Orthostatic hypotension – worsens with fasting so could affect dementia?

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Orthostatic hypotension – worsens with fasting so could affect dementia?

This topic contains 14 replies, has 5 voices, and was last updated by  Healthy_Suzanne 6 years, 3 months ago.

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  • I appreciate I haven’t done my research and only read an article from the daily mail, but they highlight that orthostatic hypotension may increase risk of dementia.

    My concerns are fasting has caused orthostatic hypotension so could fasting could, for me could increase the risk of dementia?? Thoughts ?

    Sorry for poor grammar, should have edited that post/ read it before pressing send

    Hi Bingeingqueen,
    Is this the article you read? http://www.dailymail.co.uk/health/article-4301904/Dementia-spotted-2-DECADES-starts.html
    I have read it, but it doesn’t include links to the study, so it is hard to get the whole picture. I think the thing to note is this quote in the article:

    “Dr Mike Knapton, associate medical director at the British Heart Foundation, said: ‘It’s impossible to say whether the condition is directly causing the development of dementia – however this study will be useful for designing further research to better understand this link.”

    So more work needs to be done.

    How awful that 5:2 fasting has led to you developing OH. I hope your doctor is giving you good advice for managing it and deciding whether the benefits of 5:2 outweigh the difficulties of OH.

    Your post is unclear. Are you saying that orthostaitc hypotension has been caused by fasting or that you think it might have?

    Hi, sorry I’m amazed you understood any of my original post. I’m saying fasting seems to cause oh for me…

    To clarify I don’t think fasting has been the cause but it worsens significantly when fasting or low carbing.


    I am surprised that the Daily Mail has commented on a single small group study that has only demonstrated that further research might be worthwhile which is nothing unusual in the world of research and doesn’t necesssarily mean that initial findings have any relevance.
    There is a long way to go to find out if there is any connection between orthostatic hypotension and dementia.

    This research is relevant to me because I developed orthostatic hypotension after three recent changes:
    1. adf fasting (drop of 18kg in since October)
    2. new drugs – statins, blood pressure meds, and heavy duty anticoagulants prescribed in response to an arterial clot and
    3. A heart procedure under general anaesthetic.

    Could the orthostatic hypotension be related to fasting and the quick weight drop? Maybe, because I don’t know what caused the change.

    However, thankfully, the orthostatic hypotension seems somewhat milder now. Maybe this is because the big weight drops have now slowed right down? Or because I came off the blood pressure meds and statins after the weight drop and blood pressure and cholesterol reversals? Or that I’ve halved the anticoagulants? Or that my body has now begun adapting to these changes? My doctor thinks the last explanation fits best at this stage, and suggested to give it more time to see how my body adapts. Being exceptionally tall probably also makes me more prone to orthostatic hypotension than most.

    I may stand up a little slower, as a precaution, having read this report, but am not going to sweat it too much. Why?

    1. The scientists haven’t causally related orthostatic hypotension with dementia. So at this stage it is only a speculated risk. An association doesn’t prove cause. And even if there were a causal relationship, it could be the other way around, that some forms of early dementia may cause orthostatic hypotension in some people as an early symptom.

    2. It is only a 40% higher association. Life is full of risks.

    3. The article pointed to a 100% lower association with dementia for people sleeping less than 9 hours. Well, since the fasting (and drug change) and weight loss I sleep significantly less because I’m simply less tired. So, if there is some causal connection, maybe overall my risk of dementia may have been even lowered from the fasting.

    4. The fasting and weight loss have reduced many other major risks.

    Interesting research, and I’ll keep an eye on it, but even for me this association may not at this stage be cause for too much concern. Hopefully.

    Hi Bingeingqueen,

    To make what I said a bit clearer:

    Like you I’m speculating that my fasting might possibly be associated with me now experiencing orthostatic hypotension. But my blood pressure has dropped significantly since dropping weight. From around 140/90 to around 120/75 (off blood pressure meds) in a few months. So my doctor thinks, given my current sgnificantly lower blood pressure, that the body maybe has not yet adjusted to the new increased demand to raise my blood pressure quickly when I stand up. If so, could this be happening to you too? Or are you taking any drugs that might be impacting?

    Ps In point 3 of my previous posting the figure should be 50%, not 100%.

    Hi One and Amazon,

    No autocorrect and not typing from a phone so hopefully this will make more sense than my previous posts. Blame the phone not the brain….

    Onel sorry to hear you have suffered from this. With me I am not taking other meds thats would impact blood pressure, I have actually always had slightly low blood pressure which is a family trait and my late grandma had it too, but in her later years she also developed high blood pressure. I am still quite young but we have AF in my family and I suspect I may have it too.

