Why You Feel Dizzy Every Time You Stand Up — The BP Medication Nobody Warned You

Added: 2026-05-14

[00:00:00]The dizziness you feel when you stand up is not from getting old. It is not from low blood sugar. It is not from skipping breakfast. It is from a pill on your kitchen counter. A pill your doctor handed you. A pill your doctor never warned you about. Every time you stand up and the room tilts, the inside of your brain is running out of oxygen for 3 seconds. That is not aging. That is the pill. Look at your hallway. It feels longer than it used to. Look at your couch. You wait a second before you stand up. Look at the door frame at night. You hold it. You did not used to hold it. You told nobody. You told yourself it was your age. It is not your age. It is a pill. The last fall you had was not clumsy feet. The trip on the rug, the stumble in the hallway, the grip you took on the kitchen counter last Tuesday. None of that was bad balance. That was your blood pressure crashing the moment you stood. Crashing because of a pill. A pill your doctor has never tested for this. A pill your doctor wrote 18 months ago without warning you.

[00:01:07]Before I show you which pill, look at where this video takes you. Look at your own morning 90 days from now. You wake up. You sit on the edge of the bed for 1 second out of habit. You stand. The room does not move. You walk to the bathroom.

[00:01:23]You do not hold the wall. You bend down for the newspaper. You stand back up. No gray, no tilt, no fuzz. Your wife notices on day three. She says, "You look steadier." Your doctor notices at the next visit. She takes you off one pill. Six months later, you are mowing the lawn again. You step out of the truck at the hardware store. You walk in. No waiting, no dizziness, no fear.

[00:01:49]That is where this video takes you. One pill identified. One conversation with your doctor. Three small changes. Done.

[00:01:58]There are three types of seniors watching this video right now. By the end of this video, you will know which type you are. The first type keeps the pill on the counter. They keep the dizziness. In 2 years, they fall in the bathroom. They crack a hip. One in four are not alive 12 months later.

[00:02:16]That is not a scare tactic. That is the federal data.

[00:02:20]The second type is you.

[00:02:23]You feel the dizziness now. The hallway, the bathroom at night, the hardware store. You have caught the wall. You have sat back down on the bed. You are starting to wonder if your driving days are numbered.

[00:02:36]Every near fall feels like the one that ends your independence.

[00:02:40]The third type does what you will learn in this video. They identify the pill.

[00:02:46]They have the right conversation with their doctor. They make the three small changes. Their dizziness ends in two to six weeks. Their fall risk drops 60%.

[00:02:56]They get their life back.

[00:02:58]By the end of this video, you will know what is happening inside your body every time you stand.

[00:03:04]You will know the pill class that does the most damage. You will know the test your doctor is not doing on you.

[00:03:11]You will know how to ask for it. You will know the four physical fixes that protect you while the pill is being adjusted. You will know the script you take to your doctor, word for word. This is not theory. This is not aging. This is a pill, and a pill can be changed.

[00:03:29]Look at what is happening inside your body right now while you sit watching this video.

[00:03:34]Right now, between 500 and 800 ml of your blood is sitting in your leg veins.

[00:03:40]That is almost two cups of blood, pooled, not moving, held in place by your veins.

[00:03:47]Now, stand up.

[00:03:49]The moment you stand, gravity pulls that blood downward. Within 1 second, the blood returning to your heart drops by 40%.

[00:03:58]Your heart has 40% less blood to pump to your brain.

[00:04:02]If nothing fixed that, you would lose consciousness in 10 seconds every time you stand. Your body has a fix. It is called the pressure control center. It sits in the back of your brain.

[00:04:15]The pressure control center has a second job that almost no doctor explains. The standing job.

[00:04:21]Touch the side of your neck just under your jaw. Feel your pulse.

[00:04:26]There are tiny pressure sensors right there, less than half an inch under your skin.

[00:04:31]The moment you stand, the moment your blood pools in your legs, those sensors feel the drop. They fire a signal to your pressure control center in 15 milliseconds.

[00:04:43]The pressure control center hears the alarm. It sends two commands back out.

[00:04:48]First command, heart, beat faster.

[00:04:51]Second command, vessels, squeeze tighter. Within 30 seconds in a healthy adult, your pressure holds steady. Your brain gets its oxygen. You feel nothing.

[00:05:03]The whole rescue runs on one chemical messenger. I will call it the stress chemical.

[00:05:08]Your pressure control center dumps it into your blood the moment you stand.

[00:05:13]The stress chemical travels to tiny locks on the walls of your veins. I will call those locks the vessel locks.

