Dizzy and tired after eating

[sillysocks84]

Does anyone else get dizzy and extra tired after eating? This is a newer development for me. I don't understand. I am hungry, eat and then feel dizzy and tired.

 

[minkeygirl]

It could be the energy needed to digest food. I get really tired. Dizzy I don't know. What you are eating may make a difference.

I seem to remember people talking about that here a few months ago.

 

[ahimsa]

Does anyone else get dizzy and extra tired after eating? This is a newer development for me. I don't understand. I am hungry, eat and then feel dizzy and tired.

There are many possibilities for those symptoms, so this is not a certainty at all, but one possibility could be Orthostatic Intolerance (OI), e.g., POTS (Postural Orthostatic Tachycardia Syndrome), NMH (Neurally Mediated Hypotension), or some other problem with regulation of heart rate and blood pressure.

This is mentioned in a lot of documents about OI and dysautonomia. I tried to find a good summary just now from a more reliable source but the best I could find at the moment was this extract from a Wikipedia article on hypotension:

Another, but rarer form, is postprandial hypotension, a drastic decline in blood pressure that occurs 30 to 75 minutes after eating substantial meals.[13] When a great deal of blood is diverted to the intestines (a kind of "splanchnic blood pooling") to facilitate digestion and absorption, the body must increase cardiac output and peripheral vasoconstriction to maintain enough blood pressure to perfuse vital organs, such as the brain. Postprandial hypotension is believed to be caused by the autonomic nervous system not compensating appropriately, because of aging or a specific disorder.

This problem has been mentioned by several doctors who talk about the OI found in patients with ME/CFS. Not everyone with ME or CFS has some form of OI but it is not uncommon. So it's worth looking into.

A few other signs that may indicate OI:

* It's draining or difficult to stand still (find yourself pacing or shuffling around, or find that walking is much easier than standing in line)

* Showers are extremely draining (combination of standing up and head, also raising your arms above your head to wash/dry/comb your hair)

* Heat makes things worse (more dizziness, nausea, increased heart rate)

* Lying flat almost always makes symptoms better (it may take some time but eventually things improve)

I hope this helps!

 

[Debbie23]

I get this often, along with various other symptoms. Stomach ache where it feels like I've eaten a cheese grater, nausea, feeling breathless, bad bouts of vomiting in the past etc. my heart rate can also go way up when I've eaten too, and I can get chest pain. I didn't know for sure, but I thought this could be a symptom of dysautonomia/ POTS based on my reading about them, have you considered those things as an explanation for your symptoms? I've not been formally diagnosed with either, but reading about them makes a lot of sense of my symptoms, to me and various doctors I've spoken to, and I definitely fit the criteria for POTS based on home assessment. I wonder if this could explain the symptoms you are experiencing?

For me I seem to do better on a low carb, high fat diet, but this is an experiment over the past few months so I don't know if that will continue, and I know this doesn't suit everyone. The symptoms haven't disappeared since changing my diet, but they are a lot better, especially the high heart rate and chest pain. Those two seem to be especially brought on by eating a high carb meal. The cheese grater sensation in my stomach is definitely much better since eating like this.

I still get tired and other symptoms too but I find they are definitely lessened by eating this way, and eating smaller meals more often.

 

[sillysocks84]

@ahimsa I know it's pots. I live in the midwest and have been assessed for cardiac and pulmonary disease. None found. Just high heart rate. And all the other suspicious symptoms going along with pots. In fact I went to the doctor today and she told me if it is pots there is nothing I can do but get ivs. She reluctantly referred me to a cardiologist I've seen already to hopefully look at this option. I say hopefully because this doctor told me I probably just had anxiety.

@Debbie23 I don't have an official diagnosis but I'm trying like heck to get one. I have food intolerance developing. Plus I figure if I can get the diagnosis on paper then when they get all this exciting research into treatments off the ground I can get treated easier. It is so hard in the middle of the US because these doctors really have no idea and would rather chalk most everything up to "anxiety".

 

[ahimsa]

I know it's pots. I live in the midwest and have been assessed for cardiac and pulmonary disease. None found. Just high heart rate. And all the other suspicious symptoms going along with pots. In fact I went to the doctor today and she told me if it is pots there is nothing I can do but get ivs.

She said that there is no treatment for POTS other than IVs? I wonder why she said that?

It is true that POTS can be quite difficult to treat in some patients, esp. those who also have a diagnosis of ME or CFS. Unlike many POTS patients, patients with ME or CFS can't use exercise to improve without a "crash" and PEM/PENE (although sometimes a small amount of movement or walking around can help).

And not all POTS patients can find medications that help (either drug side effects are bad or the drugs don't seem to help).

HOWEVER, saying that it can be difficult to treat is a far cry from saying that nothing can be done for POTS patients. At the very least there are lifestyle changes (avoiding heat, sitting with feet up, etc.) and non-drug treatments (salt plus extra water, electrolyte solutions, compression garments) that can be tried.

There's a lot of good information at dinet.org if you haven't already checked out that website:

http://www.dinet.org/index.php/information-resources/pots-place/pots-overview
http://www.dinet.org/index.php/information-resources/pots-place/pots-what-helps
http://www.dinet.org/index.php/information-resources/pots-place/pots-what-to-avoid

I should note that my primary diagnosis seems to be NMH (also called Neurcardiogenic Syncope or Neurally Mediated Syncope). I did not develop the POTS part until recently. Upright posture always caused my heart rate to increase but not by enough to get a POTS diagnosis back when I was first diagnosed with NMH on the tilt table test.

But there's a lot of overlap in treatment for all the various types of OI.

Good luck to you!

 

[ahimsa]

Here's an article to show your cardiologist. It mentions that doctors often misdiagnose POTS as anxiety disorder:

In primary care, many patients with POTS may be misdiagnosed as anxiety neurosis, and potential therapeutic opportunities may be missed.

See http://www.medscape.com/viewarticle/717904 for the full article

 

[Research 1st]

Here's an article to show your cardiologist. It mentions that doctors often misdiagnose POTS as anxiety disorder:


See http://www.medscape.com/viewarticle/717904 for the full article

That's an excellent point and thank you for raising it.

To complicate matters further, POTS causes anxiety and anxiety worsens POTS.

For the uneducated doctor (almost all medics as Dysautonomia isn't taught in medical school) the naturally inquisitive medic will immediate start theorising internally about their troubelsome patient with no cardiac disease related cardiac symptoms. Hmmm.....o00 What came first, the chicken or the egg? 0oo(Anxiety - symptoms or symptoms - anxiety).

Thankfully a few doctors out there have heard of a TILT test, but as we know from the British Psychiatrist Peter White, he wouldn't order a TILT test for someone with CFS as that would be ''un ethnical'' to do so. I imagine he isn't alone in thinking this.

So to conclude, no wonder (in CFS especially) POTS is poorly detected and diagnosed due to the unbridled scepticism.

 

[Research 1st]

She said that there is no treatment for POTS other than IVs? I wonder why she said that?

It is true that POTS can be quite difficult to treat in some patients, esp. those who also have a diagnosis of ME or CFS. Unlike many POTS patients, patients with ME or CFS can't use exercise to improve without a "crash" and PEM/PENE (although sometimes a small amount of movement or walking around can help).

And not all POTS patients can find medications that help (either drug side effects are bad or the drugs don't seem to help).

HOWEVER, saying that it can be difficult to treat is a far cry from saying that nothing can be done for POTS patients. At the very least there are lifestyle changes (avoiding heat, sitting with feet up, etc.) and non-drug treatments (salt plus extra water, electrolyte solutions, compression garments) that can be tried.

