Hydration Is Key

Dysautonomia requires ongoing treatment

Understanding dysautonomia

You need water with electrolytes to get blood in the right place in your body. Dysautonomia is a “misfiring” of the cardiovascular system. A subset of dysautonomia is called postural orthostatic tachycardia syndrome (POTS). Hypovolemia is a term that means low blood volume. Low blood volume can come from being dehydrated, or not having enough blood in the right part of your body. For example, you may drink enough water, but the water and blood may pool in your legs, leaving your gut and brain with little water and blood flow. This can manifest as irritable bowel syndrome (IBS), gastroparesis, diarrhea, constipation, and other stomach problems. Because your brain is not getting the water and blood flow it needs, you may get lightheaded, have headaches, abnormal heart rates, fatigue, blurry vision, and just “not feel right.” Typically with hypovolemic dysautonomia, symptoms improve when you lay down. We can usually tell if your dilated pupils constrict when you lay down flat. Fortunately, we work with the best cardiologists to help get your blood volume properly regulated. Usually, improving blood regulation results in improved GI function, energy, and a decrease in lightheadedness and headaches. We recommend drinking 2-3L of electrolyte-based drinks per day to keep your water and blood volume up and in the proper place. We like LMNT, and Vitassium. Dr. Umesh Patel recommends taking Vitassium electrolyte capsules, 1-2 doses three times a day as needed to provide cellular electrolytes to decrease fatigue, dizziness, etc. You may also choose to drink 2-3L of LMNT per day. It’s easy to fall off track, so make sure you keep a regular schedule of drinking to continue feeling well.

Neurogenic dysautonomia does not involve the regulation of fluids in your body. Instead, neurogenic dysautonomia results from an abnormality in your nervous system, either the brain or spinal cord. In patients with hypermobility, the abnormal movements of the cervical spine can cause brain, cerebellum, brain stem, cervical spinal cord, or thoracic spinal cord irritation. This is called craniocervical instability or cervical instability. You may also have cervicomedullary syndrome. We have excellent means for evaluating this. Fortunately, correcting posture with physical therapy helps significantly, although some patients do need surgery. In summary, most patients tend to have a mix of both hypovolemic and neurogenic dysautonomia. We work with you to tease this out and put together an individualized program based on all we see with imaging, labs, physical therapy notes, etc. It does take time to get the body adjusted back to normal, but fortunately; it is possible!

Electrolyte recommendations:

View this video from one of our network cardiologists, Dr. Umesh Patel:

  • Monitor your hydration status

  • Supplement with electrolytes if recommended

  • Use compression wear if recommended

    We recommend UnderArmour HeatGear for women or men (cooler in the summer)

  • Lay down if symptoms flare

  • Exercise regularly

  • Eat small regular meals to prevent too much blood flow going from your muscles to your GI tract

Continue to learn…

Check out other resources on our site, or other great information from Dysautonomia International.


Research on hypermobility and Ehlers-Danlos Syndromes is far behind other medical diagnoses. It takes the voice of the patient and the support of the community to fund research projects that will allow increased awareness, development of diagnostic criteria and evidence-based treatment protocols.

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