[00:05:20]The stress chemical is the key. The key turns. The lock opens. The vessel squeezes. The blood gets pushed back up to your heart. Your pressure holds.

[00:05:30]Now imagine glue poured into every vessel lock. The key arrives. The key cannot turn. The vessels do not squeeze.

[00:05:39]The blood stays pooled in your legs.

[00:05:41]Your pressure does not hold. Your brain does not get its oxygen. The room moves.

[00:05:47]That exactly what one class of blood pressure pills does. They are the glue.

[00:05:52]The class is called alpha blockers.

[00:05:55]These six pills are the glue. Write the names down. Doxazosin, brand name Cardura.

[00:06:01]Terazosin, brand name Hytrin.

[00:06:04]Prazosin, brand name Minipress.

[00:06:07]Tamsulosin, brand name Flomax.

[00:06:10]Silodosin, brand name Rapaflo.

[00:06:13]Alfuzosin, brand name Uroxatral.

[00:06:16]If you are on any one of these six, the glue is in your blood right now.

[00:06:21]Right now, while you sit in your chair, the glue is sitting on every vessel lock in your legs.

[00:06:26]Your body has a stress chemical waiting to fire the moment you stand. The chemical will fire. The chemical will reach the locks. The locks will not turn. Your body knows what to do. Your body cannot do it. That is what is happening inside you right now.

[00:06:43]Tamsulosin is the worst trap of all six.

[00:06:46]Tamsulosin is rarely prescribed for blood pressure. Tamsulosin is prescribed for the prostate. Men get it from their urologist. The urologist says it helps with urinary flow.

[00:06:58]The urologist does not say it is the same chemical class as one of the most dangerous blood pressure pills in cardiology.

[00:07:05]The urologist does not say the same glue that relaxes the prostate also relaxes the veins in your legs.

[00:07:12]The urologist does not say the dizziness on standing is from the little capsule he just prescribed. He hands you the prescription. He tells you to come back in 3 months. You walk out of his office.

[00:07:25]The glue is already in your blood.

[00:07:28]Russell was 68 years old, a retired insurance adjuster from Greenville, South Carolina. A two handicap golfer.

[00:07:36]Walked 18 holes three times a week for 30 years. His urologist had prescribed tamsulosin 6-weeks earlier. 0.4 mg, one capsule a day for an enlarged prostate.

[00:07:49]Russell did not think twice. The capsule was small, the doctor was confident.

[00:07:54]Russell took it every morning with his coffee.

[00:07:57]On the third weekend, Russell was on the seventh hole at his club.

[00:08:01]He bent down to place his tee. He stood back up. The world tilted hard.

[00:08:06]He grabbed his cart. He waited. The tilt passed. His playing partner asked if he was all right.

[00:08:12]Russell said he was just dehydrated. He was not dehydrated. His standing blood pressure had just dropped 25 points.

[00:08:20]The tamsulosin had glued shut every vessel lock in his legs. His brain had run out of oxygen for 3 seconds. He almost fell on the seventh green.

[00:08:30]Russell came to me 3 weeks later. The dizziness was getting worse.

[00:08:34]He was getting it standing up from the dinner table. He thought he was dying.

[00:08:39]His seated blood pressure in my office was 120 over 75. Perfect numbers. His doctor had told him everything was fine.

[00:08:47]Russell sat across from me. He said, "Doctor, I do not understand. If my blood pressure is so perfect, why does the world go gray every time I stand up?"

[00:08:58]I had Russell lie down. I took his pressure flat, 118 over 73.

[00:09:04]I had him stand up. I took his pressure at 1 minute, 88 over 54. A 30-point drop.

[00:09:12]The number on his cuff while he sat was a lie. The number on his cuff while he stood was the truth.

[00:09:18]Every time Russell stood, his pressure was crashing to a level where his brain was running out of oxygen.

[00:09:25]The problem was not Russell's heart. The problem was the capsule his urologist had handed him without one warning. One of those six alpha blockers is even worse than tamsulosin, doxazosin, the Cardura pill.

[00:09:40]Prescribed for blood pressure directly, often as the third or fourth pill when nothing else is working. In the year 2000, a massive clinical trial called ALLHAT was comparing four blood pressure pills head-to-head.

[00:09:53]The doxazosin arm got terminated early.

[00:09:56]Patients on doxazosin had a 25% higher risk of cardiovascular events than patients on a cheap water pill.

[00:10:04]The risk of heart failure was doubled.

[00:10:07]The safety board pulled the plug on doxazosin. They could not justify keeping patients on it.

[00:10:13]25 years ago.

[00:10:15]And doxazosin is still being prescribed to seniors every day in America.

[00:10:21]If you are on doxazosin, terazosin, prazosin, tamsulosin, silodosin, or alfuzosin, this video is for you.

[00:10:31]The single most important thing you can do tomorrow is have the conversation. I will give you the words.

[00:10:37]Before we get to the conversation, look at what those 3 seconds of oxygen loss are doing to your brain.

[00:10:44]Because most seniors think the dizziness on standing is just a moment. Just a brief tilt. Just a quick fuzz. The moment passes. The day continues. That is not what is happening inside your head. Your brain uses 20% of your body's oxygen. 20% for one organ.

[00:11:04]The brain has almost no backup. Other organs can survive minutes without oxygen. Your brain cannot.

[00:11:11]The brain starts losing function at 3 seconds of oxygen drop. At 8 seconds, you lose consciousness. At 30 seconds, brain cells start to die.

[00:11:22]Every time you stand up and the room tilts, your brain is sitting somewhere in that danger window.

[00:11:28]Most of the time, the loss is brief. You catch yourself. The blood comes back, the brain restarts.

[00:11:34]But, here is what the research shows.

[00:11:36]Repeated brief oxygen losses to the brain over years add up.

[00:11:41]Each tilt is a tiny silent injury.

[00:11:44]The injuries do not show up on any test your doctor runs.

[00:11:48]The injuries do show up in three other places: memory, word finding, balance.

[00:11:54]The slow drift that you have been blaming on getting old.

[00:11:58]The drift is not just age. The drift is partly the dozens of tiny oxygen losses your brain has taken every time you stood up. Hundreds of them over 5 years.

[00:12:08]All stacked up. Each one a small bruise.

[00:12:12]Each one too small to notice in the moment. All of them adding up inside the white matter of your brain.

[00:12:18]The same is true for your kidneys. Your kidneys filter every drop of your blood every 5 minutes. When your pressure crashes on standing, your kidneys get less blood. The filters take a hit. Not enough to show up on one blood test.

[00:12:33]Enough to show up over years as creatinine slowly climbing. The number your doctor watches. The number that means your kidneys are dying.

[00:12:42]Half of that decline is the age. The other half is the drug-induced standing crashes nobody connected to the kidneys.

[00:12:49]And the same is true for your heart. The coronary arteries that feed your heart muscle do their work between heartbeats.

[00:12:56]The filling happens when your pressure is at its lowest. When your pressure crashes on standing, the coronary filling crashes with it. For a few seconds, your heart muscle is running on fumes. Healthy young hearts handle this.

[00:13:10]Older hearts with even a little plaque do not handle it as well.

[00:13:14]A standing pressure crash in a senior with mild coronary disease is one of the most under-recognized triggers of a silent heart event. That is what the pill is doing to you. Not just dizziness. brain, kidney, and heart damage every standing for years.

[00:13:33]The pill is not just inconvenient. The pill is taking small bites out of your three most important organs every time you stand up.

[00:13:42]This is reversible the moment the pill is adjusted. The damage stops the day the pill comes off. Your brain stops taking bruises. Your kidneys stop taking hits. Your heart stops running on fumes.

[00:13:56]The repair work begins on the same day.

[00:13:59]That is what makes this conversation with your doctor so urgent. Not in a month, this week.

[00:14:06]There is one more piece you need to understand, the time of day when this is worst.

[00:14:11]Because your falls are not random. Your falls cluster at specific times. Once you know the times, you can protect yourself.

[00:14:19]The worst time is between 5:00 and 10:00 in the morning.

[00:14:23]There is a name for this in cardiology, the morning surge.

[00:14:27]While you sleep, your pressure is at its lowest of the day. At about 4:00 in the morning, your body starts releasing a wake-up hormone. The hormone is called cortisol.

[00:14:37]The cortisol pulls your pressure up to get you ready for the day.

[00:14:41]By the time you wake up, your pressure has climbed 20 or 30 points from its overnight low.

[00:14:47]Your pressure is also at its most unstable. It is changing fast.

[00:14:52]The pressure control center is working hard to keep up. Add an alpha blocker on top of that climbing pressure.

[00:14:59]Add a body that is dehydrated from a night of urinating fluid out.

[00:15:03]The moment you stand up at 6:00 in the morning is the most dangerous moment of your entire day.

[00:15:09]The morning surge is when most heart attacks happen. The morning surge is when most strokes happen. The morning surge is when most senior falls happen.

[00:15:18]The pill makes it worse.

[00:15:20]The second worst time is right after a meal, especially a large meal, especially a meal with carbohydrates.

