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Can you feel dizzy and have good BP readings?

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I've felt very mildly dizzy the past couple of days but my BP was high enough not to faint. Normal range. I feel like I'm laying on my back in the ocean and my head is floating over really small waves. It's very mild. Not sure what the exact definition of dizzy is in POTS. I felt a little spinning action yesterday. Not near the spinning where I took a long hot bath just trying to relax and tried to get up and couldn't walk a couple months ago.

I do have midodrine but I haven't taken it since my BP was normal. 

Another odd detail. I haven't had any caffeine in a couple of months. I drank a 12 ounce coke. It dropped my top  BP number 20 plus points. I thought that was odd. My top number is usually consistently a little high. From 130-140 average. The coke dropped it very quickly. Don't know what to make of that.


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I'm not sure why coke would drop your BP. If anything, it should probably raise it. 

I don't drink caffeine because I am very, very sensitive to it, and the last time I had a cup of coffee, I was in ER shortly after because it triggered an episode of SVT. 

Some people with dysautonomia seem to cope with caffeine, others don't. 

In regards to the dizziness, if your BP is normal and you're dizzy, there can be lots of other causes. Fatigue. Lack of sleep. Etc. So many possibilities, really. I suggest keeping an eye on it and chatting to your specialist. 

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@Derek1987 - often in dysautonomia our bodies react opposite of what they should. Normally caffeine elevates the BP by constricting the blood vessels. There is also a theory that caffeine increases your adrenaline levels. But when you have dysautonomia the ANS acts - or reacts - in different ways, so I guess anything is possible! Many people here have reported feeling better after caffeine. Did you mind the drop in BP? 

Regarding the dizziness - it is one of the commonly reported symptoms of POTS and affects many people here. Sometimes you can have vertigo - here is a link describing vertigo. 


In my case lightheadedness and dizziness usually occur when my BP is low - or when it rapidly changes from high to normal or low. Sometimes the dizziness is transient and sometimes it can last for days. They have checked me from head to toe, MRI's, neurological exams - you name it. All perfectly fine anatomically. So I have resigned my self to the fact that it is "just POTS". However - if it continues you probably should seek help from your doctor since it can have other causes. My PCP prescribed Antivert for the dizziness and I take it as needed and it helps. 


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Hi, @Derek1987!

Sorry to hear about this latest bout of dizziness.  It really is awful.  Just to clarify, did you check your BP right before you drank the Coke, and then re-check it after you finished?  Or is there any chance the number was already that low before you drank it?  I'm also wondering if the lower-than-usual BP number may have been from something physical you may have done right before checking it after drinking the Coke, such as getting up quickly.  Did you eat anything with the Coke?  Before I was diagnosed and on meds, my HR would go up after eating, but my BP would go down.  Did you drink the Coke "in stages", or did you slam it?  If you slammed it, your BP may have reacted as mine did when I ate, and dropped.

Re: dizziness and lightheadedness - a lot of people (including, I have discovered, some medical professionals) seem to use the two terms interchangeably but, for me, anyway, they are most definitely two different things.  I have had both separately, and both in unison.  I experienced some dizziness when this first came on and my BP would go a little high (such as top number in the 150s, which had previously been unheard-of for me).  That dizziness was pretty transient. 

But as the weeks went on, I started getting serious dizziness (although not vertigo-type where the room spins) that would often last all day, *with BP being normal*.  Same with light-headedness.  And the brain fog; don't get me started on that!  I was obviously slow on the uptake, because it took me a while to figure out that these may be caused by hypoperfusion (Thank you, DINET posters . . . )  So I tried laying down on the bed (we have an adjustable bed) with my legs slightly raised, and also tried sitting for a minute or so with my head between my legs.  Both brought improvement.  Once I started on my beta blocker, the improvement was more consistent.  Not sure if that might be the case with you.  There are so many individual variables with this thing.

Re: the hot baths - seriously, just don't do those until you get your meds adjusted and things settle down.  I love hot baths and had to forgo them before I was diagnosed and on meds and even now, although I can stand them hotter, I still don't take them as hot as I used to.

I do drink coffee again.  I was afraid to even come near it for the longest time after all this started, but I tried a little earlier this year after I had been on meds for a few months and did OK (by doing OK I mean no palpitations, tachy or other weird symptoms that I could tell) then a little more, and then a little more.  I will now take maybe 1/2-1/3 of a cup at a time, totaling no more and 1 to 1-1/2 cups per day.  SFSG, knock wood.

I hope you are feeling better!

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Could the sugar in the coke have been what dropped your bp?  I have to say however that I have noticed more pronounced orthostatic hypotension after drinking coffee.  I drink it black typically (and I am not a daily coffee drinker--maybe 1-2 times per week at most).  Maybe it is something in coffee other than caffeine??

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In answer to your question, ABSOLUTELY YES!!!

My BP and HR are almost always normal, except if I were to try and stand for more than about a minute in which case my HR may scrape the POTS 30bpm increase but not always. My BP goes up when I stand, both systolic and diastolic, sometimes by up to 20mmHg, but remains within normal range. 

Yet I am constantly lightheaded. (I don't use the term "dizziness", because in medical terms that is usually applied to/interpreted as meaning vertigo or a sense of spinning, rather than presyncope/near fainting - is it the latter you experience?)

A person can definitely have reduced cerebral blood flow yet have a normal BP. There are a number of possibilities where this can exist, but I believe the commonest is low cardiac output. If your cardiac output is low eg due to low blood volume, your vessels will squeeze harder to compensate, & so the blood pressure remains the same. 

Regarding the coke, some people can be sensitive to either the sugar or artificial sweetener if it was diet. Caffeine is also a diuretic, so depending on the timescale, this may also have been a factor, but this is unlikely to have been immediate. 

B xxx

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