There's a lot of good information at dinet.org if you haven't already checked out that website:

http://www.dinet.org/index.php/information-resources/pots-place/pots-overview
http://www.dinet.org/index.php/information-resources/pots-place/pots-what-helps
http://www.dinet.org/index.php/information-resources/pots-place/pots-what-to-avoid

I should note that my primary diagnosis seems to be NMH (also called Neurcardiogenic Syncope or Neurally Mediated Syncope). I did not develop the POTS part until recently. Upright posture always caused my heart rate to increase but not by enough to get a POTS diagnosis back when I was first diagnosed with NMH on the tilt table test.

But there's a lot of overlap in treatment for all the various types of OI.

Good luck to you!

To add to your very well written list of tips I would add as 'tips':

*Severe ME can be accompanied by severe autonomic dysfunction (dysautonomia) as part of the pathogenesis.
*Severe Dysautonomia causes more problems than 'just' POTS patients (without ME) report. For example, infections worsens POTS. In ME, due to chronic immune activation and infection, the CNS is antagonised much more frequently than those with 'just POTS who don't have to deal with a chronic onslaught of viruses.

*ME can be progressive and thus POTS can turn into severe dysautonomia which initially wasn't so bad, meaning the PWME needs to be monitored and helped with this, if it occurs.

The most pertinent point I feel you made, was that POTS is bad enough on it own, and POTS + ME is a nightmare. This is an important point, as PWME cannot get their muscles as strong as possible, which can help some POTS patients.

If we see that POTS could well be an autoimmune disease, it wouldn't be much of a leap of faith to propose that ME is another also. Having two autoimmune diseases + maybe a chronic unbeatable infection (Lyme Like, retrovirus etc) is going to totally slam someone.

No wonder patients can have such a hard time, when they are told to cheer themselves up with CBT and GE to 'reduce symptoms'. Hopefully in time, it will be immunologists who research both conditions, and neurologists and cardiologists/rheumatologists/endocrinologists who manage us in clinics - that are provided for our chronic multi system disease, of hopefully, known origins.

 

[taniaaust1]

Does anyone else get dizzy and extra tired after eating? This is a newer development for me. I don't understand. I am hungry, eat and then feel dizzy and tired.

Most of us have low blood volume with the ME/CFS (POTS may be involved with that too), when you eat.. more blood goes to the stomach, this can cause then tiredness and other symptoms (eating is a trigger for POTS). This by one of the top ME experts may interest you http://www.cortjohnson.org/forums/r...blood-volume-in-chronic-fatigue-syndrome.234/

 

[sillysocks84]

Most of us have low blood volume with the ME/CFS (POTS may be involved with that too), when you eat.. more blood goes to the stomach, this can cause then tiredness and other symptoms (eating is a trigger for POTS). This by one of the top ME experts may interest you http://www.cortjohnson.org/forums/r...blood-volume-in-chronic-fatigue-syndrome.234/

That is the most interesting article about our condition I've read to date. It is so wrong that even eating is exhausting, though. But thanks for the insight all the same

 

[taniaaust1]

@ahimsa I know it's pots. I live in the midwest and have been assessed for cardiac and pulmonary disease. None found. Just high heart rate. And all the other suspicious symptoms going along with pots. In fact I went to the doctor today and she told me if it is pots there is nothing I can do but get ivs. She reluctantly referred me to a cardiologist I've seen already to hopefully look at this option. I say hopefully because this doctor told me I probably just had anxiety. .

Sounds like you need to go to a doctor who is POTS aware. Most drs don't know anything about this illness and it is treatable in many by drugs eg Florinef is the most common drug used for it as it helps the body hold onto its fluid. Medical compression stockings are also important to try with it. Saline IVs are only used as a last resort in POTS (and many doctors wouldn't do that, I have to get my saline IVs for it through the hospitals emergency).

It sounds to me as if that cardologist will be useless for this seeing you've already been there (your doctor probably isn't aware where to send you to for it).. cardiologists often aren't even POTS aware as they tend to deal with actual heart problems rather then "autonomic" system issues which is what POTS is, its inability to regulate the autonomic system while ones heart is actually healthy.

I suggest to look up and find out where the closest places are which do tilt table testing as those places may have POTS aware dr you could be refered too instead of wasting your valuable energy by going back to that cardiologist.