[00:15:28]After you eat, blood rushes to your digestive system. That blood was supposed to be in your central circulation. Now it is busy digesting your food. Your standing pressure for the next hour after a meal is lower than it was before the meal. There is a name for this, too. Post-meal blood pressure drop. It hits 25 to 30% of seniors over 65.

[00:15:52]Add an alpha blocker to a post-meal drop, the stand up from the dinner table at 6:00 in the evening becomes the second most dangerous moment of your day. Stay seated for 30 minutes after a heavy meal. Drink that 16 oz of water 15 minutes before you stand.

[00:16:09]These two changes alone cut your post-meal fall risk in half. The third danger window is the middle of the night, 2:00 in the morning, 3:00 in the morning.

[00:16:20]The bathroom trip you take in the dark.

[00:16:23]Your blood volume is at its lowest of the entire 24 hours.

[00:16:28]You have been lying flat for hours.

[00:16:30]The pressure control center has gotten quiet.

[00:16:34]You sit up. You swing your legs over the edge of the bed. You stand.

[00:16:39]The blood pools. The vessels do not squeeze fast enough. You take two steps and you are on the floor.

[00:16:47]Three windows, morning surge, after meals, middle of the night.

[00:16:53]If you are on an alpha blocker, these three windows are when your brain is most vulnerable.

[00:16:59]Now you know.

[00:17:00]Now you can protect yourself. The alpha blocker is the most urgent conversation you can have with your doctor this week.

[00:17:07]Not next month, this week.

[00:17:09]Alpha blockers are the worst class for this, but four other pill classes can do the same thing in different ways. You need to know them.

[00:17:18]So, you know which question to ask your doctor. Here they are, short and clear.

[00:17:23]Diuretics drain your blood volume. Less blood means less to push when you stand.

[00:17:29]The names are furosemide, Lasix, hydrochlorothiazide, bumetanide, Bumex, torsemide, chlorthalidone, and spironolactone, Aldactone.

[00:17:43]If you are on a water pill, ask your doctor about moving the dose to evening.

[00:17:49]Morning dosing means you stand up dehydrated. Evening dosing protects the morning standing pressure.

[00:17:56]Beta blockers block your heart from speeding up when you stand.

[00:18:00]The names are metoprolol, Lopressor or Toprol, atenolol, Tenormin, carvedilol, Coreg, propranolol, Inderal, and bisoprolol, Zebeta.

[00:18:16]Carvedilol is the worst of these.

[00:18:18]Carvedilol also blocks the vessel locks like an alpha blocker. So, carvedilol gives you the double hit.

[00:18:26]Calcium channel blockers hold your arteries wide open. Blood pools more easily in your legs.

[00:18:33]The names are amlodipine, Norvasc, nifedipine, Procardia, felodipine, and nicardipine.

[00:18:42]Brain acting pills are the fifth class.

[00:18:45]Clonidine, methyldopa, and guanfacine.

[00:18:49]Clonidine goes into your brain and turns off the entire standing defense. These are the most dangerous of all the classes for daily dizziness.

[00:18:58]Miss a dose of clonidine, your pressure can rebound to a crisis. There is no good day on clonidine for most seniors over 70.

[00:19:09]That is five classes total. Alpha blockers worst, diuretics, beta-blockers, calcium channel blockers, central agents.

[00:19:19]ACE inhibitors and ARBs are the safest.

[00:19:22]Lisinopril, enalapril, ramipril, losartan, valsartan, telmisartan.

[00:19:30]These do not directly cause dizziness on standing, but these take away one of your backup defenses. So, if you are on one of these alongside an alpha-blocker or diuretic, the cumulative effect is worse than either pill alone.

[00:19:45]The pills causing your dizziness on standing are not just blood pressure pills.

[00:19:49]Most cardiologists never mention this part. There are four other types of medication you are probably taking that do the same thing.

[00:19:58]The effects stack on top of the blood pressure pills.

[00:20:02]First, trazodone.

[00:20:04]Trazodone is given to millions of seniors as a non-habit-forming sleep aid. Trazodone is also a powerful alpha-blocker. It is the same glue as tamsulosin.

[00:20:14]The senior gets up at 2:00 in the morning to use the bathroom. The trazodone has glued shut every vessel lock in the legs. The blood pools. The senior faints between the bedroom and the bathroom. He hits the doorframe on the way down. Trazodone-induced falls are one of the most under-diagnosed causes of senior hip fractures in America.

[00:20:35]Second, the old antidepressants.

[00:20:37]Amitriptyline, nortriptyline.

[00:20:40]Still prescribed for diabetic nerve pain and for insomnia. These are also alpha-blockers as a side effect. The doctor prescribing them for your sleep does not know they are dropping your standing blood pressure.

