How to Prevent Fainting

How to Prevent Fainting
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Syncope (fainting) triggered by standing, strong emotions, or common phobias to blood, injections, and injuries can be easily prevented with a number of safe, simple, effective exercises.

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Syncope, otherwise known as fainting, is the sudden, brief loss of consciousness caused by diminished blood flow to our brain that occurs at least once in about one in five people, and in about one in ten may happen over and over, responsible for millions of emergency room visits and hospitalizations. Though sometimes fainting can be caused by heart problems, most often it’s triggered just by standing (because blood pools in our legs) or strong emotions, which are called vasovagal reactions. Under certain circumstances, such as blood donation, syncope has important medical and societal significance. More than 150,000 people experience fainting spells or near-fainting spells each year when they’re giving blood. So, it would be good to find a way to avoid it. But, if you think that has medical and societal significance, what about fainting when you’re driving? It goes without saying that losing consciousness while driving can pose a serious threat to the patient and society. Of a group of folks getting tested for it, 9% reported they had lost consciousness while driving.

When it happens over and over, drugs and surgery are used, installing a pacemaker. But such therapy is expensive, efficacy is questionable, and adverse effects are common. In fact, results of most drug treatment trials have been disappointing, and the value of implanting pacemakers has been repeatedly questioned, and now there is evidence for their lack of effectiveness. So, what do we do?

Well in Italy, evidently the older generation of general practitioners advised patients prone to fainting to carry a wooden egg (used in the old days for darning socks) and to apply muscle tension by gripping the wooden egg forcefully as soon as a faint was imminent. These folklore stories inspired an Italian cardiologist to apply arm muscle tensing to combat vasovagal fainting, but it wasn’t put to the test, until now.

About a minute before losing consciousness, most about to faint experience so-called prodromal symptoms—they feel dizzy, queasy, or break out into a sweat, signaling they’re just about to black-out. When that happens, there are a number of maneuvers shown to successfully abort the impending episode. One is called isometric arm counter-pressure, where you grip one hand in the other and exert pressure trying to pull your arms apart, and you keep it up until the symptoms go away. How successful is it? Patients were shown how to do it, and reported it was successful 99% of the time. Safe and effective, proposed to be the new first-line treatment for those who start to feel faint.

Leg crossing and muscle tensing has also been shown to work, where you cross your legs, squeezing them together as you tense your leg, stomach, and butt muscles. Safe, inexpensive, effective—they propose having patients try this before having a cardiac pacemaker surgically implanted. Squatting down is another maneuver, if all else fails.

Is there anything we can do to prevent the symptoms in the first place? Do we have to wait until we’re all dizzy, clammy, and nauseous? Well, speaking of cheap, safe, and effective, just drinking water can prevent it. So, if you know needles make you whoozy, five minutes before you get stuck, chug down two cups of water, which can dramatically bring pressures up within minutes in people who are predisposed to fainting, and has similar effects in normal healthy adults. The fact that water exerts such profound effects can be exploited by blood donation programs, for example, to help prevent people from fainting. It’s also the current recommended treatment for so-called blood, injury, or injection phobia, which is actually pretty common, affecting about 1 in 25 people, 75% of which report a history of fainting in response. The problem is not just that they won’t donate blood. Avoiding anything related to blood, injury, and injections could pose a particularly serious threat if people neglect to seek medical care when necessary, but all one has to do is preload with two cups of water. The knowledge that such simple self-help maneuvers are readily available, and could be lifesaving, should prove valuable and helpful in everyday life.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Syncope, otherwise known as fainting, is the sudden, brief loss of consciousness caused by diminished blood flow to our brain that occurs at least once in about one in five people, and in about one in ten may happen over and over, responsible for millions of emergency room visits and hospitalizations. Though sometimes fainting can be caused by heart problems, most often it’s triggered just by standing (because blood pools in our legs) or strong emotions, which are called vasovagal reactions. Under certain circumstances, such as blood donation, syncope has important medical and societal significance. More than 150,000 people experience fainting spells or near-fainting spells each year when they’re giving blood. So, it would be good to find a way to avoid it. But, if you think that has medical and societal significance, what about fainting when you’re driving? It goes without saying that losing consciousness while driving can pose a serious threat to the patient and society. Of a group of folks getting tested for it, 9% reported they had lost consciousness while driving.

