For people suffering from Orthostatic Intolerance, Postural Orthostatic Tachycardia, Mast Cell Activtation or EDS. Follow me as I document my struggle towards better health.

Building Blood Volume and Exercise

Having chronic low blood volume is a condition afflicting many sufferers of CFS, ME, POTS and orthostatic intolerance.  Building and maintaining blood volume is challenging and requires constant attention.  Even one day without adequate fluids can exacerbate symptoms to the point of incapacitation.

For those of us who are newly diagnosed or who have been at the mercy of physicians who don't understand OI, what is a proven treatment for building and maintaining adequate blood volume?


There is no escaping it.  Some of us have avoided exercise because it is painful, uncomfortable, too exhausting, and/or unpleasant. BUT even though exercise is HARD to do and it can HURT and make us feel WORSE in the short term, evidence is there that says we can improve our symptoms by conditioning our bodies. As someone told me when I was whining about how much my chest hurt during my session with the rowing machine "it might hurt but you're not going to die."  All for a good cause.

On this blog I have attempted to offer evidence for the treatments I have written about in the form of studies and research from reputable publications.  Here are links to two such studies on exercise and blood volume:

Once Dr. Levine's study is published, there will be more helpful information on exercise programs but until then, if you want to start exercising don't forget to read the "Exercise" page on this blog for some tips on how to start with your own orthostatic conditioning program.

Soldier on!


  1. Elisabeth, your links aren't working on this post.
    Do you have a timeframe of when the study will be available?

  2. As a fellow POTSy, I have been really enjoying reading your blog. I have hypovolemic POTS, so I follow a pretty aggressive, regular exercise protocol. This has certainly helped, but I don't have access to a rowing machine. Instead, I walk, jog, recumbent bike, and use a stability ball. How critical do you find the rowing machine to your recovery? My POTS doctor did not mention the rowing specifically, but I have read over and over that this is probably the best exercise for POTS. I used a rowing machine regularly in college and did not find it more difficult than jogging, but perhaps it works more muscle groups. What are your thoughts?

  3. Hi Leah - Tiffany from Dr. Levine's research team said that they felt the rowing machine was the very best exercise for people with POTS. I guess it is because you are in a recumbent position and it works most of the major muscle groups: legs, back, chest and abs.

    For the first part of Dr. Levine's exercise protocol ALL exercises are performed sitting or lying down. I believe this is key to people seeking to improve their orthostatic conditioning.

    For me I am going to trade my elliptical machine for a Concept2 rowing machine if I can find one locally. I think once I have achieved a certain fitness level I will continue on a daily maintenance plan which will include rowing :-)

  4. Thanks for the response. I think what I am missing is that right blend of muscle groups. My legs are conditioned to the max, but I am missing the back, chest and abs that the rowing machine would tone. I find this crazy, but I can jog for 5 miles, but I still have very debilitating POTS. I have figured out that the running actually pumps blood back up for my brain. When I stop moving, the symptoms are soon to follow. Best of luck! I love your blog and can not wait for Dr. Levine to publish his results.