The test for postural hypotension is considered a simple home method for assessing the body’s reaction to a change in body position.
It has long been used in clinical practice; however, it is often mistakenly associated with “adrenal fatigue.” Below is a description of the method, its mechanism of action, and the correct interpretation of the results.
Description of the test
Postural hypotension is a drop in blood pressure when transitioning from a lying position to a standing position.
Normally, the body should quickly compensate for the redistribution of blood through the work of blood vessels, the heart, and the autonomic nervous system. The test allows you to assess how effectively this compensation occurs.
How to perform the test
- Lie down for 10 minutes to allow the cardiovascular system to fully relax;
- Measure blood pressure while lying down;
- Stand up and immediately measure blood pressure again;
- Evaluate the difference between the results;
- If necessary, repeat the test on different days.
How to interpret the results
It is considered that normally blood pressure should increase by 5–20 mm Hg immediately after standing up. This is due to the active work of the autonomic nervous system, which constricts blood vessels and stabilizes blood flow.
In alternative literature, a drop in pressure of 10 mm Hg or more is interpreted as “adrenal weakness.” However, this interpretation lacks scientific support and does not reflect the real causes of postural hypotension.
Why the test is not related to adrenal fatigue
The drop in pressure upon standing is due to the work of blood vessels, the nervous system, and the volume of circulating blood. The adrenal glands are only indirectly involved through hormones that regulate sodium and vascular tone.
In practice, postural hypotension occurs much more often due to other factors than due to adrenal dysfunction.
Physiological causes of the phenomenon include the state of baroreceptors, fluid balance, electrolytes, the tone of the autonomic nervous system, and the overall condition of blood vessels. Therefore, the test cannot serve as a method for diagnosing hormonal insufficiency.
What the test actually shows
- level of hydration and salt balance;
- state of the autonomic nervous system;
- presence of hypovolemia;
- possible problems with vascular tone regulation;
- tendency to dizziness with sudden position changes;
- the body’s reaction in POTS or autonomic dysfunction.
When the results may be important
Decreased blood pressure upon standing may indicate dehydration, insufficient salt intake, low sodium levels, vitamin B1 or B12 deficiency, anemia, the use of certain medications, autonomic nervous system disorders, or a sudden decrease in circulating blood volume.
In rare cases, persistent postural hypotension occurs with actual adrenal diseases, such as Addison’s disease, but such conditions require laboratory diagnosis.