When it happens over and over, drugs and surgery are used, installing a pacemaker. But such therapy is expensive, efficacy is questionable, and adverse effects are common. In fact, results of most drug treatment trials have been disappointing, and the value of implanting pacemakers has been repeatedly questioned, and now there is evidence for their lack of effectiveness. So, what do we do?

Well in Italy, evidently the older generation of general practitioners advised patients prone to fainting to carry a wooden egg (used in the old days for darning socks) and to apply muscle tension by gripping the wooden egg forcefully as soon as a faint was imminent. These folklore stories inspired an Italian cardiologist to apply arm muscle tensing to combat vasovagal fainting, but it wasn’t put to the test, until now.

About a minute before losing consciousness, most about to faint experience so-called prodromal symptoms—they feel dizzy, queasy, or break out into a sweat, signaling they’re just about to black-out. When that happens, there are a number of maneuvers shown to successfully abort the impending episode. One is called isometric arm counter-pressure, where you grip one hand in the other and exert pressure trying to pull your arms apart, and you keep it up until the symptoms go away. How successful is it? Patients were shown how to do it, and reported it was successful 99% of the time. Safe and effective, proposed to be the new first-line treatment for those who start to feel faint.

Leg crossing and muscle tensing has also been shown to work, where you cross your legs, squeezing them together as you tense your leg, stomach, and butt muscles. Safe, inexpensive, effective—they propose having patients try this before having a cardiac pacemaker surgically implanted. Squatting down is another maneuver, if all else fails.

Is there anything we can do to prevent the symptoms in the first place? Do we have to wait until we’re all dizzy, clammy, and nauseous? Well, speaking of cheap, safe, and effective, just drinking water can prevent it. So, if you know needles make you whoozy, five minutes before you get stuck, chug down two cups of water, which can dramatically bring pressures up within minutes in people who are predisposed to fainting, and has similar effects in normal healthy adults. The fact that water exerts such profound effects can be exploited by blood donation programs, for example, to help prevent people from fainting. It’s also the current recommended treatment for so-called blood, injury, or injection phobia, which is actually pretty common, affecting about 1 in 25 people, 75% of which report a history of fainting in response. The problem is not just that they won’t donate blood. Avoiding anything related to blood, injury, and injections could pose a particularly serious threat if people neglect to seek medical care when necessary, but all one has to do is preload with two cups of water. The knowledge that such simple self-help maneuvers are readily available, and could be lifesaving, should prove valuable and helpful in everyday life.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to The Clear Communication People via Flickr.

Doctor's Note

This is the final installment (for now!) of an extended video series I’ve done on water and proper hydration. Quench your curiosity by checking out the earlier videos:

If you haven’t yet, you can subscribe to my videos for free by clicking here.

77 responses to “How to Prevent Fainting

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  1. Having “low-normal” BP increases chances of fainting in every case in my personal experience. Blood loss (donation or accident, doesn’t matter) and dehydration are my leading causes of hittin’ the floor. Needles schmeedles, stick me, I’ve even had acupuncture. ;^D

    Yes, but how do we get the word out? The persistent question with all our non-commercial healthy-living facts.

      1. Hey HemoDynamic,
        Had a couple of questions for you. I was replying to Joseph and trying to get your contact info. Im an MD in California as well. Any way i can ask you questions off the message board?

        1. You can send your contact info to HemodynamicMD@outlook.com and I will try to get a hold of you. I will be driving down to Santa Rosa today to help John McDougall, MD, with an Immersion program so I will have about 3 hours that I will have free to talk while driving. Don’t worry it’s hands-free. ;-) I look forward to hearing from you.

      2. I’ve shared and shared and shared until all my friends and family are completely sick of it. No replies, no likes, no responses. Well, one here and there. So I try to limit myself to only ONE share per week.

        When I start talking about how great plant foods are and how I’ve enabled my body to fix itself and feel better all around all the time, THEY look at me like I’m a talking iguana, or a through me like I’m a ghost. There have been one or two times when I “cornered” receptive listeners, but that is rare.

