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What could cause postural hypotension?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

When I stand up from my bed suddenly, I feel dizzy for a minute. What could be causing this? My ECG and echocardiogram results are normal. When walking, I feel unsteady and as if I am floating. Currently, I am taking Xylometazoline, Atorvastatin 10 mg, Betahistine, and Febuxostat 40 mg.

Please help.

Hello,

Welcome to icliniq.com.

This suggests postural hypotension, which means that when you suddenly stand up, the blood supply to your brain decreases, causing symptoms until your body adjusts. This condition is often benign and not worrisome, and it can improve with lifestyle changes. However, we should rule out autonomic neuropathy. You should have your blood pressure checked by a local doctor or at home if you have a blood pressure monitor. To do this, measure your blood pressure while lying down and then recheck it after you stand up whenever you start feeling dizzy, and note the difference between the two readings.

You should also have your thyroid and blood sugar levels tested if you have not done so recently. If you are consuming too much alcohol, you will need to reduce your intake. Please let me know the content of the first medicine you mentioned and if you are taking any other medications. Have you noticed any response to Betahistine? For treatment, you should avoid sudden changes in posture; instead, rise more gradually, such as sitting up in bed for a while before standing. Additionally, avoid dehydration by drinking plenty of water and fluids, and consider increasing your salt intake if your blood pressure is on the lower side. We may need to add medications later if necessary.

Thanks and regards.

Patient's Query

Hello doctor,

Thank you for the reply.

I am taking Betahistine for de-addiction. I am sending you a picture of the prescription for my allergic rhinitis. Can allergies also cause imbalance while walking? Sometimes I am doing financial work, so there is no physical activity. I tend to be very lazy, and I wonder if this could also be a factor.

Hello,

Welcome back to icliniq.com.

So, you are also undergoing de-addiction. Is Betahistine helpful? Are you taking all the medications mentioned in the prescription? Your Flunarizine and Piracetam can cause drowsiness and lethargy. Additionally, Flunarizine and Piracetam mentioned in the prescription may contribute to dizziness and imbalance. You should discuss reducing these medications with your local doctor.

Allergic rhinitis does not cause imbalance. The imbalance may also occur due to vitamin deficiencies from alcohol use. You should request your doctor for Thiamine and multivitamin supplements, which can aid in your recovery. A balanced diet, including green vegetables and fruits, is also important. There are multiple potential causes for your symptoms that need to be addressed.

Thanks and regards.

Patient's Query

Hello doctor,

Thank you for the reply.

I am sending my blood report. Kindly review.

Hello,

Welcome back to icliniq.com.

I have reviewed your reports (attachment removed to protect patient identity). Your lipid profile and uric acid levels are abnormal, for which you are taking medications and should continue doing so. However, your vitamin D level is also low, and you should start taking supplements. You should take these supplements once a week for eight weeks, followed by once a month for six months. Additionally, your amylase levels were elevated, likely due to your alcohol intake, but they are decreasing from previous levels. It is important to strictly avoid alcohol, as it may precipitate pancreatitis. The rest of your reports are normal.

Thank you.

Patient's Query

Hello doctor,

Thank you for the reply.

My hemoglobin and B12 levels are slightly elevated. Can I donate blood? Can high hemoglobin levels cause dizziness or stroke? My neurologist has prescribed Homin tablets (containing pyridoxine, mecobalamin, hydrochloride and folic acid), Betahistine, and Febuxostat again. Can I stop taking the Homin tablet?

Please advise.

Hello,

Welcome back to icliniq.com.

Your hemoglobin is borderline high, but you may certainly donate blood. However, since you are on medication, they may not accept your donation for other patients and it may be discarded. Since your levels are not significantly elevated, you can drink plenty of water without donating. You may stop taking the supplements since your levels are fine. Do you smoke? Smoking can contribute to elevated hemoglobin levels, so if you do, you need to cut down.

I hope this helps you.

Thank you.

Medically reviewed byDr. K. Shobana

Published At July 31, 2018
Reviewed AtDecember 23, 2025

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