Orthostatic IntoleranceHave you ever found yourself using the walls of your hallway to guide you, as you try to make it from one room of your house to another? Have you ever stood up and felt so dizzy that you were afraid that you are about to fall face first? Have you ever tried to come up with a word, but no matter how simple it seems to do this, your mind feels foggy and the word won’t come out of your mouth?

These experiences are not unusual for people with fibromyalgia. In fact, the term “fibro fog” is used by health care providers to describe cognitive difficulties in patients with FM, and family practice doctors will often take your blood pressure while you are laying down, standing and sitting, to see if the blood in your body is making it’s way up to your head when you stand up.

The experiences of dizziness, fatigue, foggy thinking, and heart-racing are called Orthostatic symptoms. Here is a quiz that can help you grade your level of Orthostatic Intolerance. Please keep a running tally of you score.


Self-report Orthostatic Grading Scale, (Orthostatic symptoms include worsening dizziness, fatigue, racing heart or brain fog when standing.)

A. Frequency of orthostatic symptoms:

How often do you experience orthostatic symptoms when you stand up:

  1.  never
  2.  sometimes
  3.  often
  4.  usually
  5.  always

B. Severity of orthostatic symptoms:

How strongly do you experience orthostatic symptoms when you stand up:

  1.  none 
  2.  mild
  3.  moderate and sometimes have to sit back down for relief.
  4.  severe and frequently have to sit back down for relief.
  5.  severe and regularly faint if I do not sit back down.

C. Conditions under which orthostatic symptoms occur

Under which conditions, ,such as prolonged standing, a meal, exertion (e.g., walking), or when exposed to heat (e.g., hot day, hot bath, hot shower). do you experience orthostatic symptoms:

  1.  never or rarely
  2.  sometimes
  3.  often
  4.  usually
  5.  always, the specific conditions do not matter.

D. Activities of daily living:

Do your orthostatic symptoms interfere with activities and daily living (e.g., work, chores, dressing, bathing)?

  1. do not interfere.
  2. mildly interfere.
  3. moderately interfere.
  4. severely interfere.
  5. severely interfere. I am bed or wheelchair bound because of my symptoms.

E. Standing time:

On most occasions how long can you stand without experiencing orthostatic symptoms?

  1. as long as necessary
  2. more than 15 minutes
  3. 5-14 minutes
  4. 1-4 minutes
  5. less than I minute

Scores of 9 or higher suggest Orthostatic Intolerance.

For in depth information on OI, see: