[59M] Experiencing severe dizziness and fainting upon standing

What might be happening

Based on the symptoms you've described, here are some possible explanations:

1. Orthostatic Hypotension:

   • Rationale: This condition occurs when your blood pressure drops significantly upon standing, leading to dizziness, lightheadedness, and even fainting. Given that your symptoms resolve when you lie down, this is a strong possibility.
   • Typical Testing: Blood pressure measurements taken while lying down, sitting, and standing. Blood tests to check for underlying causes such as dehydration or anemia.

2. Dehydration:

   • Rationale: Dark yellow urine can be a sign of dehydration, which can also cause dizziness and lightheadedness. Dehydration can be more common in individuals with HIV, especially if not on medication.
   • Typical Testing: Blood tests to check electrolyte levels and kidney function.

3. Anemia:

   • Rationale: Anemia can cause fatigue, dizziness, and lightheadedness. It can be more common in individuals with chronic conditions like HIV.
   • Typical Testing: Complete blood count (CBC) to check for low hemoglobin levels.

4. Cardiovascular Issues:

   • Rationale: Changes in breathing and a gurgling sound when lying on your left side could indicate fluid buildup or other cardiovascular issues.
   • Typical Testing: Echocardiogram, EKG, and possibly a chest X-ray.

What you can do

Orthostatic Hypotension:

• Immediate Steps:
  • Stand up slowly and in stages (from lying to sitting, then sitting to standing).
  • Stay hydrated by drinking plenty of fluids.
  • Avoid alcohol and caffeine, which can dehydrate you.
• Long-term Steps:
  • Consult your doctor for a formal diagnosis and treatment plan.
  • Wear compression stockings to improve blood flow.

Dehydration:

• Immediate Steps:
  • Increase your fluid intake, aiming for at least 8 glasses of water a day.
  • Avoid diuretics like caffeine and alcohol.
• Long-term Steps:
  • Monitor your urine color; it should be light yellow.
  • Consult your doctor for further evaluation and advice.

Anemia:

• Immediate Steps:
  • Eat iron-rich foods like lean meats, beans, and leafy greens.
  • Consider taking an iron supplement, but consult your doctor first.
• Long-term Steps:
  • Get a blood test to check your hemoglobin levels.
  • Follow up with your doctor for a comprehensive treatment plan.

Cardiovascular Issues:

• Immediate Steps:
  • Avoid lying on your left side if it causes discomfort.
  • Monitor your symptoms and note any changes.
• Long-term Steps:
  • Consult your doctor for a thorough cardiovascular evaluation.
  • Follow any prescribed treatments or lifestyle changes.

What you should look out for

Given the severity of your symptoms and the potential for serious underlying conditions, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

• Fainting or near-fainting episodes
• Severe or worsening dizziness
• Shortness of breath or chest pain
• Significant changes in your urine color or output
• Persistent fatigue or weakness

Remember, while I can provide guidance, it's crucial to consult a healthcare professional for a formal diagnosis and treatment plan. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.