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Blood Volume Inadequate fluids Low sodium intake Blood loss or anemia Low calorie intake Deconditioning Illness Prolonged inactivity Bed rest Reduced leg-muscle pump Connective Tissue Joint hypermobility Hypermobility spectrum disorders Hypermobile EDS Venous pooling Post-Infectious / Immune Viral illness Post-viral syndromes Long COVID Autoimmune autonomic neuropathy Medication & Metabolic Stimulants Blood-pressure medications Thyroid disease Glucose instability Cellular Stress Mitochondrial dysfunction Oxidative stress Inflammation Nutrient insufficiency Mitochondria, ATP and Autonomic Regulation The autonomic nervous system has substantial and continuous energy requirements