Fibromyalgia is a chronic pain disorder that affects millions of people worldwide, causing widespread pain, fatigue, cognitive difficulties, and sleep disturbances. While fibromyalgia is often linked to autonomic nervous system dysfunction, some patients also experience abnormally low blood pressure (hypotension).
Low blood pressure in fibromyalgia can cause dizziness, fatigue, fainting, and brain fog, making everyday activities more challenging. While hypotension is not always recognized as a primary fibromyalgia symptom, it is often associated with dysautonomia, poor circulation, and nervous system imbalances.
In this article, we will explore the possible causes, symptoms, risks, and management strategies for low blood pressure in fibromyalgia patients.
1. Can Fibromyalgia Cause Low Blood Pressure?
While fibromyalgia does not directly cause low blood pressure, many of its associated nervous system dysfunctions, hormonal imbalances, and medication side effects can contribute to frequent blood pressure drops.
Potential connections between fibromyalgia and hypotension include:
Dysautonomia (autonomic nervous system dysfunction)
Poor circulation and vascular issues
Chronic pain affecting blood flow
Medication side effects
Adrenal and hormonal imbalances
Many fibromyalgia patients experience orthostatic hypotension, where blood pressure drops when moving from a sitting or lying position to standing, leading to dizziness or even fainting.
2. Possible Causes of Low Blood Pressure in Fibromyalgia
Several factors contribute to low blood pressure in fibromyalgia patients. These include:
1. Autonomic Nervous System Dysfunction (Dysautonomia)
Fibromyalgia is linked to autonomic nervous system (ANS) imbalances, which regulate heart rate, blood pressure, and circulation.
Dysautonomia can cause blood pressure fluctuations, leading to hypotension, dizziness, and fainting episodes.
Some patients experience Postural Orthostatic Tachycardia Syndrome (POTS), where standing up causes a sudden drop in blood pressure.
2. Medication Side Effects
Many fibromyalgia medications, such as antidepressants, muscle relaxants, and pain relievers, can lower blood pressure.
Tricyclic antidepressants (Amitriptyline) and serotonin-norepinephrine reuptake inhibitors (Duloxetine, Milnacipran) can cause hypotension as a side effect.
Opioids, sleep aids, and some anti-anxiety medications may also lower blood pressure and cause dizziness.
3. Adrenal Fatigue and Hormonal Imbalances
Chronic stress from fibromyalgia can lead to adrenal dysfunction, causing low cortisol levels, which may contribute to low blood pressure.
Hormonal imbalances in thyroid and adrenal function can make it difficult for the body to maintain stable blood pressure.
4. Poor Circulation and Blood Flow Issues
Fibromyalgia patients often experience cold hands and feet, which may be linked to poor circulation and low blood pressure.
Dysfunction in the nervous system can prevent proper constriction of blood vessels, leading to hypotension and dizziness.
5. Dehydration and Nutrient Deficiencies
Fibromyalgia patients are prone to dehydration, which can cause a drop in blood pressure.
Low sodium, magnesium, or electrolyte imbalances may contribute to symptoms of low blood pressure.
6. Postural Hypotension and Standing Intolerance
Many fibromyalgia patients experience a sudden drop in blood pressure when standing up (orthostatic hypotension).
This can result in dizziness, lightheadedness, and even fainting.
3. Symptoms of Low Blood Pressure in Fibromyalgia
People with low blood pressure may experience:
Dizziness or lightheadedness
Fatigue and weakness
Brain fog and difficulty concentrating
Cold hands and feet
Fainting or near-fainting episodes
Blurry vision
Shortness of breath
Since fibromyalgia already causes fatigue and cognitive difficulties, low blood pressure can worsen these symptoms, leading to reduced quality of life.
4. Health Risks of Low Blood Pressure in Fibromyalgia
If left unmanaged, low blood pressure can increase the risk of:
Frequent dizziness and falls
Reduced blood flow to the brain and organs
Fainting (syncope) and injury risks
Extreme fatigue and weakness
Potential heart and circulatory complications
Since fibromyalgia patients already struggle with chronic pain and fatigue, dealing with low blood pressure symptoms can make daily activities even more difficult.
5. Managing Low Blood Pressure with Fibromyalgia
1. Increase Salt and Electrolytes
Sodium helps raise blood pressure, so increasing salt intake may be beneficial for those prone to hypotension.
Drink electrolyte-rich fluids (like coconut water or sports drinks) to maintain proper hydration.
2. Stay Hydrated
Dehydration can cause blood pressure drops, so drink plenty of water throughout the day.
Avoid excessive caffeine or alcohol, which can lead to dehydration.
3. Avoid Sudden Position Changes
When getting up from a lying or sitting position, move slowly to prevent dizziness.
If standing for long periods, consider shifting weight between legs or using compression socks to improve circulation.
4. Monitor Medications
Talk to your doctor about adjusting fibromyalgia medications that may be lowering your blood pressure.
Avoid medications that cause excessive drowsiness or dizziness.
5. Eat Small, Frequent Meals
Large meals can trigger postprandial hypotension (a drop in blood pressure after eating).
Eat smaller meals throughout the day to help regulate blood pressure levels.
6. Exercise and Gentle Movement
Light activity (such as walking or yoga) can help improve circulation and support blood pressure stability.
Avoid intense exercise, which may cause sudden blood pressure drops.
7. Consider Compression Stockings
Wearing compression stockings helps improve circulation and prevent blood from pooling in the legs, reducing hypotension episodes.
8. Support the Nervous System
Fibromyalgia is linked to nervous system dysfunction, so supporting the autonomic nervous system can help stabilize blood pressure.
Deep breathing exercises, meditation, and stress reduction techniques may help improve nervous system function.
6. Conclusion: Understanding and Managing Low Blood Pressure in Fibromyalgia
Low blood pressure in fibromyalgia is often linked to autonomic nervous system dysfunction, medication side effects, dehydration, and circulation issues.
Although hypotension is not always recognized as a common fibromyalgia symptom, many patients report dizziness, fatigue, fainting, and cognitive dysfunction.
Managing low blood pressure requires hydration, dietary adjustments, careful medication 
management, and lifestyle changes to maintain stability and prevent symptoms.
Would you like a personalized approach to managing low blood pressure alongside fibromyalgia?