    My OHypotension was pretty average prior to fasting, like many people if I stood up quickly, my vision would go black for a split second. However, when having little/no breakfast (getting up very early), I had a few days where it was very bad and I blacked out for a plot second and was sick. Oddly. I also suspect it may be that I’m drinking more coffee when fasting, also I start the day with two squares of 90% chocolate… (I know not low kcal but have nothing else). I had had a lot of coffee on the day I really suffered and had been up since 5 am and it was around 11.30 it happened after standing for a long period at work, then reaching down and getting up again. It then seemed to be whenever I moved my head too quickly. I went and brought some salty snacks that day and that really helped instantly.

    I suspect this is quite common, and I think a reduction of oral intake can make anyone “a bit light headed” which concerns me. At the same time, fasting helps reduce weight, blood glucose, helps calm down my bright red nose (very important aesthetic benefit ;-)). I am also (as my title states) someone who can eat a lot (non stop appetite!) when not fasting and it may be just messing with my blood glucose levels. So maybe a number of cofounding factors and as mentioned it is, for me, helped by having LOTS of salt. Then I worry the damage of having los of salt might be doing to my bones etc.

    Thank you for your comprehensive answer Onel, I have maintained a steady weight so I am not sure it’s to do with adjusting to raising my blood pressure but I do have low blood pressure generally so the argument still stands, it’s harder for my body to cope with any drop. I also get very cold hands and feet in winter- not sure if connected at all????

    I was concerned because I have the aloe 4 gene, and prior to this research I had wondered the effect in my brain from blacking out/being light headed, considering certain things that improve blood flow such as aerobic exercise, cocoa, fish oils = better blood flow. I also notice I can think much better after aerobic exercise (but if I do too much then get tired it’s counterintuitive).

    On that same note, I do get low blood pressure and if I have too much coffee or pomegranate juice my blood pressure lowers! I’m serious!.

    So maybe it’s a case of managing fasting for the individual, it may be it can be beneficial if it’s managed better i.e, maybe spreading snacks through the day, continuing to restore electrolytes… but I really have no idea what I’m talking about here just speculating.

    Although the research doesn’t appear to be any way near conclusive, it was something I was concerned about,articularly as why I would stick to fasting is because I have the aloe 4, and late onset alzheimer’s in my family.

    I like your second point… breathing is a risk…. but I actually find fasting tough but if I achieve it and don’t feel ill, I can feel great and am able to think well and everyone says I look well… so like everything in life things are never straight forward.

    Amazon you are right and to be honest, sorry to the DM but they do just publish anything so I don’t take it as gospel but it was something, as I said, I was already concerned about from my own personal experience.

    Hi Bingeingqueen,

    Like you, I have increased my salt intake. Perhaps this may be why my orthostatic hypertension has similarly improved?

    It is true that reducing salt does tend to lower systolic blood pressure, by about 4% apparently. Is this necessarily a good thing? For you and me – I would say no. We do not have a problem with high blood pressure, so why would we want to artificially lower it even further?

    My cardiologist suggested that I can drink more water, and have more salt, to raise my blood pressure!!! He certainly doesn’t think this would be harmful for me, and this is in full knowledge that I have had clots in my arterial system!

    Is reducing salt beneficial for the rest of the population? If your sole measure of benefit is a small temporary reduction in blood pressure (presumably from having less blood volume, from having less water in the blood?), then yes. If your measure is to have less cardiac events, and less risk of death, then it appears this would be a terrible thing to do. See the video below:


    Hi again Bingeingqueen,

    1. An update on my O-hypotension: Happily, it seems to have mostly resolved itself. Why? I’m not sure. My weight has now stabilised at around my goal weight. So maybe the lack of ongoing weight loss? Or my body has now adapted to the heavy duty blood thinners (Eliquis) I’ve been put on? Or that I’ve been able to take myself off blood pressure & cholesterol meds, subsequent to the 18kg weight drop? I can still have moments when sudden exertion can cause either some dizziness, or more likely being extremely short of breath for a minute or so. But once warmed up I can exert myself far more without any issues. So it’s just the initial circulatory response to sudden changes. I’ve noticed that regular aerobic exercise definitely reduces these episodes.

    2. Like you, I may have AF (atrial fibrillation). That is what my heart specialist believes, despite no direct evidence yet being found of it. I had blood clots severely damage the capillaries in my right hand, very nearly to the point of gangrene. A real blessing in many ways because it put me on this fasting journey, and all the benefits it has brought. The specialist described the incident as a “stroke” which fortunately went down my arm rather than to the brain. Extremely lucky, as he said the size of the clots would have been ‘catastrophic’ if they went to the brain. And like you, my feet and hands have always been prone to getting very cold. So your suggestions on improving circulation – exercise, cocoa, fish oils – are very relevant to me. Even more so now after the “stroke”, as future gangrene in my right hand fingers will continue being a risk. So thanks for the tips.

    3. I am fascinated by the nature of our bingeing. Our individual responses to hunger pangs seem central to our weight levels. Without the hunger response, presumably we could all simply ‘choose’ our weight? Currently I’m able to get through 36 hours of fasting without any real hunger issues by water fasting. But if I eat something during the 36 hours? Then the hunger dragon takes over and it is very hard to contain. So my current training focus is on getting increasingly comfortable with that feeling of hunger, on experiencing it as a friend, and not needing it to be immediately expelled. If I can do that, then I figure weight gain should never again be a problem.

    1. Brilliant! Sounds like you have this under better control. Probably a combination of factors, I’m not an expert so no idea but fantastic all the same.
    I still struggle with light headedness but sometimes wonder if it’s worse after having a very early breakfast I.e 5.30-6 am. Then sufferered around 11 am. Salt still helps me. Standing for long periods I find triggers the dizziness and if I suddenly stand up. I’m actually wondering if cocoa and pomegranate worsen this- maybe because the are lowering my blood pressure. Mine isn’t bad though more of an observation and a slight fear I may faint at work- my idea of hell!
    I’m so pleased for you though. Interesting aerobic exercise also helps, guess it bumps up blood pressure.

    2. Oh no I’m sorry you have af. I am sorry also I offered advice as I’m not sure if that’s appropriate for you, double check with your doctor 😀 If it does end up being useful then great but I just go by my own experiences and to be honest, don’t really know much!

    3. Wow that’s a long fast. Do you find if you have small amounts within that time frame you eat more hence not eating at all?
    Bingeing, I’m sure there are a million factors that affect this. I do notice as soon as I lose weight and am at the bmi 23 mark if I start going lower than that, through either regularog kcal gradually (still including all my favourite foods and foods I tend to “binge on” ) or if I lose weight suddenly the urge to binge increases. I have sudden “I want to eat everything mode”. For me also hormones, stress and lack of sleep cause the exact same reaction. I plotted on a wall chart dates every time I was in that mode and they always correlated with the above factors. Really interestingly I notice if I am doing some complex work (relative, complex for me 😊) and the grey matter is required, like some math, times crossword (!) I have the urge to eat- something sweet . I’m aware of it so I’m careful about my exposure or access to foods when doing such tasks but maybe that psychological (stress, I’ve learnt to alleviate with food) but I wonder if something else is going on. I’m sure this has been mentioned before but others when stressed an go off food. So odd our responses to things and I often think I’m at war with my own genetics.

    Listen, it sounds like you are doing brilliantly though. Is the doc ok with you doing long fasts? How is your diet in between fasting?

    Take care and great to hear from you.

    Hi Bingeingqueen,

    No need to worry much about giving me advice BQ. I habitually check things out for myself. It helps to see how others make sense of their worlds, and often stimulates me to look at things differently, and investigate.

    You’re a 23 BMI and worried about bingeing? I see things differently. I see our natural state as jumping between famine and feast. So “bingeing” from this perspective is the natural feast state, where the body fills up reserves again for the next famine, or food shortage. So in a healthy weight range I look at bingeing, big picture, when combined with fasting, as a good thing (depending on the food being healthy food).

    36 hours isn’t really a long time to fast once the body adapts. It’s only one day with two sleeps either side. For me, sleeping is effortless fat burning when fasted. And yes, if I eat something small in the 36 hours it does get harder for me. Maybe this is because eating once turns eating into a moment-to-moment choice? In the wild, during a famine, there is no choice but to fast. And once food becomes available the body naturally binges. So by taking away all choice during the 36 hours I guess I may be mimicking what my body would be doing in the wild. And both during and after the 36 hours, it is a huge feeling of achievement every time.

    I agree that stress and lack of sleep, through our hormones, can play havoc with our bodies.

    My diet between fasts, at this stage, is pretty fatty. Albeit healthy fatty. Lots of nuts, some 85%+ cocoa dark chocolate, some meat, eggs, veges, etc. My biggest focus was in cutting out (or greatly cutting down) sugars and processed carbs. This shift away from sugars and processed carbs seems to make fasting a lot easier for me.

    Hi Bingequeen,

    Has your Dr looked at B12, folate and Ferritin levels, also thyroid function? I’ve always had low blood pressure, into my mid 30’s at least and as a child would sometimes pass out when standing, from sitting on the floor. I would say that I was malnourished until into my teens, so its possible that the OH became less of a feature because of a better diet.

    The problem re-surfaced sometime in my 30’s and I can’t tie it into any specific change in my health except it was post pregnancy and I think that was when my thyroid function started deteriorating. About 5 years into having OH again, GP’s started looking at my blood work which showed very low in range Ferritin, Folate and B12 which also tied in with thyroid function being low. However, this was the first time in my life these issues had been looked at so its possible they were there all along.

    I just mention this because it is a common problem for women, in particular and very often the thyroid issue runs in families. Decreased thyroid function leads to decreased stomach acid and this may impact nutrient absorption; that seems to be how both issues are linked. There are research documents on all this freely available.

    Please re-post with how you get on 🙂

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