How to Treat Fainting

Syncope, otherwise known as fainting, is the sudden, brief loss of consciousness caused by diminished blood flow to our brain. About one in five people experience this at least once, and about one in ten may have repeated episodes of syncope, causing millions of emergency room visits and hospitalizations. Though fainting can be caused by heart problems, it is most often triggered simply by vasovagal reactions, such as standing (because blood pools in our legs) or strong emotions. “Under certain circumstances, such as blood donation, syncope has important medical and societal significance” as fainting may, for example, prevent donors from wanting to give blood again. Indeed, more than 150,000 people experience fainting or near-fainting spells each year when they donate blood.

Speaking of the medical and societal significance, what about fainting while driving? It goes without saying that losing consciousness while driving can pose a serious threat to both the patient and society. Of a group of individuals getting tested for syncope, 9 percent reported they had lost consciousness while driving.

When syncope happens repeatedly, drugs and surgery are used, such as installing a pacemaker. But such “therapy is expensive, efficacy is questionable, and adverse effects are common.” In fact, “results of most drug treatment trials have been disappointing” and the “value of implanting pacemakers has been repeatedly questioned, and now there is evidence of their lack of effectiveness.” So, what do we do?

According to one study, “In Italy, the older generation of general practitioners advised patients prone to fainting to carry a wooden egg (used in the old days for darning socks) and to apply muscle tension by gripping the wooden egg forcefully as soon as a faint was imminent.” These folklore stories inspired an Italian cardiologist to apply arm muscle tensing to combat vasovagal fainting, but it had not been put to the test until recently. 

About a minute before losing consciousness, most people about to faint experience so-called prodromal symptoms—that is, they feel dizzy, queasy, or break out into a sweat, signaling they are just about to blackout. When that happens, there are a number of maneuvers shown to successfully abort the impending episode. One is called isometric arm counter-pressure, where you grip one hand in the other and exert pressure, trying to pull apart your arms, and continuing to do so until the symptoms go away. How successful is it? Patients were shown how to do it and reported it was successful 99 percent of the time. Safe and effective, isometric arm counter-pressure is proposed to be the new first-line treatment for those who start to feel faint. You can see a picture of this move in my video How to Prevent Fainting.

Leg crossing and muscle tensing have also been shown to work. You cross your legs and squeeze them together as you tense your leg, stomach, and butt muscles. Safe, inexpensive, and effective, no wonder researchers propose having patients try this before having a cardiac pacemaker surgically implanted. Squatting is another maneuver if all else fails.

Is there anything we can do to prevent the symptoms in the first place? Do we have to wait until we’re dizzy, clammy, and nauseated? Well, also cheap, safe, and effective, simply drinking water can prevent fainting. If you know that needles, for example, make you woozy, five minutes before you get stuck, chug down two cups of water, which can dramatically stabilize blood pressures within minutes in people who are predisposed to fainting, and it has similar effects in normal healthy adults.

“The fact that acute ingestion of water exerts such profound effects may be exploited” by blood donation programs to help prevent people from fainting. It is also the current recommended treatment for so-called blood, injury, or injection phobia, which is actually pretty common, affecting about 1 in 25 people, 75 percent of whom “report a history of fainting in response” to needle sticks. The problem is not just that they won’t donate blood. Avoiding anything related to blood, injury, and injections could pose a particularly serious threat if people neglect to seek medical care when necessary. However, all one may need to do is preload with two cups of water. “The knowledge that such simple self-help maneuvers are readily available and could be lifesaving should prove valuable and helpful in everyday life.”

Quench your curiosity about proper hydration with these videos:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

A Dietary Treatment for Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a chronic, episodic intestinal disorder characterized by abdominal pain and altered bowel habits. It affects 1 in 7 Americans, although most go undiagnosed. IBS can have a substantial impact on well-being and health, but doctors underestimate the impact the disease can have, particularly the pain and discomfort. Using some measures, the health-related quality of life of irritable bowel sufferers can rival that of sufferers of much more serious disorders, such as diabetes, kidney failure, and inflammatory bowel diseases. The first step toward successful treatment is for doctors to acknowledge the condition and not just dismiss the patient as just hysterical or something.

Another reason sufferers often don’t seek medical care may be the lack of effectiveness of the available treatments. There is a huge unmet therapeutic need. Since IBS has no cure, treatment is targeted to alleviate the symptoms. Typical antispasmodic drugs can cause side effects, including dry mouth, dizziness, blurred vision, confusion, and fall risk. New drugs now on the market, like Lubiprostone and Linaclotide, can cost up to $3,000 a year and can cause as side effects many of symptoms we’re trying to treat.

Antidepressants are commonly given but may take weeks or even months to start helping. Prozac or Celexa take 4 to 6 weeks to help, and Paxil can take up to 12 weeks. They also have their own array of side effects, including sexual dysfunction in over 70% of the people who take these drugs.

There’s got to be a better way.

Acupuncture works, but not better than placebo. Placebo acupuncture? That’s where you poke people with a fake needle away from any known acupuncture points. Yet that worked just as well as real acupuncture, showing the power of the placebo effect.

I’ve talked about the ethics of so many doctors who effectively pass off sugar pills as effective drugs, arguing that the ends justify their means. There’s actually a way to harness the placebo effect without lying to patients, though. We tell them it’s a sugar pill. Patients with irritable bowel syndrome were randomized to either get nothing or a prescription medicine bottle of placebo pills with a label clearly marked “placebo pills” “take 2 pills twice daily.” I kid you not.

