Light-headed when standing up from a crouch

[Faipdeooiad]

Hi,

Apologies this isn’t strictly a ‘men’s health’ issue but it’s the closest I could get.

For the past few years I have been experiencing really bad light-headedness when standing up from a crouch or anything below seated, a task any parent of young children will tell you is something you do multiple times on a daily basis.

I’m 37, no major health concerns, currently on TRT due to being hypogonadic (140mg test cyp/week), very occasional fexofenadine (180mg) to treat cholinergic urticaria and I have been using Reta for the last 10 months, give or take. I have never passed out but have come very close on a small number of occasions.

The incidences of being light headed when getting up haven’t gotten better, worse or more/less frequent since starting with the Reta as that was my initial thought due to any effects on blood sugar.

Blood pressure is good, last time I checked it (last week) it was 118/74 and it never really deviates from that sort of range.

I’m posting here to see if any of you might have any pointers or ideas as to what might be causing it or suggestions on next steps to try and investigate the cause and try to either resolve it or, at least, understand what’s causing it and how to adapt without having to take 10-15 seconds to compose myself whenever I stand up.

Thanks in advance.

 

[Ghoul]

It’s positional, also called “orthostatic” hypotension.

In an otherwise healthy male, it’s most likely dehydration, and related to that, but also potentially from other causes, reduced plasma (blood) volume.

The fact GLPs reduce thirst as much as hunger isn’t discussed much, and it’s very easy to become unwittingly dehydrated without feeling thirsty. This is the overwhelmingly most likely cause imo.

The next is the impact Reta has on the vagal nerve, The root cause of the increased resting heart rate many report. The same mechanism can interfere with the body’s natural compensation when there are sudden changes in BP, like standing. Monitoring your heart rate sitting, and checking again when standing quickly and feeling dizzy may give you a clue. (A sudden increase in heart rate shortly after is the sign that’s the cause). Other GLPs don’t do this as much, so either lowering the dose or switching to Tirz could fix it.

Fexofenadine isn’t the issue,

For completeness, here’s a list of other common causes, in order of likelihood, so you can troubleshoot it further if needed, but I suspect it’s dehydration, Reta, insufficient sodium, or a combination.


Positional (Orthostatic) Hypotension in a 35-Year-Old Male – Most Common Causes

1. Relative dehydration
- Low water intake
- Excess caffeine
- Sweating from exercise
- Low-carb diet / fasting
- Alcohol (vasodilation + diuresis)

2. Medications or supplements
- Stimulants (amphetamine, pre-workout)
- Tadalafil / sildenafil
- SSRIs / SNRIs
- Alpha-blockers
- Antihypertensives
- Diuretics
- GLP-1 agonists (tirzepatide/semaglutide)

3. Rapid weight loss
- Reduced sympathetic tone
- Lower renin-angiotensin activity
- Lower plasma volume

4. Autonomic under-activity (“low sympathetic tone”)
- Very fit endurance athletes
- Chronic low caloric intake
- High vagal tone
- Post-viral dysautonomia

5. Low blood volume from low sodium intake
- Clean dieting
- Drinking excessive plain water
- High sweat rate

6. Adrenal issues (usually mild)
- Relative adrenal insufficiency after stopping stimulants
- Overtraining
- Chronic stress
- Rare true adrenal insufficiency

7. POTS / post-viral autonomic dysfunction
- HR rise ≥30 bpm on standing
- Common after viral illness or COVID

 

[Mushy404]

BP is pretty good, and if you aint dipping down around/below 110 then I'd look to hydration.

Are you on top of your electroytes? Particularly if you are eating a lot less on Reta

 

[Faipdeooiad]

Amazing, thanks both.

I think you’ve nailed it with the dehydration and caffeine - I don’t drink enough as I should do so that’s probably it.

I’ll increase intake with electrolytes and report back.

 

[BigDadd7]

It's ebola. You're going to die.

 

[Faipdeooiad]

It's ebola. You're going to die.

Don’t get my hopes up.

 

[Mushy404]

Amazing, thanks both.

I think you’ve nailed it with the dehydration and caffeine - I don’t drink enough as I should do so that’s probably it.

I’ll increase intake with electrolytes and report back.

Happy to help. Hopefully it is just that and you don't have to keep searching for a cause.

There are probably good electrolyte products out there, but most are mainly sodium with inadequate amount of the rest (Potassium, Magnesium). Be sure you are getting the others also.

I use a relatively cheapish electrolyte product myself, but I also supplement HIGH dose Magnesium (800mg Elemental) and 400mg of potassium separately. And of course a good mutli-vit. This works well for me.

Good luck with it!

 

[Faipdeooiad]

Happy to help. Hopefully it is just that and you don't have to keep searching for a cause.

There are probably good electrolyte products out there, but most are mainly sodium with inadequate amount of the rest (Potassium, Magnesium). Be sure you are getting the others also.

I use a relatively cheapish electrolyte product myself, but I also supplement HIGH dose Magnesium (800mg Elemental) and 400mg of potassium separately. And of course a good mutli-vit. This works well for me.

Good luck with it!

I’ve got a rake of the Ghost electrolytes so I’ve been using them as and when I remember but I’ll have a look to see if there’s anything better.

I was using Strom Hydramax for a while but with it being such a big tub, the flavour got a bit sickly and I gave it away

 

[Mushy404]

For what it's worth, for me, I don't often buy all in one popular blends, especially when they have catchy names, if I can help it. They tends to be overpriced in my opinion. But if you get it for a good price then go for it.

I prefer to get good standalone products in bulk, and often flavourless, as this tends to keep the cost way down. I can optimise the ratios I consume this way too and just add a cheap sugar-free flavouring to it myself.

If you are in the UK, then Bulk (dot) com or PeakSupps (dot) co.uk would be a good place to look. Between the 2 sellers you can get great bargains

 

[Faipdeooiad]

Yea cheers, I got a few bags of the ghost from Nutricircle as they were short dated and about a third of retail but I’ll look into making my own once I’ve moved house and got room for individual bags as I’m a bit cramped for space at present and my wife’s liable to kill me before the Ebola if she comes home to a load of bulk pouches.

Thanks again

 

[Infernalmango]

@Faipdeooiad howd this ever fair for you? I was experiencing similar things on Reta and increased electrolytes dramatically. While it for sure improved symptoms, they didn’t go away completely.

 

[Faipdeooiad]

@Faipdeooiad howd this ever fair for you? I was experiencing similar things on Reta and increased electrolytes dramatically. While it for sure improved symptoms, they didn’t go away completely.

Hey, yea I’ve experienced pretty much the same - I’m generally feeling a lot better overall suggesting I was dehydrated and whilst the light headedness hasn’t completely subsided, it’s less frequent than it was.

 

[Infernalmango]

Hey, yea I’ve experienced pretty much the same - I’m generally feeling a lot better overall suggesting I was dehydrated and whilst the light headedness hasn’t completely subsided, it’s less frequent than it was.

Good to hear. I’ll be discontinuing the Reta in another week or so, interested to see if I fully return to symptom free after that. Thanks for your reply