Brief Answer:
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Detailed Answer:
Hello XXXX,

Before trying to fix this with herbals, I recommend further work up.

First, has your doctor taken orthostatic blood pressure and pulse readings? If there is a drop in systolic blood pressure of 20 or more or diastolic of 10 or more, or an associated rise in pulse, then that constitutes an orthostatic blood pressure change.

Here is the procedure explained by the CDC (copy and paste link into address bar to see it) https://www.cdc.gov/steadi/pdf/measuring_orthostatic_blood_pressure-a.pdf

Causes of orthostatic blood pressure changes include anxiety, but chalking it up to anxiety should be made by excluding medical causes, unless the anxiety is blatantly uncontrolled, such as with panic attacks.

If you had a CBC done which was normal, that rules out anemia.

But you should definitely also have an EKG done, or a cardiac stress test, if the orthostasis is documented.

Medications are always suspect and it is possible that the Cymbalta may be contributing to it un less you had it before you were on Cymbalta.

I assume, when you say you had a full blood work up that that included a thyroid panel? If not, get that checked as thyroid abnormalities can cause BOTH fatigue and anxiety.

Inadequate hydration can cause light headedness, but not usually fatigue.

Alcohol can cause light headedness in some people, even remotely after drinking.

Adrenal insufficiency can cause both fatigue and light headedness, and muscle weakness or achiness.

Other endocrine problems can cause symptoms too.

Finally, some people have autonomic nervous system dysfunction and treatment is increased salt and water for some types.

I would be happy to tell you about Ginko Biloba if you still wish, but you can also look that up on the Memorial XXXXXXX Kettering Herbal site (which I use for professional researched data).

But first, best to make sure all reasons for the light headedness and fatigue have been evaluated.

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Brief Answer:
Thoughts on this

Detailed Answer:
So specific orthostatic blood pressure and pulse readings were done with you lying down, seated, and standing as described? It isn't a matter of what your blood pressures are normally, it's a matter of the change in blood pressure readings when you change position. If the nurse at your doctor's office isn't skilled at this, a tilt table test will do the job.

There are herbals for low adrenal function but before embarking on taking one of those, it's important to determine your ACTH and 8 am cortisol levels. The adrenal glands and pituitary/hypothalamus work on a feedback loop. So if you take an herb that has corticosteroid effects, that will tell your pituitary to produce less ACTH (adrenocorticotropic hormone). If you produce less ACTH, your adrenal function will get turned down and you will not respond to stress situations with increased cortisol. This effect can last for weeks to months. If you are not then taking enough of the corticosteroid when you then encounter stress (both physical and mental), with the adrenal gland turned down, you can get pretty sick, because you won't have enough cortisol to rise to the occasion. So it's better to know where things are at before taking exogenous corticosteroids.

Also, some of these herbs can compound the anxiety problem. But in general, herbs that are used for this purpose are licorice (best if combined with other things as Traditional Chinese Medicine practitioners do), and Siberian Ginseng.

You may benefit, however, from a vitamin B complex, which the adrenals do need to function well. This can be used without having negative hormonal consequences.

Have you had an EKG or exercise stress test? Because cardiac causes are common reasons for light headedness. These include everything from valvular problems to arrhythmias.

It's really hard to say what you should take to help with the light headedness without knowing what the underlying problem is that needs to be treated. In general, for people's who's blood pressures run on the lower side like yours does, increasing table salt can help.

For adrenal support I recommend Vitamin B complex, Vitamin C, and magnesium. But careful with the magnesium - just start with a little, because it can cause diarrhea and weak muscles.

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