GLP-1 receptor agonists, such as semaglutide and tirzepatide, are effective medications for weight loss and blood sugar control. However, some individuals experience orthostatic dizziness, a sensation of lightheadedness or faintness when standing up too quickly. This can be concerning, but understanding the underlying causes and how to manage them can help patients continue their treatment safely.

Orthostatic dizziness refers to a sensation of lightheadedness, faintness, or unsteadiness that occurs when transitioning from a sitting or lying position to standing. It is often caused by a sudden drop in blood pressure, known as orthostatic hypotension, which temporarily reduces blood flow to the brain. Common symptoms include blurred vision, weakness, nausea, and, in some cases, fainting. This condition can be influenced by dehydration, low blood volume, medications (including GLP-1 receptor agonists), or underlying health conditions affecting circulation. Drinking adequate fluids, increasing salt intake (if appropriate), and rising slowly from seated positions can help prevent orthostatic dizziness.

What Causes Dizziness When Standing on GLP-1 Therapy?

1. Mild Dehydration – GLP-1 medications slow down digestion, which can reduce thirst signals. If you’re not drinking enough water, your blood volume may drop, making it harder for your body to keep blood pressure stable when you change positions.
2. Lower Blood Pressure – GLP-1 therapy can slightly lower blood pressure, which is usually good for heart health. However, in some cases, this drop can cause dizziness, especially if combined with dehydration.
3. Vasodilation (widening of blood vessels) – These medications can widen blood vessels, improving blood flow but also lowering blood pressure. This can make you feel lightheaded if you stand up too quickly.
4. Rapid Weight Loss – Losing a lot of weight quickly can reduce your overall blood volume, which may contribute to dizziness when standing.
5. Medications – If you take medication for high blood pressure, it is very likely that weight loss will result in a need to lower your doses or even stop medication for hypertension. If your dose of medication for high blood pressure has not been adjusted, this could be a factor in dizziness.

How to Prevent Orthostatic Dizziness on GLP-1 Therapy

The good news is that orthostatic dizziness can often be managed with simple lifestyle changes:

1. Stay Hydrated – Drinking plenty of water is the most effective way to prevent dizziness. Aim for at least one liter of water per day, and more if engaging in physical activity.
2. Slowly Change Positions – When moving from sitting or lying down to standing, do so gradually to give your body time to adjust.
3. Monitor Blood Pressure – If dizziness persists, check your blood pressure regularly and consult your healthcare provider if significant drops occur.
4. Maintain a Balanced Diet – Ensure you’re consuming enough salt and potassium-rich foods (like leafy greens, nuts, and bananas) to support blood pressure regulation.

When to Seek Medical Attention

Dizziness is a very non-specific symptom and can be caused by both minor or serious conditions. If dizziness is severe, persistent, or accompanied by symptoms like chest pain, shortness of breath, or fainting, seek medical attention immediately. This usually means being seen in Urgent care or the ER. Your provider can address  the  appropriateness of your medication dose and evaluate other contributing factors after you’ve been evaluated for dangerous conditions.

GLP-1 therapies remain  effective tools for weight loss and metabolic health, but staying hydrated and mindful of blood pressure changes is key to minimize the discomfort of mild dizziness. Dizziness can also affect balance and safety when doing activities that require coordination such as driving, playing sports, and cycling, so it’s important to use extra caution and avoid these activities if feeling any dizziness until the cause of the symptoms is identified. If you have concerns about dizziness or any other side effects, consult with your healthcare provider for personalized recommendations.

At Flow Wellness, we support your journey with GLP-1 therapy and can help you optimize hydration and nutrient balance. Reach out to us for expert guidance!