For people suffering from Orthostatic Intolerance, Postural Orthostatic Tachycardia, Mast Cell Activtation or EDS. Follow me as I document my struggle towards better health.

Blood Volume

There are several ways that have been proven to increase blood volume which do not require medications.  They are:
  1. Drinking more fluids
  2. Eating more salt
  3. Doing exercises (in accordance with Dr. Levine's protocol)
  4. Elevating the top of your body when you sleep (using a bed wedge) See new information on this below...
As someone who has experienced symptoms of Orthostatic Intolerance for over 25 years I have come to understand that medications should not be used by me as a quick-fix for OI symptoms.  Many medications have side-effects which may complicate the condition which, as we all know,is not particularly well understood.  My preference is to seek solutions which do not include medications.  But that is my personal choice and I don't hold fault with anyone who decides to take drugs like  florinef and amadine or midodrine to help alleviate some of the life-altering symptoms that accompany the condition.  I do, however, encourage people to at least investigate alternatives to drugs because we might find that the alternatives offer the best chance for a healthier life with OI.   

On Blood Volume
I found an interesting article on blood volume which states
Microgravity decreases PV (plasma volume) and EV (erythrocyte volume) which contribute to orthostatic intolerance and decreased exercise capacity in astronauts. PV decreases may result from lower set points for total body water and central venous pressure, while EV decreases may result from increased erythrocyte destruction. Trauma, renal disease, and chronic diseases cause anemia from hemorrhage and immune activation which suppresses erythropoiesis. The re-establishment of EV is associated with healing, improved life quality, and exercise capabilities for these injured/sick persons.
It goes on to say:
Erythrocyte volume expansion usually occurs slowly over many weeks to months, whereas plasma volume expansion can occur rapidly over several hours to days.
I have been consuming an extra 8,000mg of salt and 3 litres of water daily for a week now.  Even though I have experienced an immediate increase in "plasma volume" hence my weight gain, to get true benefit from my efforts at increasing total blood volume, including erythrocyte volume, I guess it will take weeks to months of:
  1. Drinking more fluids
  2. Eating more salt
  3. Doing exercises (in accordance with Dr. Levine's protocol)
  4. Using a bed wedge... 
Elevating Head During Sleep helps Orthostatic Intolerance

Does it really? I wanted to know because I BOUGHT a bed wedge and have been torturing myself with it for the last 6 nights. You'll see the girl in the picture on the right looking blissfully asleep on the foam triangle. Hah! The reality is that the foam is a like a concrete slab. I can't imagine she would be comfortable using the wedge without a pillow unless her last bed was a bed of nails.

So why does sleeping on a bed wedge help Orthostatic Intolerance? To answer that question I had to hunt around using Google looking for research studies on the topic. I found one recent paper published in 2008 entitled:
Physiological effects of sleeping with the head of the bed elevated... 

I suggest you read the paper if you are considering using a wedge to treat OI symptoms. If you have read or heard any other studies regarding elevating the head during sleep and its effects on O,I I would be very grateful to hear about them.

Dr. Levine recently wrote me to say:


"It is not very helpful to just elevate your head on a wedge. In order to be most useful at expanding the plasma volume, you need to sleep with your WHOLE BODY on an angle. "
After reading this I now have a railroad of pillows on my bed running up the bed wedge so that my entire body is slanted. Dr. Levine went onto suggest that one could elevate the head of the bed by 4-6" but since that would not be met with great enthusiasm in our home, I elected to do the railroad thing.