[00:20:52]Third, sleep medications. Zolpidem, brand name Ambien.

[00:20:57]Diphenhydramine, which is in Benadryl and in Tylenol PM and Advil PM.

[00:21:02]These slow your brain's response to a pressure drop.

[00:21:06]Fourth, and this one is critical for men, erectile dysfunction medications, sildenafil, brand name Viagra, tadalafil, brand name Cialis, vardenafil, brand name Levitra. These are powerful vessel openers. Take a man on tamsulosin for his prostate, add Viagra for his sex life. He is stacking two strong vessel openers on top of each other. The combination can drop his standing pressure to levels that cause sudden death. If he is also on a nitrate like nitroglycerin for chest pain, the three together is absolutely forbidden.

[00:21:40]Every year, men die in hotel rooms from this combination. No doctor sat them down and said the three cannot be taken together. If you are taking any of these alongside a blood pressure pill, you are stacking the effect. This is the part nobody told you. Doris was 76 years old, a retired registered nurse from Fort Wayne, Indiana. She was on three pills.

[00:22:02]Furosemide, 40 mg for ankle swelling.

[00:22:06]Metoprolol, 50 mg for an irregular heart rhythm. Amitriptyline, 25 mg for nerve pain in her feet from diabetes. Three pills.

[00:22:16]All for different reasons. None of them prescribed by the same doctor.

[00:22:21]Her cardiologist looked at the metoprolol. Her primary care doctor looked at the furosemide.

[00:22:27]Her pain doctor looked at the amitriptyline.

[00:22:30]Not one of them looked at all three.

[00:22:33]Doris came to me because she had started feeling exhausted every time she stood up. Not dizzy, not faint, exhausted.

[00:22:42]Like all the strength had drained out of her legs in the moment of rising.

[00:22:47]Her daughter had to help her up off the couch. She had stopped driving. She had stopped going to her church group.

[00:22:54]Doris sat across from me. She said, "Doctor, I feel like I have aged 10 years in 3 months.

[00:23:02]My daughter wants me to move in with her.

[00:23:04]I am only 76 and I cannot stand up without help. What is happening to me?

[00:23:11]What was happening was this. The furosemide had shrunk her blood volume by 15%. The metoprolol was blocking her heart from speeding up when she stood.

[00:23:21]The amitriptyline, the nerve pain pill, was secretly acting as an alpha blocker, the same glue as doxazosin.

[00:23:29]Three pills, three different attacks, stacked on top of each other. Each one taking away one of her body's three defenses against standing.

[00:23:39]The blood volume gone, the heart rate blocked, the vessels glued.

[00:23:44]She was a walking time bomb. She did not need to move in with her daughter. She needed all three pills reviewed by one doctor at the same time.

[00:23:53]This is the reason I made this video. I am tired. I am tired of seeing seniors come into the emergency department with broken hips.

[00:24:02]A urologist had prescribed Flomax, not one conversation about blood pressure.

[00:24:08]I am tired of watching daughters move their mothers out of their own homes.

[00:24:12]The mother had fallen three times in a week. Everyone blamed her age. The real cause was a pile of pills nobody had reviewed.

[00:24:21]I am tired of the system. The system that gives a doctor 12 minutes per appointment. Six of those minutes are spent on documentation. That leaves zero time to ask the patient how she feels when she stands up.

[00:24:34]I am tired of the lies, the pill first dogma, the assumption that more pills must be better, the blindness to what those pills do the moment a patient leaves the office and tries to live a normal life.

[00:24:46]So, this channel exists to tell the truth. How your body actually works. The pathways, the names, the doses, the actual science. Not the dumbed-down version. Not the guidelines written by a committee paid by the company that makes the pill, the truth. I read every comment on these videos, every single one. The question I see most is this, how do I talk to you directly? How do I ask about my pills, my numbers, my body?

[00:25:14]A video cannot do that. A video talks to everyone. A video cannot talk to you.

[00:25:19]So, I built one more way to reach you.

[00:25:21]Every day I write an email, one email. I send it to a small group of seniors who wanted more than videos.

[00:25:28]In those emails, I go deeper. I answer questions. I respond to replies. When you write back to me, I write back to you. Not a team, not an assistant, me.

[00:25:40]Senior Health Life Daily, the first link below this video. It costs nothing. You give me your email. Tomorrow morning, you have a message from me in your inbox. Reply to it. I will see it. I will respond. 10 seconds today. Tomorrow we start talking. Now look at the test your doctor is not doing on you.

[00:26:01]Tomorrow morning, you can do this test on yourself. You need a home blood pressure cuff.

