Dysautonomia and “Orthostatic Intolerance”

From Wiki: OI can also be defined as “the development of symptoms during upright standing relieved by recumbency,” or by sitting back down again.

When we stand up, the body is meant to do things to force the blood from the lower half of the body to the upper. In healthy people, the body does these things successfully in a split second. A healthy person’s body will react to standing by making the heart beat slightly faster (temporarily) to increase the force of the heart’s contractions, and by tightening the blood vessels of the lower body to force blood back up. They can then go about their normal, everyday activities with no adverse effects.

In people with dysautonomia, the blood stays in the lower half of the body which can cause problems in the body regulating blood pressure and heart rate. The heart beats rapidly (tachycardia) and stays doing so just from the simple act of standing. The blood pressure might drop causing fainting or near fainting; in others it can raise. Either way, for the person with dysautonomia, standing doesn’t feel right.


People with dysautonomia are not getting enough blood to their brain (remember- it’s all in the lower half of the body) and can thus be forgetful or unclear in their thinking. They are not stupid, they are simply suffering from the cognitive effects of not enough blood reaching their brain. They may get headache and generally feel unwell- all simply from standing.

The rapid heart rate is the body’s way of trying to compensate for the changes in blood pressure a person with dysautonomia will experience on standing- and is often the cause of their excess fatigue and feeling washed out after upright activities- even things you wouldn’t think of as being strenuous such as waiting in a queue can be very tiring for a person with dysautonomia.

An important fact to remember:

A dysautonomiac uses three times as much energy just to stand- let alone walk around and go about day to day life. They get tired ‘easily’ because standing is not easy on their body and puts it into ‘fight or flight’ mode all the time. Living with dysautonomia is therefore a daily battle against fatigue and the resulting symptoms brought on by standing.

Remember also that this illness is invisible- it’s all happening on the inside- so the person with dysautonomia might look healthy and even be able to act normal, when inside they are suffering quietly with all manner of symptoms. Just because they look okay doesn’t mean that they feel okay, and it certainly doesn’t mean they are ‘faking it’.

If you don’t have dysautonomia, just think for a moment about how you take for granted the simple act of standing. You take for granted that your body will adjust to it (in fact, you probably didn’t even know that your body has to adjust, because it does it so naturally). Imagine what it would be like if you knew that standing would either make you faint or would bring on unpleasant feelings such as nausea, headache and aching muscles. That will give you just a glimpse into what every day life is like for someone with dysautonomia.


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