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Fluids

Inadequate fluid intake, if persistent and significant, can result in dehydration and associated fatigue and/or malaise.  However, patients with autonomic dysregulation are at risk for vascular dysautonomia and may experience orthostatic changes in blood pressure and heart rate.  An inadequate intake of fluids can result in dizziness or lightheadedness, syncope, and significant fatigue, and may be associated with chronic nausea and vomiting, as well as an increase in migraine frequency and severity.

Although most individuals can accommodate a suboptimal intake of liquid (by concentrating their urine appropriately), patients with vascular dysautonomia may show significant clinical symptoms unless they are able to take in their daily requirement, or more (fruits and vegetables count toward the total daily fluid volume).  Gut dysmotility may impact a patient's ability to meet this requirement enterally.  Intravenous fluids can provide an effective alternative though with a risk of complications.

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