[00:26:06]Take your pressure lying down in bed.

[00:26:09]Stay flat for 5 minutes first. No pillow under your head.

[00:26:13]Take the reading. Write it down.

[00:26:16]Now stand up. Wait 1 minute. Take the reading again. Write it down.

[00:26:22]Wait until 3 minutes are up since you stood. Take it one more time. Write it down.

[00:26:29]If your top number dropped 20 points or more, you have your answer.

[00:26:33]The dizziness on standing has a name. It is real, and the pill is the suspect.

[00:26:40]Right now, while you sit watching this video, you can plan to do this tomorrow morning. The cuff is probably already on your kitchen counter. The notebook is in the drawer next to it.

[00:26:51]There is also a hidden version of this.

[00:26:53]In some seniors, the pressure does not drop in the first 3 minutes. The body fights it off for a while, then the defense system fatigues. The crash happens between 3 and 10 minutes of standing. This catches almost half of all seniors with this problem.

[00:27:10]A 2-minute office test misses it completely. So, if your 3-minute reading is fine, but you still feel dizzy 10 minutes after standing, take a fourth reading at 10 minutes. That is where your answer may be hiding.

[00:27:24]Now, look at the four physical fixes that work right now.

[00:27:27]While you wait for your doctor to adjust the pill, because the doctor's office may take a week to schedule, the pill adjustment may take 8 weeks to fully work, you need protection during the gap. These four fixes are the protection.

[00:27:42]The first fix is the water trick.

[00:27:44]15 minutes before you stand up from a meal, drink 16 oz of cold water.

[00:27:50]>> [snorts] >> 16 oz is a tall water glass full to the rim. Cold, not room temperature. Drink it within 5 minutes, quickly.

[00:28:00]Here is what happens next. The cold water hits a vein in your liver. Stretch sensors in that vein fire a signal up your spinal cord.

[00:28:08]The signal triggers a defense surge. The stress chemical pours out. Your blood pressure rises 20 to 30 points within 15 minutes.

[00:28:18]This was published in the journal Circulation, Shannon and colleagues, 2002.

[00:28:24]Drink the water 15 minutes before you stand from any meal.

[00:28:28]Drink it 15 minutes before you get up from a long sit.

[00:28:32]Drink it the moment you wake up, before you stand for the day.

[00:28:36]Do this tomorrow morning. Fill the glass tonight. Put it on your nightstand.

[00:28:42]The second fix is the leg cross and squeeze.

[00:28:45]The moment you feel the dizziness coming, or before standing from a chair, cross one leg tightly over the other.

[00:28:53]Squeeze your thigh and buttock muscles as hard as you can.

[00:28:56]Hold 10 to 15 seconds.

[00:28:59]The squeeze physically compresses the veins in your legs and pelvis.

[00:29:03]The squeeze pushes the pulled blood up to your heart by force. Blood flow to your brain rises 15 to 20% in seconds.

[00:29:12]The dizziness eases or never starts.

[00:29:16]This is also the move you do if a faint is coming in public.

[00:29:20]Cross, squeeze, hold.

[00:29:23]Sit if you can.

[00:29:25]The faint passes.

[00:29:27]Practice this tomorrow morning three times before you stand from a chair.

[00:29:32]Cross your legs, squeeze, stand.

[00:29:36]Feel the difference.

[00:29:38]The third fix is the head of the bed.

[00:29:41]This sounds strange.

[00:29:42]The physiology is exact.

[00:29:45]When you lie flat at night, the pressure in your kidney arteries rises. Your kidneys read the rise as a signal to dump fluid. You urinate that fluid out in the night, often without waking up.

[00:29:58]By morning, your blood volume is 1 L lower than it was at bedtime.

[00:30:03]You stand up with the lowest blood volume of your entire day.

[00:30:08]That is why your worst dizziness is often in the morning.

[00:30:12]The fix is to raise the head of your entire bed by 4 to 6 in. inches.

[00:30:17]Not pillows under your head. Pillows do nothing. Your kidneys are still flat.

[00:30:23]You need the entire mattress angled. The easy way is bed risers under the two legs at the head of the bed.

[00:30:30]Wooden blocks, metal risers, any hardware store. Your kidneys stay above your heart through the night. The overnight fluid loss drops by half. You wake up with more blood volume. The morning dizziness eases. Do this tomorrow. Two wooden blocks at the hardware store cost less than $10 or two stacks of old books. Slide them under the legs at the head of your bed tomorrow morning. One night to feel the difference.

[00:30:58]The fourth fix is compression.

