Fainting spells from standing up too quickly

The below following was read from TrainerRoad forum.
I am facing similar condition. Anyone in SUF is facing the same condition.
Or is there anyone will like to share what is going on from medical point of view and perhaps how to alleviate the condition.

I am figuring that too much leg work has been going on this year. Maybe I should train up my upper body. Will this alleviate the condition?

**** from TrainerRoad ****
Hi all,

Before I begin I’ll state that I’m seeking professional medical advice from my doctor, but I still would appreciate opinions from fellow cyclists who’ve experienced similar issues.

Personal details:

40 year old male
I have a pretty stressful job and several young children, I would categorize family life as very stressful
Started cycling May 2018 with bike commuting, started regular training regimen with TR in May of 2019
May 2018 I weighed 240 lbs, I have since dropped that to 209 lbs as of today, about 1/3 that weight was lost in the last two months.
Resting HR between 45-60 bpm, depending on whether I exercised that day or not. My resting HR has been steadily dropping the more I’ve been cycling.
5-6 hours/week on the bike
6-7 hours sleep with a couple wakes a night.
Issues:
Last week I experienced a near fainting episode while singing with my kids, shortly after I gathered myself I developed a minor headache that went away with Tylenol but felt tired for the rest of the day. Since then, I’ve been having issues with dizziness when standing up from lying down.

Contributing factors?

The near-fainting episode happened at the end of a pretty hard cycling week. I did 3 difficult outdoor rides. 1 was a ride up a local mountain where I shaved 14% off my best time (thanks to TR!) and another was my first group ride over 50 miles, I would categorize it as a fast ride at 19.9 mph average with about 1,600 feet of climbing (again, thanks to TR!).
I am strength training twice a week along with my cycling program.
Thoughts?

Could I be overtrained? I’m only on the low volume short-power build plan which, while extremely hard per workout, only equates to 300-350 TSS per week.
When I consulted Dr. Google it appears a lot of endurance athletes suffer from orthostatic hypotension, though I haven’t had the time to read through the studies to find out exactly why. But again, who is an endurance athlete? A 40-year old guy who rides 3 times a week or a 20-year old collegiate athlete?
If you’ve had similar issues with dizziness please let me know your thoughts. Again, I’m seeking medical advice and I hope to get this issue resolved, but I’d like to know the thoughts of other cyclists who have experienced these issues.

Thank you in advance!

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Appears to me like RED-S which is a condition not so commonly known among recreational endurance athletes like most of us. There’s a current, well written and informative Runners’s World article about this


If you want to dig deeper, I suggest you have a look at some of the scientific publications like the consensus statement that covers the issue in its full complexity
https://bjsm.bmj.com/content/52/11/687
or some a bit more - erm - digestible stuff like a cyclist’s patient voice
https://bjsm.bmj.com/content/54/21/1303
I do however suggest you go see your doctor just to make sure there’s no other underlying condition and when you get the all clear perhaps check with a nutritionist for additional advice.
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Thanks fir the comment about getting medical advice as that of course is actually the only way to go here.

——

From another guy who was once 40, and once would get dizzy spells … who never went to the doctor …
I was simply losing too much weight while exercising more … and had got in to a hugely successful place from a fat loss (as a percentage) point of view, and also from a running capability point of view.
But I was going too fast. So on days when I was eating less, I’d simply be dropping my blood pressure and standing up would make be dizzy (was my own analysis which may be nonsense)
I needed to eat more.
It all went away when the weight loss stopped. I can recreate it at will by not eating enough over a period and will get the same standby-uppy dizzy thing.
I remind myself I’ve not eaten enough, but generally I don’t let it happen now.

That may or may not be you (I note quite a significant loss of weight for you while upping exercise levels which sounded similar)

I’ll leave the doc to let you know whether you’re in need of anything else though …

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…which is exactly one of the typical symptoms of RED-S. Relative Energy Deficiency in Sports (sorry I didn’t mention the full term in my initial post)

Take care of yourselves, eat well, sleep sufficiently, hope you’re back to proper suffering (the Sufferlandrian way) soon :+1:

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Hello !
Take it easy man for a while … your total load (sport, family, work, …) is too stressfull
Ways to boost your own energy:

  • Sleep more > 7hrs
  • Rest when you are tired (it sounds obvious but listen to your body)
  • Cardiac coherence and/or guided meditation
  • SUF Plans “Ramp Down” and “Ramp Up”
    Good Luck
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I also experience short dizzy spells occasionally when I stand up from seated. Sometimes it can be a few times in a day, and then at other times I’ll go for a few weeks without it happening. I feel fine afterwards though. I’ve put it down to relatively low (low end of normal) blood pressure, and relatively low resting heart rate.

