Hello,
I understand you’ve been dealing with low blood pressure (around 95/65 mmHg) for nearly 10 months, and now feeling excessively sleepy, dizzy when standing up, and you've also noticed weight loss and drop in hemoglobin. Let’s go through this step by step.
1. What Might Be Happening
Your symptoms — low BP, fatigue, dizziness on standing (orthostatic hypotension) — suggest your autonomic nervous system or hormonal balance might be involved.
The fact that hemoglobin dropped from 15.7 to 12.9 g/dL shows a significant fall, which may point to chronic illness, nutritional deficiency, or early-stage anemia.
Weight loss (from 56 kg to 52 kg) also needs to be taken seriously, especially when unexplained.
2. Why You Still Have Symptoms Despite Water and Salt Intake
You're already taking 3–4 liters of water and extra salt, which is good. But if symptoms are not improving, we need to look beyond basic dehydration:
There could be adrenal insufficiency (low cortisol, like Addison’s disease)
Hypothyroidism, which can cause fatigue, hypotension, weight changes
Chronic infection, malabsorption, or internal inflammation
Autonomic neuropathy, especially if there’s
diabetes or other systemic illness
3. What You Should Do Next
You need to go one step deeper in testing:
✔️ Blood tests:
Serum cortisol (morning)
TSH and free T4 (
thyroid profile)
Serum
electrolytes,
vitamin B12,
ferritin, and
CRP
✔️ Postural BP check:
Measure BP lying down and 3 min after standing — drop in BP confirms orthostatic hypotension
✔️ 24-hour BP monitor if needed
✔️ ECG/ECHO to rule out heart rhythm or structural cause
4. What You Can Try in the Meantime
Try slowly standing up after sitting for a while — avoid sudden postural changes
Use compression stockings (if no contraindications) to improve circulation
Add small frequent meals with complex carbs and protein
Consider light exercise (under guidance), especially leg movements, to help blood flow
Conclusion:
Although your doctor found no major issue on initial tests, your persistent symptoms, weight loss, and drop in hemoglobin need more focused evaluation — especially for endocrine or autonomic causes. Please don't ignore this — it is not normal to feel sleepy and dizzy all the time.
Reference: Based strictly on Harrison’s Manual of Medicine – Hypotension, Orthostatic Hypotension, and Endocrine Disorders section.
Mark HELPFUL 🙂