Postural Hypotension / POTS-like Symptoms
Users on Reddit report varied experiences with Postural Hypotension and POTS-like symptoms while on GLP-1 medications. Some find their symptoms worsen, while others see no change or even improvement, particularly if weight loss alleviates other health issues. Dehydration is frequently cited as a trigger or exacerbating factor for these symptoms.
Experiences with Postural Hypotension / POTS-like Symptoms:
One user "couldn't get off the couch... My energy plummeted and I felt like I was going to pass out almost every time I stood up. "[7] They also noted that while they usually have low BP, on the medication it was "almost always in Stage 2 Hypertension," which is an unusual response compared to others experiencing low BP. [8]
Another user shared, "I started my initial dosage on Friday afternoon and 24 hrs later, I am feeling weak with sore muscles, nauseated with a bit of lightheadedness, dry mouth even after drinking so much water. "[9]
Dehydration is a significant concern. A user with POTS emphasized, "being dehydrated is like a death sentence. "[4] Another noted, "Keep in mind that these meds can dehydrate you easily, so POTS will likely be worse than usual on it. "[3]
Some users experienced these symptoms for the first time or were diagnosed with POTS after starting GLP-1s. "I didn't realize I had POTS until I was on one. I'd say it's actually led to me being diagnosed. "[3]
A user on Zepbound who experienced severe dehydration, vomiting, and diarrhea after increasing their dose, had to go off the medication for 4 weeks before restarting at a lower dose. They stated, "It hasn't affected my POTS. I haven't gotten worse or better. I'd say, getting 50 lbs off has made me feel better overall. "[4]
One user with fibromyalgia and POTS mentioned that GLP-1s can throw their "tenuously balanced fibro, which is neuroimmune in nature... out of whack by these meds, leading to autonomic issues. " They experienced palpitations which resolved with folinic acid and glutathione. [11]
A user taking Ozempic for diabetes reported, "My blood pressure had dropped 15 points on either side. " This was seen as a positive side effect in their case, along with other health improvements. [14]
Another user on Ozempic for 18 months still gets "palpitations" among other side effects like fatigue and brain fog. [12]
A user described an experience where at a higher dose (12. 5mg), they "thought I was having a stroke and called an ambulance. Panic attack. All obs. Perfect! Before that, I was having occasional shortness of breath, light headed... "[13]
Remedies and Preventions Recommended:
"You do have to be very intentional about eating and drinking enough to combat the orthostatic hypotension. I lived off of protein shakes. "[5]
A user with POTS stated, "I sometimes struggle to drink the bazillions of water I need for POTS, and I may have to choose water/electrolytes over a snack if my tummy is just saying no. Or have an electrolyte icy pole to give that food feeling. "[6]
"I have been trying very hard to stay hydrated and eat lots of protein. Everything isn't perfect but I feel like it's all helping my health improve. "[15]
One user found that "when I drink a ton of water (around 135 ounces), I don’t have a lot of side effects. I thought the hydration aspect was a bit overblown, but no, it’s definitely true and very important for your kidneys as well! "[16]
Dietary Adjustments:
Focus on protein intake: "You do have to be very intentional about eating and drinking enough to combat the orthostatic hypotension. I lived off of protein shakes. "[5]
Ensure adequate food intake: "I do notice that days when I don’t eat properly, because of Semaglutide, I’m much worse than I’d be without it but the secret is to EAT. "[17]
Slow Titration/Dose Adjustment:
Starting with very small doses and increasing slowly was helpful for some. "I started by VERY small doses so I could monitor for side effects and using that method I have had ZERO issues. "[18]
Another user advised, "I started at half the lowest dose and very very slowly increased it. By doing it that way I never had symptoms. "[19]
A user with fibromyalgia and POTS recommended to "go down on the GLP-1. "[11]
Managing Other Conditions:
For a user with MTHFR mutation, POTS, and fibro, adding "folinic acid (leucovorin) and glutathione" helped their palpitations. [11]
Electrolytes: One user specifically mentioned, "Keep up on electrolytes. "[20]
It's important to note that experiences are highly individual. Some users with dysautonomia reported no negative impact on their POTS symptoms from GLP-1s. [21, 22] One user even stated, "it hasn't affected my POTS. I haven't gotten worse or better.
Experiences with Postural Hypotension / POTS-like Symptoms:
- Some users with pre-existing dysautonomia or POTS reported worsening symptoms.
Remedies and Preventions Recommended:
- Hydration and Electrolytes: This is the most frequently mentioned remedy.
It's important to note that experiences are highly individual. Some users with dysautonomia reported no negative impact on their POTS symptoms from GLP-1s. [21, 22] One user even stated, "it hasn't affected my POTS. I haven't gotten worse or better.