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Signs and Symptoms
What Causes It?
Who's Most At Risk?
What to Expect at Your Provider's Office
Treatment Options
Prognosis/Possible Complications
Following Up
Supporting Research

Shock is characterized by inadequate circulatory provision of oxygen, which causes your vital organs and tissues to shut down. It typically occurs when your blood pressure falls to a very low level, either from reduced cardiac output, or from reduced effective circulating blood volume. As your blood pressure falls, your brain and other organs don't get enough blood or oxygen to function, and they begin to fail. Shock can arise from any of a number of causes. It is a life-threatening medical emergency and must be treated early to avoid serious complications and even death.

Signs and Symptoms

Common signs and symptoms of shock include:

  • Low blood pressure
  • Altered mental state, including reduced alertness and awareness, confusion, and sleepiness
  • Cold, moist skin. Hands and feet may be blue or pale
  • Weak or rapid pulse
  • Rapid breathing and hyperventilation
  • Decreased urine output
  • In septic shock (from overwhelming blood infection) -- shaking chills, rapid temperature increase, warm, flushed skin, and rapid pulse
  • In shock related to heart problems -- lung congestion, rapid pulse, heart murmur, enlarged neck veins

What Causes It?

Shock can have several causes. Doctors classify shock according to categories:

  • Loss of fluid in the bloodstream (hypovolemic shock) -- occurs after heavy bleeding from an injury or a condition, such as bleeding ulcers. Hypovolemic shock can also occur if your body loses too many fluids other than blood (such as losing water after severe diarrhea or vomiting, or losing plasma after serious burns).
  • Blood vessels become too dilated (distributive shock) -- If the blood vessels expand too much, they are not able to keep blood circulating to all organs. Septic shock, which occurs when bacteria invade the bloodstream, and anaphylactic shock, which is a severe allergic reaction, are examples.
  • Heart problems (cardiogenic shock) -- In this case, the heart doesn't pump enough blood through the body. It can be caused by a heart attack, abnormal heart rhythm, or damage to the heart from heart disease.

Who's Most At Risk?

The following conditions and characteristics increase the risk for shock:

  • Serious injury and trauma
  • Heart conditions, such as heart disease or heart attack
  • Surgery
  • Bacterial infection that has spread to the blood
  • Bleeding
  • Losing large volume of fluids from severe diarrhea or vomiting
  • Excessive alcohol use
  • Severe anemia
  • Weakened immune system
  • Allergic reaction to a drug, food, or environmental exposure
  • Drug overdose
  • Pregnancy

What to Expect at Your Provider's Office

Shock is an emergency and requires immediate conventional treatment. Your health care provider will diagnose shock based on your symptoms and any information about underlying disease or recent injury. Your health care provider will check blood pressure, assess mental status (memory, orientation, and alertness), measure urine output, and order blood tests to check heart, lung, and kidney function and search for evidence of sepsis (blood infection). Imaging and other procedures -- such as x-ray, electrocardiography (ECG), echocardiography, and ultrasonography -- may be performed to check the heart.

Treatment Options


If you have heart disease or another condition that makes you susceptible to shock, you should seek treatment for that condition. If you have severe allergies, avoid substances that may trigger anaphylactic shock and carry self-injectable epinephrine to treat anaphylaxis.

Treatment Plan

The main goals of treatment are to maintain blood pressure and to make sure the person's vital organs get enough blood and oxygen. First aid for shock includes having the person lie on their back, raising their legs to help blood return to the heart, stopping any bleeding, covering them with a coat or blanket to ensure warmth, and performing cardiopulmonary resuscitation (CPR), if needed. Emergency medical staff will administer oxygen, and in the case of hypovolemic and septic shock, intravenous fluids.

Drug Therapies

The following medications may be used to treat shock:

  • Drugs that increase pressure in the arteries and help the heart pump more blood, such as dopamine, dobutamine, and norepinephrine
  • Medications to either dilate or constrict blood vessels (depending on the cause of shock)
  • Antibiotics for septic shock, to combat wide-ranging infection
  • Corticosteroids to reduce the incidence of vasopressor dependent septic shock
  • Thrombolytic therapy (drugs that dissolve clots as they form) may be considered in the case of heart attack or pulmonary embolism

Complementary and Alternative Therapies

Shock is always life threatening and requires emergency conventional medical care. Some complementary and alternative therapies, however, may be used along with conventional treatment after a person's condition stabilizes, to help prevent shock. For instance, certain nutrients may help protect against the harmful effects of shock and improve the outcome of conventional treatment.

Nutrition and Supplements

Oxidative stress (damage to cells caused by the body's normal use of oxygen) may play a role in shock. Several studies show that antioxidants that help rid the body of free radicals (harmful byproducts of the oxidative process) may protect against some types of shock. However, most of these have been animal studies. It is not known whether or not these supplements will also benefit humans.

You may address nutritional deficiencies with the following supplements:

  • A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals such as magnesium, calcium, zinc, and selenium.
  • Omega-3 fatty acids, such as fish oil (1 - 2 capsules or 1 - 2 tablespoonfuls daily), for inflammation. Omega-3 fatty acids can have a blood thinning effect and can interact with other blood thinning medications, such as Coumadin (warfarin) and aspirin.
  • Vitamin C, 1 - 6 gm daily, as an antioxidant. You may use higher doses. If diarrhea develops, lower dosage.
  • Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant support. Coenzyme Q10 can have a blood thinning effect and can interact with other blood thinning medications, such as Coumadin (warfarin) and aspirin.
  • Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support. People who are malnourished from alcoholism or other reasons, or who have low levels of Thiamine (B1) should not take alpha-lipoic acid without first increasing their levels of Thiamine due to the potential for dangerous side effects.
  • L-carnitine, 500 - 2000 mg daily for support of a healthy cardiovascular system. A study of 115 patients with septic, cardiac, or traumatic shock showed that acetyl-L-carnitine helped return heart rate and blood pressure to normal and boosted oxygen delivery throughout the body. L-carnitine may interact with some medications, including thyroid hormone, Coumadin (warfarin), and others; speak with your physician.
  • Resveratrol (from red wine), 50 - 200 mg daily, for antioxidant effects.


Since shock always requires emergency conventional medical treatment, it should never be treated with herbs. Talk to your doctor before taking any herbs to treat or prevent shock.


No scientific studies have evaluated homeopathic remedies for the treatment of shock. The remedy aconite, however, is often used by homeopathic doctors for emergency conditions. In homeopathic remedies, aconite is highly diluted, and only a trace amount of the herb is present, so it is not toxic in a homeopathic formulation.

Prognosis/Possible Complications

If someone suffering from shock receives immediate treatment, the prognosis is good. Immediate treatment for anaphylactic shock, for example, usually results in complete recovery. But any case of shock is life threatening, regardless of its cause, particularly in the elderly. Shock often causes organ damage (including the kidneys, brain, and liver), cardiac arrest, and respiratory failure. More than 90% of young, otherwise healthy patients with hypovolemic shock survive with appropriate treatment. In comparison, septic shock, or shock associated with heart problems, can have substantially worse mortality rates, even with optimal care.

Following Up

If you are suffering from shock, you will likely be admitted to intensive care. Following treatment, your health care provider will carefully monitor your condition, including temperature, blood pressure, heart function, urine flow, and blood chemistry.

Supporting Research

Corbucci GG, Loche F. L-carnitine in cardiogenic shock therapy: pharmacodynamic aspects and clinical data. Int J Clin Pharmacol Res. 1993;13(2):87-91.

De la Fuente M, Victor VM. Anti-oxidants as modulators of immune function. Immunol Cell Biol. 2000;78(1):49-54.

Farolan LR, Goto M, Myers TF, Anderson CL, Zeller WP. Perinatal nutrition enriched with omega-3 polyunsaturated fatty acids attenuates endotoxic shock in newborn rats. Shock. 1996;6(4):263-266.

Gasparetto A, Corbucci GG, De Blasi RA, et al. Influence of acetyl-L-carnitine infusion on haemodynamic parameters and survival of circulatory-shock patients. Int J Clin Pharmacol Res. 1991;11(2):83-92.

Greenberg SS, Xie J, Zatarain JM, Kapusta DR, Miller MJ. Hydroxocobalamin (vitamin B12a) prevents and reverses endotoxin-induced hypotension and mortality in rodents: role of nitric oxide. J Pharmacol Exp Ther. 1995;273(1):257-65.

Groeneveld AB, Molenaar N, Beishuizen B. Should we abandon corticosteroids during septic shock? No. Curr Opin Crit Care. 2008;14(4):384-9.

Hochman JS, Sleeper LA, Webb JG, et al. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. N Engl J Med. 1999;341(9):625-34.

Jack RA. Aconite -- the number one shock and fever medicine. Hahnemannian. 1986;121(3):5-6.

Kliegman: Nelson Textbook of Pediatrics, 18th ed. Philadelphia, PA: Saunders Elsevier. 2007.

Kumar: Robbins and Cotran Pathologic Basis of Disease, Professional Edition, 8th ed. Philadelphia, PA: Saunders Elsevier. 2009.

Lelli JL, Drongowski RA, Gastman B, Remick DG, Coran AG. Effects of Coenzyme Q10 on the mediator cascade of sepsis. Circ Shock. 1993;39(3):178-187.

Lodha R, Arun S, Vivekanandhan S, Kohli U, Kabra SK. Myocardial cell injury is common in children with septic shock. Acta Paediatr. 2009;98(3):478-81.

Mendez C, Jurkovich GJ, Wener MH, Garcia I, Mays M, Maier RV. Effects of supplemental dietary arginine, canola oil, and trace elements on cellular immune function in critically injured patients. Shock. 1996;6(1):7-12.

Mitra SK, Gupta M, Suryanarayana T, Sarma DN. Immunoprotective effect of IM-133. Int J Immunopharmacol. 1999;21(2):115-120.

Sligl WI, Milner DA, Sundar S, Mphatswe W, Majumdar SR. Safety and efficacy of corticosteroids for the treatment of septic shock: A systematic review and meta-analysis. Clin Infect Dis. 2009;49(1):93-101.

Victor VV, Guayerbas N, Puerto M, Medina S, De la Fuente M. Ascorbic acid modulates in vitro the function of macrophages from mice with endotoxic shock. Immunopharmacology. 2000;46(1):89-101.

Weimann A, Bastian L, Bischoff WE, et al. Influence of arginine, omega-3 fatty acids and nucleotide-supplemented enteral support on systemic inflammatory response syndrome and multiple organ failure in patients after severe trauma. Nutrition. 1998;14(2):165-172.

Winter BK, Fiskum G, Gallo LL. Effects of L-carnitine on serum triglyceride and cytokine levels in rat models of cachexia and septic shock. Br J Cancer. 1995;72(5):1173-1179.

Yamada M. Effects of coenzyme Q10 in hemorrhagic shock. Crit Care Med. 1990;18(5):509-514.

Zingarelli B, Salzman AL, Szabo C. Protective effects of nicotinamide against nitric oxide-mediated delayed vascular failure in endotoxic shock: potential involvement of polyADP ribosyl synthetase. Shock. 1996;5(4):258-264.

Review Date: 10/11/2010
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Conditions with Similar Symptoms
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Carnitine (L-carnitine)
Coenzyme Q10
Docosahexaenoic acid (DHA)
Eicosapentaenoic acid (EPA)
Omega-3 fatty acids
Vitamin B12 (cobalamin)
Vitamin B3 (Niacin)
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