        My thoughts: The OVERLOAD of conflicting information causes them to shut down to new information, and that’s right where the JUNK pushers want them.

        FTR, I don’t use the “share” links provided here, so there’s no record of my sharing unless you want to look at my FB.

        1. I have the same response when I share but eventually it will get through to a few who care.

          Also I have a more captive audience when they are in my office because they are usually not wanting pills so they listen to what I have to say and share.

          Furthermore, I have learned not to say much about it when I am out and about because meat eating is like a religion to some and telling people that all animal products cause chronic disease is like telling a Christian that they are non-Christian.
          It is with religious fervor that people defend eating meat.

          Keep up the great work and ultimately you are doing this for you! That’s the most important person–You!

          1. Hemo, re: “meat eating is like a religion.” I have said the same thing to my friends. And, actually I get many of my Christian friends to listen to me just to see if the analogy is true. They generally figure out that it is very similar so I challenge them to please, please, please just watch one video (I usually recommend “Uprooting . . .” to see if it makes sense to them.
            Also, very effective is the fact that I have a heart stent. I have Dr. Esselstyn’s book on my phone and I show them the pictures of Joe Crow’s arteries, the same picture Dr. Greger uses . . . showing the reversal of coronary disease from Nov 1995 to July 1996. (page 278 on my phone version) Just 32 months . . . Incredible difference. Then, I page forward to the PET scans showing the blood flow improvement after 3 weeks, and six weeks (pp.282-285). Invariably, they ask me if I feel better! Well, of course the answer is YES! That’s why I’m showing this to you! And, these pictures show why some people who try eating plant based for just 30 days, end up never going back . . . they feel so much better.
            And, get this, I once sent a question to Dr. Sprouts via his website, and one night my phone rang it was Dr. Esselstyn on the other end to discuss my question with him. wow. . . .

        2. Holy s–t Wade, isn’t it frustrating, I do the same thing and rarely ever get a single reply except for a few close friends who just don’t want me to feel ignored! I just left a minor meltdown with my ex who is basically committing slow suicide…he’s diabetic, eats whatever he wants or is handy, gets his daily DD fix… with greasy donut, SMOKES again after quitting for years, has already lost part of a leg and is depressed as hell. He is killing both of us because even though he no longer lives here, he’s been in my life for 45 years, but no matter how I approach him, he ignores me or changes the subject. I know this is messed up but today I calmly asked him to get his papers in order and give them to me so I don’t have to go searching for them when he succeeds in killing himself. No reaction at all, he just said okay. Now I feel even worse. I’ve tried so hard to decode the defining moment when I stopped being oblivious and chose to change, but it’s too damn convoluted.
          And you hit it on the head about the conflicting dietary info. It’s so confusing (and generally wrong) that it becomes random noise…everyone ignores it…as planned. So SAD!!!

          1. I don’t lecture, I try to gently inform. I care about my friends and family.

            My dad has MS and a cancerous tumor in one lung.

            I show up the other day and he is eating warmed-over, grocery-boxed frozen White Castle “burgers” and washing it down with a knock-off brand soda. I didn’t say anything.

            He then got out some peanut butter and I said, “Hey, now that’s got some nutrition in it!”

            It was for the dog.

          2. Same here, there were a series of attempts and defining moments and I’m still getting better at this. Main problem now is when I’m tired and don’t want to cook. Finally I’m getting regular with being sugar-free.