[00:31:00]Compression stockings that reach the thigh or better the waist. The over-the-counter knee-high socks from the drugstore are almost useless. Here is why. The pulled blood when you stand is not in your calves. The pulled blood is in your thighs and your abdomen. The compression must reach those areas. You need medical grade compression. 20 to 30 mm of mercury minimum. 30 to 40 for severe cases. Thigh high or waist high.

[00:31:29]A vascular doctor or a good medical supply store can fit you. The stockings are uncomfortable to put on. The stockings work. The blood stays where it needs to be. You can stand without crashing. Call your insurance tomorrow.

[00:31:43]Most insurance plans cover medical grade compression stockings with a prescription.

[00:31:48]There is a fifth fix that helps.

[00:31:50]Increasing your salt intake. If you have severe standing dizziness and no congestive heart failure or kidney disease, your doctor may want you to eat more salt.

[00:32:00]6 to 10 g of sodium per day. This goes against everything you have heard about salt for 40 years. For a senior with low standing pressure, the extra salt holds water in your bloodstream. More water means more blood volume. More blood volume means a better standing pressure.

[00:32:17]Do not do this on your own. Ask your doctor. If your doctor agrees, the difference can be enormous.

[00:32:24]Before we get to the doctor conversation, one practical thing about your home cuff. Most home blood pressure cuffs are inaccurate by 10 to 20 points in seniors. The wrist cuffs are the worst. The upper arm cuffs are better, but only if the cuff size matches your arm.

[00:32:40]A small cuff on a big arm reads too high. A big cuff on a small arm reads too low.

[00:32:47]The reading you have been writing down for years may have been wrong all along.

[00:32:53]Two simple checks.

[00:32:55]Measure the distance around your upper arm in inches. The cuff should cover 80% of that circumference. Most cuffs come in three sizes: small, regular, and large. Buy the right one.

[00:33:08]Second check. When you take a reading, sit with your feet flat on the floor, back supported, arm resting on a table at heart level.

[00:33:17]If your arm is hanging at your side, your reading is high by 10 points.

[00:33:21]If your feet are crossed, your reading is high by five points. Small things that add up to a number your doctor is treating wrong. Get the cuff right, then the data you bring her is the data she can trust. What I am saying next is critical. Do not stop your pill on your own. Do not adjust your dose on your own. Do not skip days on your own.

[00:33:43]This video gives you the power to have a smart conversation with your doctor.

[00:33:48]This video does not give you the power to play doctor with yourself.

[00:33:52]Otis was 78, a retired carpenter from northern Indiana. He watched a video like this one. He decided he would just stop his pill on his own.

[00:34:02]Within five days, his pressure rebounded to 168 over 100. He had a small stroke.

[00:34:08]He recovered, mostly. Some weakness on his right side. The weakness has not fully resolved.

[00:34:15]The pill adjustment is a supervised process. You bring the data to your doctor. She makes the call. She tapers the dose. She watches the response. She substitutes if needed. That is the order.

[00:34:28]Any other order is what put Otis in the hospital.

[00:34:32]Here is the conversation you have with your doctor, word for word. Bring this script with you. Doctor, I have been experiencing dizziness when I stand up.

[00:34:41]I am worried about my fall risk. I would like to take my blood pressure today lying down for 5 minutes, then again at 1 minute, at 3 minutes, at 5 minutes after I stand. I also want to review all of my current medications, including the ones from other doctors. I want to know if any of them might be causing this. I have read that alpha blockers in particular cause this problem in seniors. If any of my pills are alpha blockers, I would like to discuss alternatives. I want to do this slowly under your supervision.

[00:35:13]Every word of that script matters. The phrase lying down for 5 minutes tells her you know the protocol.

[00:35:20]The phrase alpha blockers tells her you have done your homework. The phrase under your supervision tells her you are not going home to stop the pill on your own.

[00:35:31]Doctors respect a patient who comes in with specifics.

[00:35:34]Doctors dismiss a patient who comes in with feelings. Bring the specifics.

[00:35:39]There is a medical framework your doctor may know by name. It is called the Beers Criteria.

[00:35:45]The Beers Criteria is a list of pills considered potentially inappropriate for seniors over 65.

[00:35:52]Alpha blockers like doxazosin and terazosin are on the list. Many old antidepressants are on the list. Many sleep aids.

[00:36:01]If your doctor reviews your prescription list against the Beers Criteria, she will spot the highest risk pills first.

[00:36:08]The timing of when you take your pill also matters.

[00:36:11]As much as which pill you take.

[00:36:13]If you are on a water pill, ask your doctor about moving the dose to evening.

[00:36:19]Most doctors prescribe water pills in the morning by default. The morning dose floods your bladder for the day.

[00:36:25]The morning dose also crashes your blood volume right when the morning surge of stress hormone is raising your pressure.

[00:36:32]Evening dosing flips the script. Your blood volume drops while you sleep. Your standing pressure in the morning is the one that matters. Ask your doctor. If you are on a beta blocker, take it at night, not in the morning.

[00:36:46]Beta blockers blunt your heart rate response. The morning is when your heart needs to respond fastest.

[00:36:53]Evening dosing keeps the protection through the night. Lets your morning pressure control center work properly.

[00:37:00]If you are on an alpha blocker that you cannot stop yet, ask your doctor about bedtime dosing.

[00:37:06]Bedtime dosing means the worst hours of the pill happen while you are lying flat.

[00:37:11]The flat position protects you. You stand up the next morning when the pill has been working for 8 hours. The peak is past. The risk is lower.

[00:37:21]These three timing changes are small.

[00:37:23]Your doctor can adjust them in 2 minutes. The change costs nothing. The change works in 3 days. You will feel the difference by the end of the first week.

[00:37:33]>> [snorts] >> There are two numbers I cannot leave out of this video. These two numbers change how seriously you take what I just told you.

[00:37:41]First number, every year in America, more than one in four seniors over 65 falls. That is 3 million emergency room visits annually for fall injuries.

[00:37:52]The Centers for Disease Control tracks the number. The number has been rising for the past decade.

[00:37:58]Second number, of the seniors who fall and break a hip, the one-year mortality rate is between 21 and 26%.

[00:38:07]Read that again. Of the seniors who fall and break a hip, one in four are not alive 12 months later. Not from old age, from the chain the fracture sets in motion. The surgery, then the months of immobilization, then the pneumonia from being bed bound, then the blood clots, the depression, and the slow decline.

[00:38:27]This is why the medication review I am asking you to schedule matters. The pill causing your dizziness is not just inconvenient. The pill is the leading reversible cause of one of the most lethal events in geriatric medicine.

[00:38:41]You [snorts] do not get a second chance at that hip fracture. You get one chance to prevent it. The conversation you have with yourself today, the call you make to your doctor tomorrow morning, the script you bring to that appointment, that is the chain that prevents the fall.

[00:38:56]Look back at the start of this video.

[00:38:58]There are three types of seniors. The first type keeps the pill, keeps the dizziness, falls in the bathroom. One in four are not alive a year later.

[00:39:08]The second type meant to schedule the appointment, never did.

[00:39:12]The third type calls tomorrow morning, does the lying and standing test, brings the script, identifies the pill, has the supervised adjustment, keeps the independence.

[00:39:22]Russell was not the third type the day his head started spinning on the seventh hole.

[00:39:26]Doris was not the third type when her daughter wanted her to move in.

[00:39:30]They became the third type when they sat in their doctor's office and said the right words.

[00:39:35]Which type are you? Not in theory.

[00:39:37]Tomorrow morning.

[00:39:39]If this video helped you, three things before you click away. Leave a comment with the pills you are on.

[00:39:46]Your morning home reading.

[00:39:48]Whether you have felt the dizziness on standing.

[00:39:51]Not for me. For the next senior who finds this video. YouTube will see your comment.

[00:39:57]YouTube will decide this video is worth showing to one more senior on three pills.

[00:40:03]One more senior who does not know what is happening to them when they stand up.

[00:40:07]Your one comment could prevent someone's fall.

[00:40:10]Send this video to the person you are thinking of right now.

[00:40:14]The one whose mother fell last month.

[00:40:16]The one whose father is on Flomax and has been holding the wall in the bathroom.

[00:40:21]The one whose wife has had two near falls and they have both started blaming her age.

[00:40:26]Be the person who reaches them.

[00:40:28]The blood pressure protocol is my ebook, the full system. Not one pill, not one number.

[00:40:35]The protocol looks at every pill you are on, every interaction, every adjustment.

[00:40:41]It shows you how to bring the right data to the right conversation with your doctor. Link in the description. That is what this is about. This is not about Doxazosin or Tamsulosin or any one pill.

[00:40:53]It is about the morning you stand up out of bed and the room stays still.

[00:40:58]>> [snorts] >> The walk to the bathroom at 2:00 in the morning. You do not have to hold the wall.

[00:41:03]The afternoon at the hardware store. You step out of the truck, you walk in. No waiting, no dizziness.

[00:41:10]You bend down to pick up your grandchild. You stand back up. No gray, no tilt, no fear.

[00:41:17]Tomorrow morning, one call, three small changes, your life back.