 

[sillysocks84]

@taniaaust1 , yeah I am afraid it will be a waste of an appt. She really kept wanting to prescribe me anti anxiety stuff last time. Told me it still is fast at rest because at night your minds racing. Uh, no.

I'm so happy for this forum someone like you who gets it. I just told my mom tonight what's been up on and off for 3 years and more constant the last 10 months. Felt I had to with the holidays coming and I'm getting allergic to food now...

I don't know where to start. I had called my gp a few weeks ago asking for referral to a cfs/me/pots specialist. They were like, huh? And then, well you have to come here first to be seen. I did and now I have appt to food allergist and cardiologist. I want a set in stone diagnosis! So I can be treated! If I find these clinics, assuming they exist in the midwest, I thought I'd need a referral. I hope that's not the case

 

[taniaaust1]

You will probably have to find out for yourself where your closest ME/CFS specialist is. Its usually not something a dr can direct one too. Try asking on these forums for your area/state. Also try doing an online goggle search for things such as postural orthostatic tachycardia, your city and doctor to find ones close to you (or seek out researchers in these areas close to you. I was connecting with researchers in my city and having ME/CFS research tests before I ever found ME/CFS specialists as they weren't taking new patients)

 

[sillysocks84]

@taniaaust1 Should I see the me cfs specialist before a pots diagnosis? Thank you for the insight in looking up researchers, I may have a possible person to call now. One, but it is an improvement over zero.

 

[PatJ]

Does anyone else get dizzy and extra tired after eating? This is a newer development for me. I don't understand. I am hungry, eat and then feel dizzy and tired.

What happens if you eat a meal that is 1/4 the size of the regular amount? Do you still get dizzy and extra tired?

I spent years eating regular sized meals and then being exhausted for the next three hours. I finally read about low blood volume, and blood being redirected to the stomach for digestion. So I tried eating much smaller, more frequent meals, and now I'm no longer a zombie after eating. It may help to lie down after a small meal as well.

I also noticed that if I had eaten a large meal and was due to have a bowel movement then I could barely stay conscious. Presumably because even more blood was redirected to the colon and bowels.

 

[sillysocks84]

@PatJ thank you for your advice! I have begun fasting on and off and that helps a little, but why I didn't think of eating a smaller percent of food each meal I'm not sure. I mean I started eating less but not the big difference in size you are saying. But now I'm thinking I should. As weird as it sounds, I wish I were fatter.

 

[PatJ]

@PatJ thank you for your advice! I have begun fasting on and off and that helps a little, but why I didn't think of eating a smaller percent of food each meal I'm not sure. I mean I started eating less but not the big difference in size you are saying. But now I'm thinking I should. As weird as it sounds, I wish I were fatter.

The smaller amount of food means that less blood needs to be redirected for digestion. You may need too experiment to see how you feel after various size meals. You could try 1/4 size to start and adjust up or down from there based on how you react. Just remember to increase the number of meals in the day so you still take in the same amount of food.

The kind of food has some influence for me as well. I can't tolerate too much protein at once, even though I use Betaine HCL capsules to aid digestion.

Lower than normal weight can increase OI or general blood pressure problems. I started losing weight after I came down with CFS and can't seem to gain it back. Freddd's treatment helped me to gain some weight, but it might have been just the methylB12. I think I remember Freddd posting a link to a research document about farm animals gaining weight when they were given methylB12.

 

[Research 1st]

@taniaaust1 Should I see the me cfs specialist before a pots diagnosis? Thank you for the insight in looking up researchers, I may have a possible person to call now. One, but it is an improvement over zero.

Hello again, well to reply:

In my opinion as a patient and service user with severe ME + POTS..

No I would do it the other way round: Screen for POTS first, then see an ME specialist if POTS TILT or other autonomic diagnosis explaining symptoms is negative. If POTS test is positive, consider if you still think you have ME due to the other symptoms and signs you learn about that aren't consistent with POTS you read about in research, or talking to others in person.