            1. Kim: re: “when I’m tired and don’t want to cook…” Been there, done that! I have some ideas for you. You may have already thought of these, but just in case it might be helpful:
              .
              > frozen veggie burgers – the type sold in the stores are usually at the low end of healthy, but the ones you make yourself freeze just as great and are ready to eat with just one minute in the microwave. Most recipes seem to make a large number of burgers, which is great because you can freeze the extras. I’ve tried many, many different home made versions with varying degrees of success. My current favorite (so much so that I’ve been raving about them) are from Miyoko’s new Vegan Pantry book. A must-try and very easy. And juicy and tasty. You don’t have to eat them with a bun either. I like them by themselves with a little ketchup or some mushrooms and onions on top.
              .
              > freeze left overs in single serving jars. Not all dishes freeze well, but with a little experimentation you will develop a good sense of what freezes well and what does not. And then you will have ready-made meals that just need thawing and reheating.
              .
              > Almost instant vegan bowls: Trader Joes sells frozen brown rice that is pre-cooked and has nothing in it but brown rice. It becomes a perfect bowl of steaming rice in 3 minutes in the microwave. Other grain options include those starchy/konjac noodles that are already cooked and quinoa which cooks in one high minute in a pressure cooker. For the greens, frozen broccoli, artichoke hearts, or whatever you want has already been pre-cooked and cut etc. Let someone else be your sous chef. Just heat them up. Finally, you need a sauce. Some pre-made store bought sauces come in healthy varieties – pasta sauces, barbeque, hoisin, etc. Also, I recommend a book The Saucy Vegetarian for a bunch of no-cook sauces that come together quickly in a blender or food processor.
              .
              > carefully selected restaurant dishes – most restaurants are not going to provide food that is all that healthy. But there are some out there that can come through for specific dishes. If you make a list for something you can have in your back pocket, even if it is just a side dish that you can bring home, that can help when you just don’t have the energy to cook.
              .
              I’m sure there are other ideas out there. And none of these ideas is mind blowing. But it can be nice to have a set of strategies in place to help when you need it. Good luck!

              1. Thank you, Thea, for a great and carefully thought-out answer! I haven’t ever thought of making a better burger, but there’s no reason why not. I certainly will round up ingredients and bang out a batch. I am freezing portions of rice and such, and with your encouragement, I’ll go back to freezing complete dishes (I tried it before and made some chili and pasta things for lunches that, once thawed, looked somewhat like dog food and tasted so sad. But I’m much braver with spices now). I certainly appreciate your ideas and I wish you good luck too!

                1. Kim: re: “I tried it before and made some chili and pasta things for lunches that, once thawed, looked somewhat like dog food and tasted so sad.” I JUST saw a description of a brand new cookbook on vegan recipes where all of the recipes freeze well. The book is supposed to be for the busy person. I just ordered the book, so I don’t know how good it is. But I remembered our conversation and I just had to find your post so I could share with you:

                  http://www.amazon.com/gp/product/1581573049?psc=1&redirect=true&ref_=oh_aui_detailpage_o00_s00

        3. Me too. I got a death threat from a cousin on fb. One by one they are getting diagnosed with diabetes, cancer, cataracts, essential tremor, or having triple or quadruple bypasses. But they’re right and I’m wrong. I’m not going to stop though. They’ll have to block me or kill me.

    1. Like Hemo Said – SHARE! Share with anyone who encounters such problems and share with other health professions who may be interested. :-)

      1. Hey Joseph, would it be possible to post a link to Dr Greger’s optimal nutrition recommendations in an easy to find location? It doesn’t come up easily when searching and you have to hunt for where it has been posted before. Also, it seems that page was originally written in 2011. Do you think it needs to be updated at all? Thanks!

          1. Joseph: Consider this a second vote for Brett’s request. I made a similar one some time ago. I think this needs to be easier to find. Even a link/section on the FAQ page or how about a new under “Popular Topics” below might work. Thanks for looking into it.

              1. Joseph: Yes, your description is exactly one of my suggestions as a possible way to make it easier for people to find that page.

                I would be curious to hear what Brett or others think of that idea. Do others agree that having a row labeled “Optimal Nutrition Recommendations” at the bottom of “Popular Topics” (which is a section on the bottom of every page on this site–see below) be helpful?

            1. As of now we’re trying to get folks interested in Dr. Greger’s new book, How Not to Die because there is better information about nutrition recommendations. So for now we won’t be adding a link to the optimal nutrition recs unless asked for.

          2. Thanks for the link. I’ll bookmark it.

            But for others, yes I think a link under the popular topics list would be good. Thanks for your help!

        1. Brett: This won’t help the common person, but a tip for you until a better link is given: Search under “brazil”. The one thing that is unique-ish about the Optimal Nutrition Recommendations from 2011 is the brazil nut. So, I search for “brazil” and then get a short enough list of videos in return to find the right one. I’ve used this trick for years and it is still working.

  2. Cool–I’ll pass this on to spouse, though he now seems to be able to give blood without fainting.

    Would that it could have helped my mom, who died of the nasty but rather rare Multiple System Atrophy, the Shy-Drager variety. In Shy-Drager, the autonomic nervous system doesn’t trigger increase in blood pressure when one stands, so one “faints”.

  3. Here’s another simple technique just reported by Science Daily: http://www.sciencedaily.com/releases/2015/10/151017152233.htm

    My 88 year old mother goes on 2, 2 mile walks every day (Yay, Mom!!) but occasionally gets faint. I’m going to pass all of these tips on to her.

    So appreciate NutritionFacts.org! (I finally decided to be a monthly donor rather than an occasional one. Hey folks, you can set up an auto-pay in under a minute and give as little as $5. It feels good!)

      1. Thanks to YOU and the entire NFacts team.

        You are most welcome for the contribution. Wish I could give more. Hopefully lots of your readers pitch in. It’s so easy to set up the recurring payments and have the donation come out of one’s checking account automatically.

  4. One of the reasons I am not a vegan. After I’m on the diet for several weeks I start to lose weight (I’m thin already) and I can’t stand up without being seriously dizzy.

    1. Interesting! Do you think you are eating enough food? Adding plenty whole grains, beans, and nuts and seeds? I am not advising you eat a vegan diet, but I may question exactly what you’re eating to help answer why you’d be losing weight so fast or feeling dizzy. It may not be diet related at all. Let me know if I can help?

      Best,
      Joseph

      1. Joseph: I think this is a good question. I was able to help a friend with this same suggestion. She was losing weight and feeling dizzy. I suggested she make sure to add nuts and seeds to her new vegan diet and this fixed her problem.

        1. Sometimes strict veg diets can fill one up quickly (lots of fiber) and they actually are not getting enough kcals for the day. So glad you were able to help your friend. Probably the last thing folks expect to hear from a dietitian it EAT MORE! :-) Thanks for your note, as always Thea.

          1. Oh, if only I could have such a “problem”! LOL! I am pretty religious about what I eat because I was diabetic, really limit the fats, but after 5 years there is still too much of me! Guess I like food too much?

  5. I faint very rarely. Short story, last time i fainted. Hit the floor (tiles) chin first. Broken jaw, massive cut on chin, 4 smashed teeth. Not fun. Getting up out of bed quickly in middle of night to go to bathroom. Dr’s wanted to insert pacemaker. Did more research and testing… not needed for the reasons pointed out in this video. I just never knew about them until after my accident.

    Now, i’m always hydrated, and after heavy triathlon training sometimes i feel a touch faint when i bend over (dehydrated). First thing i do is go into an immediate squat. Some deep breaths into gut area. I’m good within a few seconds – and then i go drink a lot of water.

  6. Not to make light of the subject, but the first person I thought of (at ‘blood donations) was Doc Martin! Y’all do know of whom I speak, right? Blood does it for him.

    Actually I have a close relative with a number of health issues including Orthostatic hypotension (postural hypotension). I’m going to send him this link now.

    1. MarthaLA: re: “Doc Martin” Oh yeah! I haven’t seen that show in a while, but I really remember liking that. Perhaps we should send him a link. ;-)

  7. For those women who faint while they are on their period because of pain and heavy blood loss, a whole food plant based diet can prevent this too! This is my experience :)
    It’s also good to know about the hydration factor. I couldn’t explain why I sometimes feet “almost” like fainting in the middle of a jogging session and now I have an obvious explanation. Thanks!

  8. My blood pressure is on the low side 91/65 yet it has dipped so low (80/51) that I have been at risk of fainting. I will try drinking white tea, eating fruit meals and drinking water to see what I can do. I weigh 116 pounds 5′ 7.25″ am vegan. My diet includes for now nuts without oil or salt, mostly curried beans with greens, brown rice and some fruit.
    Please how much liquid including coffee need I drink a day to keep my pressure up?

  9. Thanks a lot for the video. I had the same problem myself but now after doing plant-based diet and exercising regularly(each day) I overcame that issue.
    Can I ask you for a favor, please? On the YouTube site nutritionfacts.org(Michael Gregor YouTube site) there is troll named futurevideo10.For months he keeps spamming nonsense.You can check for yourself if you would like to.Can you please block him from the channel.He shows rude behaviour towards other coments.It is impossible to argue on scientific grounds with him about medicine, specifically the well established benefits of a well planed plant-based diet.Thanks for reading this comment.

  10. I remember when I was a Royal Canadian Air Cadet. At annual inspection you had to stand motionless and at attention for a long time in a warm armoury building. You just surreptitiously kept clenching your toes. No-one knew and it kept you upright.

  11. Hey I just cured my Type 2 diabetes. I went on John Mcdougalls diet for 1 weeks. That’s 7 days. And I’m not taking anymore insulin and my doctor is shocked. Potatoes, rice, beans, corn and some veggies and fruit people. Who’s allergic to any of those simple food? The only sad part is I’m not supposed to eat vegetable oils, meat, or milk/dairy. Oh well. I feel great! I’m never eating mcdonalds ever again though. Two cheeseburgers away from a heart attack, but I’m only 23! Cheers!!
    Hope this helps a fellow sufferer.

  12. This was so very helpful i have been prone to fainting my whole life since i was a child and have had so many tests to be told nothing by doctors so hopefully this will work ☺

    1. Hayley: Thanks to you and the others who have shared your stories. I guess I am one of the lucky ones. I’ve never fainted or to my knowledge known anyone who did. I had no idea this was such a problem for people.

      I hope this work for you too!!!

  13. I have a brain tumour in the brain stem / cerebellum and often feel faint – 1 in 2 days or so, though I rarely actually pass out. Thanks for the techniques, I’ll give them a try. :)

  14. Salt and caffeine may also help raise blood pressure too, along with some medications. On the parade ground we were advised to to wiggle our toes.

  15. I have had fainting problems my whole life, I’ve tried everything, from keeping hydrated to a good diet, it has got bad to the point where I am agraphobic, due also to certian areas of my life also. I so wish there was a cure for this ;(.

  16. Definitely a very useful video.

    None of the exercises though could be done while driving to avoid the risk of fainting while driving that the Docyor pointed out.

  17. Thank you for this video. I have been using the water remedy which works.
    When I was new to the vegan diet I also found that not having enough rice and grains also made me feel week and lightheaded.

  18. Thank you for posting this! I’ve struggled with fainting periodically and it’s great to know there is something I can do to prevent it other than lying down on the floor!

  19. Hi, This is off subject so hope it is OK. My question is about food cravings. And in particular mustard. Have there been any Scientific studies about food cravings? Thanks.

  20. A friend of mine suffers from low BP and regular fainting with a severe fall last year cracking her skull. I am concerned the medical advice she has been given and is following is too increase salt consumption.

  21. Keywords such as: “orthostatic hypotension”, “postural hypotension”, and even “hypotension” do not return any hits when entered in the search box. If the powers that be read this, please consider adding those.

    I frequently get dizzy when standing up from a sitting or lying position, especially, but certainly not exclusively, after exercise. Typically, I bend over or kneel down to aid blood flow to the brain. I usually have about 5 seconds to do something or black out. On three occasions over a ten year period I have fainted and fallen. Luckily only once did I hit something hard enough on the way down to result in stitches to the forehead.

    Thanks for the tips on contracting large muscle groups like legs and arms. These techniques will come in handy because no way am I going on drugs or having a pacemaker installed for this problem.

    1. Gatherer: I have heard of hypertension before, but not hypotension. I looked it up after seeing your post. Thanks for the education. I may not have that problem, but enough people are interested that I too hope that we can address it at some point.

  22. Excellent video !

    It gave me some great ideas.

    I would like to ask the following:
    The video says “Cheap, safe, effective, is just drink water. So, if needles do you whoozy, 5’ before get stuck, drink two cups of water, which can dramatically bring pressures up within minutes”

    How many ml is two cups of water ?
    One cup is 240 ml ?

    Thank you in advance for your time

    Regards

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