It’s interesting to see that there can be some correlation with food intake and weight loss. I’ll keep that in mind as I try to better understand what triggers these dizzy spells for me.

And +1 on checking in with your doctor to make sure it’s not a symptom of something else that you need to address.

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Interesting to read this thread as I’ve also experienced the dizzy spell thing when standing up quickly. Usually happens on a Sunday afternoon following a 60-70ish mile club ride. Up until recently, it was just 3-5 secs of wobbly-ness and then I was fine. A few weeks back, it happened on a Friday morning after getting up from doing Yoga with Abi. This time though it ended with a thump as I fainted and hit my head on the skirting board. Fortunately it was just a bit of blood and a lump on my head for a week. Checked my blood pressure and it was a bit on the low side.

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I have occasional postural hypotension, ie if I’ve been quite still for a while and get up, about 60-90 secs later I start getting tunnel vision and may faint.
Doesn’t happen all the time but when I start increasing training it happens more often.
Will read up on RED-S, thanks for the links

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Could simply be dehydration. Less water in your system reduces blood volume.

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I’ve had something like this for many years. If I stand up quickly sometimes my eyesight goes funny and I feel a bit dizzy for a few seconds. But it always clears quickly (no more than 5 seconds) and I’ve never actually fainted from it or had a headache afterwards. I’ve never really given it a second thought, but I certainly would if it was something that had never happened to me previously. My blood pressure has always been in the normal range.

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I am not a doctor, nor do I play one on TV.

Sometimes, if somebody in good physical shape sits down for a long time, their blood pressure can get low enough that you can feel faint for a few seconds when you get up, and then it clears.

The only reason I mention this is that while it may take some time for the physician of the OP to find out what is going on, there are plenty of non chronic reasons (as some of the other posters have mentioned) that could cause those symptoms.

I’m not a doctor, I also suffer from this, and think it’s just a symptom of being fit.

Over the years of training I have gone from a resting HR of about 70 with 130/80 pressure to about 48-50, 110/70.

I get this head lightedness fairly frequently when standing up. It’s not common when I wake up, but more common in the evenings. That could point to hydration, blood sugar or exhaustion.

I did have my blood work done and let my doctor know about this, they said the blood work was good, and that the light headed ness is common for cardio athletes, like runners and cyclists.

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Sounds exactly like my symptoms. I’ll be happy as long as it stays like that and doesn’t get worse or more frequent.

In a way, it’s good to hear that there are others out there who experience the same thing.

Hey,
I would say immediately lower the intensity of your workouts and reduce the volume also until you have consulted your GP. As a coach, here is some anatomical info you may find useful.

It looks like you have a healthy HR at 45-60bpm but it is also worth knowing what your blood pressure is. The heart pumps oxygenated blood from the heart around the body and also clears away deoxygenated blood back to the heart and lungs. A low HR does suggest a healthy and efficient one but by looking at your blood pressure you can determine a little more about the ‘efficiency’ of your heart. A ‘normal’ BP reading is 130/80 (first number representing pressure exerted on artery walls during heart contraction and second during relaxation so lower).

After a workout especially, your heart like your other muscles will have been working harder than usual and stopping to sit down after a workout can cause blood flow to slow down and pool. So when you get up suddenly it takes some time for the body to keep up and thats when you feel that drained and faint feeling. (this also occurs for people with low blood pressure)

As a recommendation I would say make sure you spend longer on your cool downs post workout (5mins after a video has ended) and just pedal slowly while your HR comes back and steadies at your familiar level.
Remember I am no GP, this is just some anatomical advice from a coach. I hope your consultation goes well and you get over these spells.

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Take electrolyte/sodium intake (salt tablet, etc) 1/4, 1/2 and 3/4 of the ride especially during longer rides. The loss of sodium can drastically lower blood pressure.

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gotta be a bit careful with this, it’s not supported by scientific evidence.

There are a number of online sport articles which highlight the loss of sodium. A number of earlier comments pointed the symptom to the result of dehydration.

You can read it up. Here is one:

I’m talking about scientific evidence, not marketing or endorsements :wink: