Managing orthostatic hypotension (feeling dizzy or lightheaded when standing up) with MS often requires a team approach — typically working with both a neurologist and a cardiologist together. The good news is there are several strategies that can help.
Lifestyle & Diet Changes
These won't eliminate the root cause but can Show Full Answer
Managing orthostatic hypotension (feeling dizzy or lightheaded when standing up) with MS often requires a team approach — typically working with both a neurologist and a cardiologist together. The good news is there are several strategies that can help.
Lifestyle & Diet Changes
These won't eliminate the root cause but can meaningfully reduce how often symptoms occur:
- Drink plenty of water (at least 64 oz per day)
- Increase salt intake (with doctor guidance)
- Avoid alcohol
- Avoid overheating
- Don't cross your legs when sitting
- Sleep with your head slightly elevated
- Rest after eating
A MyMSTeam member shared: "The cardiologist put me on a high-salt, high-fluid diet to keep my blood pressure up. I live on Goldfish crackers! It has helped a lot." Compression Garments
Compression stockings or abdominal binders help prevent blood from pooling in the legs, which can worsen dizziness when standing. These work by helping blood vessels constrict properly.
Medications
A doctor may prescribe medications to raise blood pressure, such as:
- Droxidopa (Northera)
- Fludrocortisone
- Midodrine (Orvaten)
- Pyridostigmine (Mestinon)
⚠️ These can have side effects and may interact with some MS treatments, so it's important your care team coordinates carefully. Treating MS Itself
Staying on an effective disease-modifying therapy (DMT) and avoiding relapses may be the best long-term approach. Reducing MS disease activity can help limit autonomic nervous system disruptions that contribute to orthostatic hypotension.
⚠️ Also worth noting — some MS medications like fingolimod (Gilenya) and ozanimod (Zeposia) can themselves affect blood pressure, so always flag any new dizziness to your doctor promptly.
August 11
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