Most people associate Parkinson’s disease (PD) with its motor symptoms: tremor, imbalance, muscle stiffness, and more. Yet experts warn that there’s a wide range of non-motor symptoms associated with the condition, and they tend to go overlooked—especially when they’re not outwardly visible to the naked eye. “Lack of awareness around certain symptoms can delay diagnosis. For people with Parkinson’s, it can sometimes be difficult to tell when symptoms are a part of Parkinson’s disease or from something else,” writes the Michael J. Fox Foundation, an organization working to raise awareness about these lesser-recognized signs of PD.
Their experts say that among their top 10 most overlooked symptoms is one that may take effect when you change positions—most frequently when you go from sitting to standing. Read on to find out which non-motor symptom may occur at that moment, and what you can do to mitigate its effects.
One lesser-known symptom of PD and its medications is orthostatic hypotension (OH), says the Michael J. Fox Foundation. This is characterized by a sudden drop in blood pressure while changing positions, usually when you go from laying down or sitting to standing.
In some patients, OH can cause lightheadedness and dizziness, leading to “passing out, fatigue, or nausea.” In extreme cases, patients experience gait instability and are more prone to falling accidents, writes Rachel Dolhun, MD, a movement disorder specialist who works in medical communications at the Michael J. Fox Foundation.
A 2015 study published in the medical journal Movement Disorders, which analyzed a cohort of 210 individuals with Parkinson’s, found that half of PD patients met the criteria for a diagnosis of orthostatic hypotension. Roughly one third of that group reported experiencing symptoms—the rest were diagnosed based solely on biomedical markers of the condition.
The study also found that the prevalence of OH increased with age and length of time living with Parkinson’s. Older individuals also saw more dramatic drops in blood pressure than younger people with OH.
Because high blood pressure comes with its own set of health risks, doctors may be hesitant to treat low blood pressure with medication unless it causes notable symptoms. Besides medication, your health care provider may suggest dietary changes, compression devices, or behavior modification. The latter may include avoiding rapid changes in position, drinking more water especially before standing up, sleeping propped up by pillows, or engaging in more exercise.
However, some studies have concluded that if your blood pressure drops low enough when you stand, you may be a good candidate for medication. “People with an average standing blood pressure under 75 mmHg may benefit from medications to treat their OH,” says the Parkinson’s Foundation. “These people are the ones who are most likely to experience the negative symptoms of OH, like dizziness, and may warrant treatment with drugs to raise blood pressure,” their experts add.
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Though OH has been found to affect roughly half of PD patients, there are several other underlying causes that could be to blame for the condition.
Experts say that besides Parkinson’s disease, you may experience sudden drop in blood pressure resulting from dehydration, anemia, or as a side effect of a range of medications. These may include diuretics, antidepressants, hypertension medicine, and more.
If you notice sudden lightheadedness, dizziness, or other signs of blood pressure drop when you change positions, talk to your doctor about the full range of possible causes.