Hypotension Naturopathic Protocol
Hypotension Naturopathic Protocol
This Hypotension Naturopathic Protocol is provided as information for patients of HealthMasters Naturopath Kevin Tresize ND as part of a treatment plan to assist patients with understanding of their treatment plan and should not be substituted for medical advice, diagnosis or treatment. It is important to note that this is a summary only and is intended to assist discussion between practitioner and patient as part of consultations. This Hypotension Naturopathic Protocol may be changed to suit the individual requirements of the patient and should not be substituted for medical advice, diagnosis or treatment.
HealthMasters Naturopath Kevin Tresize ND
Hypotension is a condition in which the blood pressure is below 100mmHg systolic and/or 50mmHg diastolic. There are a number of categories of hypotension, depending on the causes and other factors:
- Low blood pressure on standing up (postural or orthostatic hypotension). If normal compensatory heart rate and vasoconstriction fails, blood pressure falls when standing up leading to symptoms of dizziness, light-headedness, blurred vision and even fainting. Postural hypotension may occur due to dehydration, prolonged bed rest, pregnancy, diabetes, heart problems, burns, excessive heat, large varicose veins and certain neurological disorders. It is especially common in older adults, with as many as 20 percent of those over age 65 experiencing postural hypotension, but may also affect young, otherwise healthy people.
- Orthostatic hypotension in the elderly. Acute orthostatic hypotension is usually secondary to medication, fluid or blood loss, or adrenal insufficiency, whereas chronic orthostatic hypotension is frequently due to altered blood pressure regulatory mechanisms and autonomic dysfunction.
- Low blood pressure after eating (postprandial hypotension). This affects mostly older adults as a large amount of blood flows to the digestive tract after eating. If compensatory mechanisms fail, this may lead to dizziness, faintness and falls. Most likely to affect those with high blood pressure or autonomic nervous system disorders such as Parkinson's disease.
- Low blood pressure from faulty brain signals (neurally mediated hypotension). This disorder causes blood pressure to drop after standing for long periods, leading to signs and symptoms such as dizziness, nausea and fainting. Mostly affects young people when nerves in the heart's left ventricle signal the brain that blood pressure is too high, rather than too low. As a result, the brain lessens the heart rate, decreasing blood pressure even further.
- Low blood pressure due to nervous system damage (multiple system atrophy with orthostatic hypotension). Also called Shy-Drager syndrome, this rare disorder causes progressive damage to the autonomic nervous system, which controls involuntary functions such as blood pressure, heart rate, breathing and digestion.
2. Aetiology / Risk Factors
- Pregnancy. The circulatory system expands rapidly during pregnancy. During the first 24 weeks of pregnancy, systolic pressure commonly drops by five to 10 mm Hg and diastolic pressure by as much as 10 to 15 mm Hg. Blood pressure returns to pre-pregnancy level after giving birth.
- Heart problems. Some heart conditions that can lead to low blood pressure include extremely low heart rate (bradycardia), heart valve problems, heart attack and heart failure.
- Endocrine problems. An underactive thyroid (hypothyroidism) or overactive thyroid (hyperthyroidism) can cause low blood pressure. In addition, other conditions, such as adrenal insufficiency (Addison's disease), low blood sugar (hypoglycaemia) and, in some cases, diabetes, can trigger low blood pressure.
- Dehydration. Even mild dehydration can cause weakness, dizziness and fatigue. Fever, vomiting, severe diarrhoea, overuse of diuretics and strenuous exercise can all lead to dehydration.
- Medications. Drugs used to treat high blood pressure — diuretics, beta blockers, calcium channel blockers and angiotensin-converting enzyme (ACE) inhibitors — as well as antidepressants and drugs used to treat Parkinson's disease and erectile dysfunction.
- Acute hypovolemic shock (serious) a life-threatening complication of dehydration. It occurs when low blood volume causes a sudden drop in blood pressure and a reduction in the amount of oxygen reaching your tissues. If untreated, severe hypovolemic shock can cause death within a few minutes or hours.
- Severe infection (septicaemia) when infection in the body enters the bloodstream. These conditions can lead to a life-threatening drop in blood pressure called septic shock.
- Severe allergic reaction (anaphylaxis). Anaphylaxis is a severe and potentially life-threatening allergic reaction, causing breathing problems, hives, itching, a swollen throat and a drop in blood pressure.
- Lack of nutrients in your diet. A lack of the vitamins B-12 and folate can cause anaemia, a condition in which your body doesn't produce enough red blood cells, causing low blood pressure.
3. Signs and Symptoms
- Dizziness or light-headedness
- Fainting (syncope)
- Lack of concentration
- Blurred vision
- Cold, clammy, pale skin
- Rapid, shallow breathing
4. Treatment Recommendations
Determine the cause of low blood pressure to address as a priority – see “Definition” above.
4.1 Support cardiovascular energy, vascular tone and autonomic nervous system function
High Potency Taurine, Glycine and Magnesium for Cardiovascular Health - 1 scoop twice daily
Enhanced Bioavailability Coenzyme Q10 150mg - 1 capsule twice daily
4.2 If dehydrated
Endurance and Rehydration Formula - 1 serve up to 3 times daily
4.3 If associated with anaemia
High Potency Iron and Co-factors - 1-2 tablets daily
Or if vegan/vegetarian:
High Potency Vegetarian Iron with 5-MTHF - 1-2 capsules daily
4.4 If associated with blood sugar imbalances
Cocoa, Cinnamon and Chromium for Metabolic Syndrome - 1 capsule twice daily
4.5 If associated with ageing and postural hypotension
Wellness and Healthy Ageing Program
Resveratrol Age Well - 1 tablet daily
4.6 If associated with low thyroid
Lycium Hypothyroid Support - 2 tablets twice daily until improvement then, 1 tablet twice daily
4.7 If associated with infection
Cordyceps, Coriolus and Reishi for Immune Stimulation - Acute: 1 serve three times daily Chronic: 1 serve daily
High Bioavailability Zinc with Vitamin C - 1 serve daily
4.8 If associated with stress
Assess neurobiology using the Mood and Stress Questionnaire
5. Supportive Programs
6. Diet and lifestyle
Dietary and lifestyle guidelines may assist in the management of hypotension:
- Following the principles of the Wellness and Healthy Ageing Program, includes a diet high in fresh fruit (whole), vegetables (non-starchy), essential fatty acids and lean protein sources provides essential phytonutrients, antioxidants, magnesium and helps to control inflammatory processes in the blood vessels. Avoid or limit refined carbohydrates including sugar, sweets, fruit juices, white breads, pasta and potatoes should be avoided.
- Increasing water intake can help to raise blood pressure levels and prevent dehydration, which one of the major causes of low blood pressure.
- People who suffer from circulatory conditions that contribute to low blood pressure can find some relief by wearing elastic compression stockings. The stockings can reduce the amount of blood that pools in the legs and help it to pump through the body appropriately. In addition to elastic hose, the National Institute of Neurological Disorders and Stroke recommends sitting up frequently throughout the day if prolonged bed rest causes the hypotension.
- People with lower than average blood pressure readings should change positions carefully, especially when moving from a sitting or prone position to standing. Lying still for a few moments and taking a few deep breaths before getting out of bed in the morning can help to prevent dizziness.
- Alcohol consumption should be avoided if a person is prone to low blood pressure because alcohol naturally dehydrates the body.
- Since blood pressure often drops sharply after meals, those with low blood pressure issues should eat more small meals during the day and avoid foods high in carbohydrates, such as potatoes, pasta and bread.
- Drinking coffee or other caffeinated beverages with a meal may help to maintain proper blood pressure levels.
- Salt raises blood pressure. Patients, especially elderly people with low blood pressure, should consult a doctor before increasing salt intake because too much sodium can cause heart failure. Soy sauce can be a healthy alternative to added salt in dishes. Dry soup mixes are another option for adding extra salt to a diet.
- Healthy circulation may be supported with warm baths that are infused with Epsom salts taken for 20 minutes before bedtime can help to balance body systems.
- Smoking cessation is the highest priority in currently smoking patients.
- Regular aerobic exercise (starting slowly and increasing as patient’s fitness improves) has been shown to support healthy circulation.
- Breathing exercises may help those whose blood pressure may be affected by mild hyperventilation.
- Stress management techniques, such as yoga, meditation and exercise are advised.