Withdrawal Symptoms After Quitting Smoking: A Focus on Blood Pressure Issues - Smoking Cessation

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Symptoms after starting to quit smoking?


I experienced symptoms of orthostatic hypotension 17 hours after I stopped smoking, and they were extremely severe.
I first lost my sense of balance, my vision went black, and I fell to the ground and couldn't get back up, which can also be described as fainting.
I have had similar episodes in the past, but they were not as severe; I would typically regain my vision within 30 seconds, but now I have nearly lost my sight for 5 minutes, along with a loss of balance and severe tinnitus.
I am unable to sleep, feel weak and sore all over, and have no appetite.
I have thalassemia, but it has not affected my daily life until now, which is 28 hours after quitting.
I have not been able to swallow any food.
I can only lie on a chair or bed, and if I need to get up, I have to sit for about 10 minutes to alleviate the fainting symptoms.
Would supplementing with large amounts of vitamin B12, vitamin D, salt, and iron help alleviate these symptoms? Is this issue caused by a drop in blood pressure due to not smoking? If so, when can I expect to return to normal?

Z, 10~19 year old female. Ask Date: 2004/11/28

Dr. Tang Xinbei reply Smoking Cessation


Dear friend: It seems that quitting smoking has triggered some uncomfortable reactions for you! Generally, withdrawal symptoms from smoking cessation are mild and commonly include: mood swings or feelings of sadness, insomnia, irritability, frustration or anger, anxiety, difficulty concentrating, decreased heart rate, increased appetite or weight gain.
Other symptoms such as dry mouth, increased rapid eye movement (REM) sleep leading to vivid dreams, headaches, skin tingling, and cravings for cigarettes are also quite common.
Of course, after quitting smoking, blood pressure tends to decrease, which may contribute to your discomfort.
Your symptoms, occurring in a time sequence after quitting smoking, may be related to this change, but it cannot be definitively concluded that this is the sole cause, as other factors may also be involved.
Since your issue is related to the balance system, I recommend that you visit a nearby comprehensive hospital's neurology or otolaryngology department for evaluation and examination by a qualified healthcare professional.
Wishing you peace, joy, and success in quitting smoking!

Reply Date: 2004/11/28

More Info


Quitting smoking can lead to a variety of withdrawal symptoms, and your experience with severe postural hypotension (a drop in blood pressure when standing) is concerning and warrants attention. The symptoms you describe, including loss of balance, temporary vision loss, tinnitus (ear ringing), and overall weakness, can be distressing and may indicate a more complex physiological response to the cessation of nicotine and other substances found in cigarettes.

When you quit smoking, your body undergoes significant changes as it adjusts to the absence of nicotine. Nicotine has a stimulating effect on the central nervous system and can influence blood pressure and heart rate. When you stop smoking, your body may experience a rebound effect, leading to fluctuations in blood pressure. This can manifest as postural hypotension, particularly when moving from a sitting or lying position to standing. The fact that you have experienced these symptoms 17 hours after quitting suggests that your body is reacting strongly to the absence of nicotine.

Your history of Mediterranean anemia (thalassemia) may also play a role in your current symptoms. Individuals with thalassemia can experience various complications, including issues with blood volume and oxygen transport, which may exacerbate feelings of weakness and dizziness, especially during times of physiological stress, such as quitting smoking.

Regarding your question about whether taking vitamin B12, vitamin D, salt, and iron can help alleviate your symptoms, it's important to note that while these nutrients are essential for overall health, they may not directly address the withdrawal symptoms you are experiencing. Vitamin B12 is crucial for red blood cell production and neurological function, while vitamin D is important for bone health and immune function. Iron is essential for hemoglobin production, which is particularly relevant given your thalassemia. However, supplementation should be approached cautiously and ideally under the guidance of a healthcare provider, especially since you are experiencing significant symptoms.

As for the timing of when your blood pressure and overall health will stabilize after quitting smoking, this can vary widely among individuals. Some people may notice improvements in their symptoms within days to weeks, while others may take longer. Factors such as your overall health, the duration and intensity of your smoking habit, and any underlying medical conditions will influence your recovery timeline.

It is crucial that you seek medical attention as soon as possible. A healthcare professional can conduct a thorough evaluation, including checking your blood pressure in different positions, assessing your anemia, and ruling out any other potential causes for your symptoms. They may also recommend specific treatments or interventions to help manage your withdrawal symptoms and ensure your safety during this transition.

In summary, while quitting smoking is a significant and positive step for your health, the withdrawal symptoms you are experiencing, particularly the severe postural hypotension, require immediate medical evaluation. Your healthcare provider can help you navigate this challenging period and provide the support you need to achieve a successful and healthy transition away from smoking.

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