LOW blood pressure (not orthostatic)

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I got diagnosed with nuerocardiogenic syncope last year (after lots of other tests). You might want to see if your dr can order a tilt-test to be conclusive, this is usually the deciding factor. I'm treating mainly with lots of salt. It is a lot easier to eat salt tablets than a lot of salty food (I started with salty food but cut it out mainly because a lot of salty food tends to have high fat as well). A couple of things to note:

I was not limiting salt in any way before, the condition wasn't a lack of salt this is just a way to correct it.
The salt only works if you also have a fair amount of fluids (mainly water in my case). If you drink a lot of water without the salt you may not retain it and in fact may make matters worse by flushing existing salts out of your system. Prior to my diagnosis, I was always thirsty and drinking a lot but it didn't help me, I was actually still very dehydrated it just went right through. On the salt I became less thirsty, funnily enough.
I also increased caffeine (moderately) to help blood pressure. This isn't for everybody but is recommended by some.
I also take licorice when needed. Again, not for everybody, in some people this increases the heart rate unsafely. This wasn't dr recommended just my own choice.
Increasing my salt (by way more than anyone could consume in diet) did NOT raise my resting blood pressure (which has always tested in the low normal range). But it did help my neurocardiognic syncope symptoms. Treating with salt can be more problematic if you also have high blood pressure (some people with NCS do), in some people this raises their resting blood pressure more.
Rule out heart conditions first (I had a bunch of tests done to determine nothing was actually wrong with my heart, just apparently in the communication between heart and brain in terms of regulating blood pressure, mainly when changing position or when I have remained standing in one place for a few minutes).
There are numerous factors which can trigger the blood pressure drops to a dangerous extent in people with NCS, including but not limited to: excessive heat/sun, exercise, large meals, certain foods, stress,immobility/bed rest, deyhydration (big one), menstruation, drawing blood, coughing or clenching muscles, etc.
Treating NCS for me also helped related problems including migraines, visual auras/disturbances, fatigue, etc. There's a wide range of negative effects cause by low blood pressure or NCS.

Nuerocardiogenic syncope is also related to (or in the cases of some of these, equivelant to) a whole host of related conditions: Neurally mediated hypotension, orthostatic hypotension, POTS (postural tachycardia syndrome), vasovagal syncope, autonomic dysfunction, if you check these out online there are other tips and symptoms mentioned that may help diagnose, but I think it's important to rule out other more serious conditions as well like physical heart problems.

wow, just wow. thank you so much, grendel! i have so much to take away from this advice. thank you thank you thank you.

i have one question - can this problem cause blood pooling in the legs? it is one of my biggest issues right now. sometimes after a shift at work my legs ache very badly and i have to lie down elevate them above my head. it also makes me crazy-tired. but when i tried to research it, the problem seems to be caused by HIGH blood pressure. so i am confused. i have had the leg problem since i was a teenager, but it improved for the period when my blood pressure was elevated. now that it is low, the problem is back.

Yes, definitely causes pooling. The way I understand it (in my favorite way by making analogies), the blood is like a finite amount in the body. Imagine your body is like a sack of rice that is not all the way full. When it is sitting down it more or less looks full. when you pick the bag up by the top all the rice condenses into the bottom and the top feels empty. This is when there is little or no blood getting up to the brain. This is about where the analogy runs out but I like the imagery . Adding salt basically causes you to retain water which increases the overall blood volume, so there is more rice in the bag (or swelled up rice if you prefer) and then when you pick it up, it does go to the bottom but there's still more up in the top (blood reaching the brain).

Under normal circumstances the brain is constantly sending signals to the heart to make adjustments so that the blood keeps circulating where it is supposed to when you do things like stand up, bend over, run fast, etc. For example even normal people may occasionally experience an occasional "head rush" when standing abruptly or faint in extreme heat conditions when they are dehydrated. In people with NCS there is a miscommunication in this signal, which varies depending on what type of the condition (for instance in some people it also causes their heart to race - tachycardia) you have so this is happening over and over again all the time. Watching the numbers during my tilt test were very illuminating in this respect for me. My blood pressure was "low normal" at first. I was raised up (slowly, it's not like a tilt-a-whirl) and my heart rate shot up (properly, to increase blood pressure, according to the helpful assistant who talked me through the whole procedure). But then, my blood pressure plunged. Then, it went up again as my brain/heart attempted to stabilize things. But then as I remained in that position, instead of remaining steady, it plunged again. And again. And again. My brain is constantly trying to adjust equilibrium but not doing it very well. It's like a person with a manual scale and every time they try to balance the bar they send the little balance weight too far one way or another. During the test my blood pressure dropped so low I was easily diagnosed even though I did not pass out during the test. I can only imagine how low it must have dropped during times where I collapsed. But the symptoms were very familiar to me. As my body attempted to maintain normal blood pressure, I felt my blood circulating and pooling. Sometimes my feet went to sleep. My whole body would be washed over with cold and then hot sensations. I would become soaked with sweat. My brain felt like it was going into sleep mode. I felt lightheaded. All things which I commonly experienced all the time without realizing they were connected to my blood pressure trying to regulate until I saw it correlating on the screen.

The cumulative effect of this happening all the time, even when it's not always to the point of feeling "dizzy" or seeing spots or other visual disturbances, or losing your balance or blacking out, is extreme fatigue, "mental fog", nausea, abrupt exhaustion, difficulty regulating temperatures, etc.

Blood pooling in extremities exacerbates the problem because there is less of it getting up to your brain (the old rice in the sack). According to my dr's this is even worse if you are tall (I'm 5'9, so not excessive but apparently tall enough for it to be more of a problem). Many people with NCS wear extra-strong support stockings for this. I have heard mixed results on how much the compression stockings actually help with the blood flow. There are also abdominal bindings with the same idea. If you have to stand for work, you might also have success flexing the leg muscles, raising and lowering on the toes, etc can help keep circulation going (I do this if I have to stand for a period of time and start to feel lightheaded, now that I know what it means). If you can avoid standing for periods of time it may help, or crossing the legs when sitting (this tends to make my feet go numb after a while but it keeps the blood up where I need it more I guess).

From what I read (and I have tried to do a lot of research since getting diagnosed in November) the symptoms of very high blood pressure can sometimes be similar to NCS symptoms, but BP monitoring and tilt test can make that clear, also the things that tend to be recommended for people with high BP tend to be the same things that make those with NCS feel worse. Imagine the bag is overstuffed with rice for instance. You could still have problems in the legs, maybe even more so, you'd just also have blood flow to the brain. ). Some people with NCS also have high blood pressure at the same time, which I imagine would be very challenging to treat. It can be very hard to find solutions for LOW blood pressure online because the US take in general recently seems to be the lower the better... not true in my case hehe . However it's also well known that despite the general recommendations to "lower sodium" to the population at large, doctors generally do accept that increasing salt does not raise blood pressure for everybody even those with high blood pressure conditions, and it is not determined exactly why it seems to be linked to hypertension in some and not others. I was at first concerned about piling on as much salt at they told me to eat, however they assured me with my healthy heart and general healthy profile this was unlikely to be a problem. Sure enough it has not made my resting blood pressure high, it remains low (sometimes troublingly so) but definitely amazingly helps the symptoms. Finding out about this condition has been like a miracle for me in terms of day-to-day life.

^ In addition to the brain not getting enough blood, the same goes for the heart, which may relate to the fatigue. And also the same for the muscles in the shoulders and back which can cause "coat hanger pain."

I had very low blood pressure until I started a high-sodium diet, sodium pills, caffeine, and licorice. I used to have a bp of around 70/30, occasionally lower. I used to "grey out" all the time and was incredibly tired. I still have a low bp of around 100/60, but it feels much better now. I've had heart problems in the past and still take a beta blocker to help control heart rate, but I take a very low dose. I use pink Himalayan salt on my foods, and try to get about 200 mg of caffeine each day. I eat licorice candies from the health food store, but you have to be careful about licorice if you have low potassium. I also used to get sore legs that I had to elevate, still do sometimes but not as bad. I hope you and your doctor get this sorted out soon!

For a while my BP was so low my Dr. could almost not find it. I went to the cardiologist. Had all kinds of tests. Nothing really bad, just a minor arrhythmia. What helped me the best was Gatorade. Something about the mix of electrolytes in that stuff helped balance me out. I'd drink one med. sized bottle throughout the day. The cardiologist never did pinpoint the reason for the really low BP.

thanks for the advice and stories, everyone! for this last week or so my bp has been back to normal. i haven't a clue what has changed