If you’re experiencing dizziness, lightheadedness, or fatigue upon standing, these symptoms may be caused by a condition called neurogenic orthostatic hypotension, or “nOH”

What is nOH?

Neurogenic orthostatic hypotension (nOH) causes a drop in blood pressure after standing or changing positions. In patients with diseases like Parkinson’s, OH may be caused by damage to the nervous system (“neurogenic”). Due to this damage, the body may not release enough of a chemical called norepinephrine, which normally helps keep blood pressure from dropping too low. Without enough norepinephrine, blood pressure remains low after standing. This can lead to feelings of dizziness, lightheadedness, fatigue, blurred vision, and other symptoms. People often think the symptoms of nOH are due to their underlying nervous system disorder, such as Parkinson’s, and assume the symptoms are something they must learn to live with. However, nOH is a separate condition with symptoms that can also be managed.

What else do I need to know about nOH?

While nOH can result in sudden feelings of dizziness or lightheadedness at any time, these symptoms tend to occur more often in the morning. They may interfere with your ability to complete your usual daily activities. It’s important to understand that nOH symptoms may also result in serious consequences, such as falls. If you’re experiencing symptoms like these upon standing or changing positions, or feel like you may black out or faint, it may be time to talk to your doctor. Before you do, take a few minutes to complete this online symptom checker to help prepare for your discussion. Be honest about your symptoms. Describe how you feel when you stand up or change positions.

Talking with your doctor about nOH?

Here are some tips and resources to help you prepare for your next visit and for talking to your doctor. Track your symptoms. Use a notebook, tracker, or your phone to keep track of symptoms so you can discuss them with your doctor. Talk about what’s important to you. Talk to your doctor about the impact your symptoms are having on your life (especially if they are limiting or interfering with your daily activities).

• It’s important to discuss how your symptoms are affecting you so that you and your doctor can develop a management plan together

At your doctor appointment, ask for blood pressure readings in different positions (lying down if possible, or sitting, then standing).

• This is very important for diagnosing nOH and determining your management options

Questions to ask your doctor.

• When meeting with your doctor, it may be helpful to have a list of questions to ask to help you better understand nOH and its management

There are different approaches to treating the symptoms of nOH

Living with nOH can be challenging, but your doctor may suggest some lifestyle changes that may help manage your symptoms. Always talk to your doctor before making any changes to your nOH management plan or your daily routine.

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