It's important you remember the following facts in points labelled 1) + 2) as they will help you if you are blocked from medical care and testing and have doubts cast over the legitimacy of your own symptoms (if you have CFS are are ignored) and legitimacy of them.

1) POTS is an exclusionary diagnosis for Fukuda CDC CFS. This is because a 'Chronic Fatigue' (and minimal other symptoms in Fukuda CFS criteria) must be unexplained to have CFS diagnosed. Part of a POTS symptoms is 'chronic fatigue' (including severe), however, as POTS is an accepted neurological condition, the fatigue is considered neurologically based and organic (Autonomic Dysfunction is known to cause Chronic Fatigue). If this is the case, the person cannot have Fukuda CFS, and POTS would be diagnosed.

Why does POTS get missed so frequently in ME?

To trap people in CFS for life, various government health agencies refuse to alter the weak CFS criteria in use. A patient is then unaware they may have a chronic, diagnosable neurological condition as part of their ME ....Autonomic Dysfunction! This is clearly unethical to not alter criteria as the science progresses, but it is politically acceptable for reasons that are not disclosed to the general public. (The state bizarrely stops CFS having an inclusion based neurological test - a TILT test as part of CFS screening tests) otherwise the public would 'twig' that most with CFS diagnosis have an ongoing disease process in their 'CFS' not a syndrome - and thus many have ME and not Fukuda CFS - as they have permanent autonomic dysfunction).

With this lack of knowledge in place, conversely, to many physicians, the 'fatigue' in CFS is under-suspicion as organic, or is presumed to be reversed with intervention (sleep disorder,depression, vitamins and minerals, antivirals etc). These interventions won't 'fix' POTS, but they might 'fix' CFS, because CFS is so weakly defined, the cause can be just about anything that hasn't been looked at during the time of diagnosis!!!! (A batch of standardised blood tests for other conditions you don't have - ).

2) POTS is common in ME and CFS but this fact (proven by research and by patients reporting both) is denied politically as worthy of note. A patient can have both ME CFS + POTS, but there is no 'evidence' of this in official medical literature that goes down the CBT GE route! You will find nothing on the American CDC website saying CFS patients have neurological POTS, or the UK 'NHS' system either - it's taboo, unmentionable. The system is in complete denial, because to recognise POTS is frequent in CFS, would prove that many cases of CFS have an underlying neurological cause, or even share the same causative pathological agent - Lyme variant -Lyme Co Infection etc?. The idea of CBT GET to 'fix' patients, would then be exposed as a scam, and patients would be able to demand a biomedical approach legally. A proposed biomedical approach for ME, 46 years after 'ME' was accepted by the World Health Organisation (in 1969) as neurological is only now what is being considered by some, as a 'better' way than psychiatry, but is still not in place!!!

3) POTS patients with additional 'ME', can hide their other life destroying condition ME (Those who face hostile doctors, go under cover to get better care as 'just POTS'). This is sad, as their ME never gets looked at, or treated in any way. Imagine how bizarre it is, not to report repeat infections, hallucinations, severe forgetfulness, in case the physician 'twigs' they think you have 'CFS' as well and this 'CFS' must be psychiatric and not neurological and/or Lyme (Lyme causes hallucinations, seizures etc).

.So to conclude if I was reasonably sure I had POTS and wanted to get a TILT table test and other autonomic tests:

*I would know if I wanted to, I could 'dump' my old diagnosis of CFS legally and get psychiatrist reports on me that defame me or my family torn up by a judge. This may be very useful to end hostility or lack of any medical treatment for a 'CFS' I was being blocked on - I may never have had CFS in the first place!

*I would know that I'd be in difficulty if I had severe CFS (ME) by having classic signs of this that differ from POTS as I won't get any treatment in the current political climate for ME, and will stay sick, even if my POTS is cured.

POTS may be cured (autoimmune POTS) in the future, but having ME on top (two diseases at once) is a big problem in terms of treatment, and currently, in terms of diagnosis.

I hope that helps.