Orthostatic Intolerance and Low Cerebral Blood Flow


New Member
Orthostatic Intolerance and Low Cerebral Blood Flow

Most people with CFS have Orthostatic Intolerance and Low Cerebral Blood Flow. So why do so few people with CFS try to ameliorate these conditions?

Probably the main reason why people do not address O.I. is that medical practitioners declare that if you can stand for 6 minutes without specific B.P. and Pulse changes you do not have O.I. (Australian Practice) Currently, some practitioners are doing 10-minute standing tests, which is what NASA has been doing for returning astronauts for decades. These practices continue despite that the very well-regarded researcher Peter Rowe has been saying for decades that a 10-minute standing test is sufficient to detect Postural Orthostatic Tachycardia Syndrome, but a 45 minute standing test is necessary to detect all forms of O.I.

Possibly the reason that people do not address Low CBF is that, like me until recently, they are unaware that simple non-drug measures can increase CBF.

In 2008 I tested myself for O.I. intending to stand for 45 minutes. I stopped at 30 minutes. I was exhausted. I was blue to the knees. Drop in Pulse Pressure exceeded the Bell/Streeton criteria. It took me hours to recover.

I increased my water and salt intake and tested again. After 30 minutes standing I did not feel tired. My BP and Pulse did not exceed any criteria. My feet had a blue tinge.

To counter CFS symptoms, I had to slowly increase water and salt. I stopped increasing these at 5 litres water and 4 teaspoons of salt (plus 2 teaspoons Potassium Chloride to offset the salt). I then began wearing compression tights, then added an abdominal binder.

By late 2022 these measures were becoming insufficient. I could walk fast but not slowly. Taking Pseudoephidrine was useful but prescription restrictions were limiting. I tried Ispiratory Muscle Training, which was effective but rather tiresome. Then I began to get sore feet. My 75yo feet were no longer tolerating maximum compression tights. It seemed that I was going to have to try drugs, but I would first have to convince doctors that I had O.I.

I had known that people with CFS had low CBR for a long time but had only heard about drug treatment. Now I looked around for anything that would improve CBF. A fairly comprehensive list is at optimallivingdynamics.com I tried several, with no real expectation that any would make a difference. Several had a positive effect, but the absolute standout was chewing gum.

I began chewing gum in October 2023 and have been chewing gum when upright or sitting ever since. If I accidentally stop chewing it takes about an hour for fatigue to begin.

Other measures which keep me CFS symptom free are:- Extreme no plant food diet. Supplements to replace minerals and vitamins that I am not getting in my diet. Inject 600mg Mg daily.


Active Member
Cort has a quite a series of blog posts on this topic:

And he has made a special sub-section on this forum as well:

I’m glad you have found some non-medication measures that help.

I thinks most doctors are confused about what orthostatic intolerance is. Some think it is the same as POTS, some think it only refers to orthostatic hypotension, some don’t know it can be a chronic condition, and some have never heard of it.

I’ve seen people told variously that there is no treatment at all for OI, or that there is no medication that can help if non-pharmacological interventions don’t help.

If only we could get them to watch a lecture from Dr Rowe or have a read of the Bateman Horne Center website!
Thanks for the tip about chewing gum. I hadn't come across that one before.

I've been meaning to get into chewing Xylitol gum to help prevent cavities so this is another incentive to make a move on that.

Thanks to Health Rising blogs I have been able to improve my OI using Oral Rehydration Solution. I'm probably 80% better than where I was 2 years ago. I still struggle to sit and concentrate at my desk all day without needing to lie down for a while, this is particularly worse on hot days and after I've eaten. I'm wanting to return to full time employment in the coming year so I'm needing to make some more progress in order to handle that. I suspect ongoing low blood volume so will return to my GP and naturoptath in coming weeks to discuss. I know my mineral levels are still out of balance (they were all very low on HTMA 2 years ago) so I'm wondering if that is playing a role.

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