well, I know which response my body is having. ;)

http://www.ncbi.nlm.nih.gov/pubmed/8321 ... t=Abstract

Loved the line "Trained men can run, but they cannot stand".
Last edited by sogood on Tue Mar 03, 2009 1:19 pm, edited 1 time in total.
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by BNA » Mon Mar 02, 2009 9:24 pm

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Postby justD » Mon Mar 02, 2009 9:24 pm

I was going to say that's me, but I'm too unfit to be one of the "trained".

I've suffered from high BP for many years. I'm on 3 BP pills, one being a water pill and my doctor and I are now collecting stats to see if we should reduce my medication.

Since I started cycling more seriously my BP is very seldom over 125/85 and mostly around 115/75, which is pretty close to perfect. However, on Saturdays after longer trips I've sometimes struggled to keep my eyes open after a cycle and when checking my BP it has been as low as 91/61. I make a point of almost drinking too much water on Saturdays now and (without my doc's knowledge) I don't drink my BP medication on Saturdays.
It's been much better lately, so I don't think mine is the same as explained in the link, but I do still have regular (almost always) dizzy spells when changing orientation (from standing to lying down or lying down to standing).
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Postby sogood » Tue Mar 03, 2009 6:28 am

justD wrote:I've suffered from high BP for many years. I'm on 3 BP pills, one being a water pill and my doctor and I are now collecting stats to see if we should reduce my medication.

That's a totally different story when you are on antihypertensive drugs. They are there to modulate all your BP control systems and I am not surprised that you are getting these episodes. Might be good to have your medicine reviewed by your doctor.
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Postby philip » Tue Mar 03, 2009 6:52 am

Yeah I've had those symptoms a couple of times after long rides when I really push myself hard - not recently though, so maybe my body is getting used to it :) The other symptom I've noticed is my lips feel sort of numb/tingly. For me these symptoms don't last for days though, they generally go away a few hours after the ride.
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Postby sogood » Tue Mar 03, 2009 7:11 am

philip wrote:Yeah I've had those symptoms a couple of times after long rides when I really push myself hard - not recently though, so maybe my body is getting used to it :) The other symptom I've noticed is my lips feel sort of numb/tingly. For me these symptoms don't last for days though, they generally go away a few hours after the ride.

If it's only for a short period after the ride, then maybe dehydration is involved. My symptoms seemed to stay for a few days and matches with what's described in the study pretty well. All very interesting.

Paresthesia of the lips may suggest some electrolyte imbalance in your system. Salt depletion?
Last edited by sogood on Tue Mar 03, 2009 1:38 pm, edited 1 time in total.
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Re: Great, training -> orthotopic hypotension

Postby JV911 » Tue Mar 03, 2009 7:36 am

sogood wrote:The classic symptom being dizziness/visual blackouts on standing quickly from sitting or lying positions


had your BP checked lately?...could be low
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Re: Great, training -> orthotopic hypotension

Postby sogood » Tue Mar 03, 2009 9:03 am

JV911 wrote:
sogood wrote:The classic symptom being dizziness/visual blackouts on standing quickly from sitting or lying positions

had your BP checked lately?...could be low

BP is fine but just when standing up suddenly. As described by the quoted papers, it's likely to do with the altered regulatory responses following hard exercises. Human physiology is very interesting.
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Postby Parrott » Tue Mar 03, 2009 12:29 pm

I have had these symtoms on postural change as you describe intermittently since teenage years (40 now), never actually passed out, been close on a few occaisions though, dizzy momentarily seeing stars etc. I have noticed it the next day after a hard workout though I don't think the overall incidence has increased with my cycling. BP is fine by the way.
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Postby sogood » Tue Mar 03, 2009 1:18 pm

Parrott wrote:I have had these symtoms on postural change as you describe intermittently since teenage years (40 now), never actually passed out, been close on a few occaisions though, dizzy momentarily seeing stars etc. I have noticed it the next day after a hard workout though I don't think the overall incidence has increased with my cycling. BP is fine by the way.

Maybe we are the real "Trained men can run, but they cannot stand".
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Postby colafreak » Tue Mar 03, 2009 1:26 pm

Hey sogood, know exactly what you're on about.

I had heard of this before and you're right, it happens for days afterwards not just straight away. It's physically a change to the way your body deals with the changes in blood pressure.

For me, it's no biggie and I actually like it, it makes me feel like I'm getting somewhere.

I started getting it after I started commuting (but that's a different story).
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Postby sogood » Tue Mar 03, 2009 1:34 pm

A friend of mine just suggested that I should pay closer attention to my salt intake and I think I will do that. Although I have sports drink along the ride and eat and drink plenty of regularly salted food after, this factor is not totally excluded. Not exactly sure how I can monitor the salt replacement yet and may need to do some reading up on it.
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Postby colafreak » Tue Mar 03, 2009 1:40 pm

Wikipedia reckons doctors sometimes treat it with EPO...
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Postby sogood » Tue Mar 03, 2009 1:43 pm

colafreak wrote:Wikipedia reckons doctors sometimes treat it with EPO...

I won't question the source of your tip but... :wink:
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Postby colafreak » Tue Mar 03, 2009 1:51 pm

This is very interesting, though. (I only have the abstract: [url="Linky"]http://hyper.ahajournals.org/cgi/content/abstract/45/3/391[/url])

Endurance Exercise Training in Orthostatic Intolerance
Robert Winker; Alfred Barth; Daniela Bidmon; Ivo Ponocny; Michael Weber; Otmar Mayr; David Robertson; André Diedrich; Richard Maier; Alex Pilger; Paul Haber; Hugo W. Rüdiger



Our data demonstrate that endurance exercise training leads to an improvement of symptoms in the majority of patients with orthostatic intolerance. Therefore, we suggest that endurance training should be considered in the treatment of orthostatic intolerance patients.


It should be noted, though that this is a bit different, in that it's talking about people who already have orthostatic intolerance. So in THOSE cases, you would expect that exercise would benefit them. I believe we are actually talking about those who don't have it to start with.
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Postby Mulger bill » Tue Mar 03, 2009 2:03 pm

I'm in about the same boat as Parrott, couldn't say whether it changed after I restarted riding tho'. It's always on standing up for me.

Thought it mighta been one or two to many :D

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Postby sogood » Tue Mar 03, 2009 2:06 pm

colafreak wrote:It should be noted, though that this is a bit different, in that it's talking about people who already have orthostatic intolerance. So in THOSE cases, you would expect that exercise would benefit them. I believe we are actually talking about those who don't have it to start with.

Yes, as I already commented in the original post, there seemed to be conflicting effects of endurance training on this symptom. But good point that this particular study relates to those who already have the symptom.

Without going into further depth of these studies, I am comforted in that this seemed to be a normal response rather than something pathological.
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Postby sogood » Tue Mar 03, 2009 2:10 pm

Mulger bill wrote:I'm in about the same boat as Parrott, couldn't say whether it changed after I restarted riding tho'. It's always on standing up for me.

Orthostatic hypotension is a perfectly normal physiological response, even in normal individuals. But in my case, training has potentiated the phenomenon.
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