Lo and behold, it worked! That’s how powerful the placebo effect can be for irritable bowel. They conclude that for some disorders it may be appropriate for clinicians to recommend that patients try an inexpensive and safe placebo. Indeed, sugar pills probably won’t cost $3,000 a year. But is there a safe alternative that actually works?

As you can see in my video, Peppermint Oil for Irritable Bowel Syndrome, nine randomized placebo-controlled studies have indeed found peppermint oil to be a safe and effective treatment for irritable bowel syndrome. A few adverse events were reported, but were mild and transient in nature, such as a peppermint taste, peppermint smell, and a cooling sensation around one’s bottom on the way out. In contrast, in some of the head-to-head peppermint versus drug studies, some of the drug side effects were so unbearable that patients had to drop out of the study. This suggests it might be a reasonable approach for clinicians to treat IBS patients with peppermint oil as a first-line therapy, before trying anything else.

The longest trial only lasted 12 weeks, so we don’t yet know about long-term efficacy. The benefits may last at least a month after stopping, though, perhaps due to lasting changes in our gut flora.

The studies used peppermint oil capsules so researchers could match them with placebo pills. What about peppermint tea? It’s never been tested, but one might assume it wouldn’t be concentrated enough. However, a quarter cup of fresh peppermint leaves has as much peppermint oil as some of the capsule doses used in the studies. One could easily blend it into a smoothie or with frozen berries to make something like my pink juice recipe. You can grow mint right on your window sill.

We doctors need effective treatments that “are cheap, safe, and readily available. This is particularly relevant at the present time as newer and more expensive drugs have either failed to show efficacy or been withdrawn from the market owing to concerns about serious adverse events.” Just like it may be a good idea to only eat foods with ingredients you can pronounce, it may be better to try some mint before novel pharmacological approaches, such the new dual mu-opioid agonist delta-antagonist drug with a name like JNJ-27018966.

I have some other mint videos: Enhancing Athletic Performance With Peppermint and Peppermint Aromatherapy for Nausea. Lemon balm is also in the mint family, so check out Reducing Radiation Damage With Ginger & Lemon Balm and Best Aromatherapy Herb for Alzheimer’s.

You can also sprinkle dried mint on various dishes. See Antioxidants in a Pinch.

What else might work for IBS? See Kiwifruit for Irritable Bowel Syndrome and Cayenne Pepper for Irritable Bowel Syndrome and Chronic Indigestion.

Irritable bowel symptoms can overlap with problems with gluten, so make sure your physician rules out celiac disease. These may be helpful:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Ginger Root for Migraines

Many successful herbal treatments start like this: Some doctor learns that some plant has been used in some ancient medical tradition, like ginger for headaches. Well, the physician has patients with headaches and so tries advising one with migraines to give it a try since it’s just some safe, common spice. At the first sign of a migraine coming on, the patient mixed a quarter teaspoon of powdered ginger in some water, drank it down, and poof! Within a half-hour, the migraine went away. It worked every time for them with no side effects. That’s what’s called a case report.

In my video, Ginger for Migraines, I show the remarkable case report, but case reports are really just glorified anecdotes. Case reports have played an important role in the history of medicine, though. AIDS was first discovered as a series of case reports. Some young guy walks into a clinic in Los Angeles with a bad case of thrush, and the rest is history. Reports of an unusual side effect of a failed chest pain drug led to the billion-dollar blockbuster, Viagra. Case reports may represent the weakest level of evidence, but they are often the first line of evidence, where everything starts. The ginger and migraine report isn’t helpful in itself, but it can inspire researchers to put the treatment to the test.

The problem is, who’s going to fund it? The market for migraine drugs is worth billions of dollars. A quarter teaspoon of powdered ginger costs about a penny. Who would fund a study pitting ginger versus the leading migraine drug?

No one… that is, until now. A double-blinded, randomized, controlled, clinical trial compared the efficacy of ginger to sumatriptan, also known as Imitrex, one of the top-selling billion-dollar drugs in the world in the treatment of migraine headaches. Researchers tried using only one-eighth of a teaspoon of powdered ginger versus a good dose of the drug.

They both worked just as well and just as fast.

Most patients started out in moderate or severe pain but, after taking the ginger or the drug, ended up in mild pain or completely pain-free. The same proportion of migraine sufferers reported satisfaction with the results either way. As far as I’m concerned, ginger won—not only because it’s a few billion dollars cheaper than the drug, but because there were significantly fewer side effects in the ginger group. People taking sumatriptan reported dizziness, a sedative effect, vertigo, and heartburn. The only thing reported for ginger was an upset tummy in about 1 out of 25 people. (As a note of caution, taking a whole tablespoon of ginger powder at one time on an empty stomach could irritate anyone’s stomach.)

An eighth of a teaspoon of ginger is not only up to 3000-times cheaper than the drug, but you’re also less likely to end up as a case report yourself of someone who had a heart attack or died after taking the drug—tragedies that have occurred due to sumatriptan.

These are my favorite kinds of posts to do because I can offer something that is immediately practical, cheap, safe, and effective to reduce suffering. If this kind of information helps you or someone you love, I hope you’ll consider making a tax-deductible donation to support the nonprofit organization that runs NutritionFacts.org. We have a growing staff and server costs to cover, and any help you could give would be much appreciated (and there are perks!).

For more on ginger root:

Avoiding aspartame (Aspartame and the Brain) and using lavender may also help (Lavender for Migraine Headaches). If you have cluster headaches, ask your physician about capsaicin (Hot Sauce in the Nose for Cluster Headaches?).

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: