Things That Help or Hurt When You Have POTS or Orthostatic Hypotension And Contributing Factors

• Sitting or standing for long periods (shop in off-peak hours. Move your legs around)
• Warm environments (hot showers, saunas, hot tubs)
• Sodium/salt depletion 
• Prolonged bed rest
• Varicose veins
• High carbohydrate meals
• Diuretics, vasodilators, alpha-blockers
• Alcohol

  This is because they result in venous pooling and hypovolemia. 

• Stress
• Excercise
• Pain
• Hypoglycemia (low blood sugar)
• Albuterol
• Epinephrine

 They will increase catecholamines.

Some helpful things are:

• Raising the head of your bed
• Compression Garments i.e. support hose, body shapers/girdles. abdominal binders
• Waist high are better than thigh high which are in turn better than knee high 
• Standing with legs crossed
• squatting
• sitting knees to chest
• leaning forward when you are sitting
• elevating your knees when sitting (try using a foot rest)
• clenching your fists when you are standing up

All of these use your own muscles to pump blood. 

• Drink a minimum of 2 liters a day/0.52 gallons/67 ounces
• Drink at least every 2 hours
• Avoid sleeping more than 12 hours a day because you can't drink in your sleep
• Increase your salt according to your taste and add salt tablets

Even though you have exercise intolerance, some exercise is good. Being inactive is bad

• Avoid excessive bed rest/sleeping
• Start excise slowly and gradually increase
• Recumbent exercise bikes or lying on your back are good 
• Swimming
• Manual forms of Physical Therapy can be helpful

You need to be treated for any conditions that contribute to your orthostatic intolerance;

• food allergies
• anxiety
• depression
• pelvic vein incompetence
• EDS/JHS  ( Ehlers-Danlos Syndrome/Joint Hypermobility Syndrome)
• Chiari 1 malformations
• stenosis of the cervical spine
• Migraines
• movement restrictions
• Infection
• allergies/asthma because inhalants make you worse

Medications: Can be used alone or in combinations

• Vasoconstrictors: Midodrine, dexodrine, methylphenidate, SSRIs, SNRIs, aescin(horse chestnut seed extract), L-DOPS(Droxidopa) is being used in trials.
• volume expanders: Sodium consumption or IVs, fludrocortisone/Florinef, clonidine,
• catecholamine release inhibitors:beta blockers, disopyramide, SSRI's, ACE inhibitors
• Other treatments include but are not limited to:  pyridostigmine bromide