Its part of Hypermobility in a way and I have often wondered why i get blurred vision, problems swallowing dry chips and food and having really low blood pressure at times, mainly after eating and after standing.
- lightheadedness, sometimes called pre-syncope (pre-fainting) dizziness (but not vertigo, which is also called dizziness)
- exercise intolerance
- extreme fatigue
- syncope (fainting)
- Excessive thirst (polydipsia)
- cold extremities
- chest pain and discomfort
- muscle weakness
- visual disturbances
- brain fog
- decreased mental stamina
- difficulty finding the right word
- impaired concentration
- sleep disorders
- POTS is often accompanied by vasovagal syncope, also called "neurally mediated hypotension" (NMH) or "neurocardiogenic syncope" (NCS). Vasovagal syncope is a fainting reflex due to a profound drop in blood pressure. Autonomic dysfunction that occurs with these disorders causes blood to inappropriately pool in the limbs away from the heart, lungs, and brain. The combination of misdirected bloodflow and hypotension will invoke syncope. Tachycardia associated with POTS may be a cardiac response to restore cerebral perfusion.
- POTS may be a cause of chronic fatigue syndrome in patients that exhibit signs of orthostatic intolerance. Treating POTS will greatly improve or even eliminate disabling fatigue for these patients.
- Some patients with fibromyalgia complain of dysautonomia-related symptoms. Treating these patients for POTS will often improve myofascial and neuropathic pain.
- Autonomic dysfunction is most likely responsible for irritable bowel syndrome in many patients as well.
- Patients with Ehlers-Danlos syndrome may also have POTS. Joint hypermobility is a feature of the most common subtype of Ehlers-Danlos.
- Some POTS patients experience symptoms associated with restless leg syndrome. Treating POTS should also relieve these symptoms.
- Some findings link this with hypermobility
- A small percentage of pediatric cases of POTS have been associated with moderate to severe memory loss.
- Drinking more water improves symptoms for nearly all patients. Most patients are encouraged to drink at least 64 ounces (two liters) of water or other fluids each day.
- Alcohol has been shown to drastically exacerbate all types of orthostatic intolerancevasodilation and dehydration properties. In addition to its adverse effects, it interacts unfavorably with many of the medications prescribed to POTS patients. due to its
- Eating frequent, small meals can reduce gastrointestinal symptoms associated with POTS by requiring the diversion of less blood to the abdomen.
- Increasing salt intake, by adding salt to food, taking salt tablets, or drinking sports drinks and other electrolyte solutions, is a treatment used for many people with POTS; however, salt is not recommended for all patients. Increasing salt is an effective way to raise blood pressure in many patients with orthostatic hypotension by helping the body retain water and thereby expand blood volume. Different physicians recommend different amounts of sodium to their patients.
- Diets high in carbohydrates have been connected to impaired vasoconstrictive action. Eating foods with lower carbohydrate levels can mildly improve POTS symptoms.
- Caffeine helps some POTS patients due to its stimulative effects; however, other patients report a worsening of symptoms with caffeine intake.
- Tilting of bed to an angle of roughly 30 degrees can also help reduce symptoms. (Feet up, head down.)
Physical therapy and exercise
- Angiotensin converting enzyme inhibitors, or ACE inhibitors, are used to increase vascular capacity, cardiac output, and sodium and water excretion.
- Clonidine can work in patients with reduced sympathetic activity. Clonidine lowers catecholamine(epinephrine and norepinephrine) production.
- Disopyramide, or Norpace, is an antiarrhythmic medication that inhibits the release of epinephrine and norepinephrine.
- Erythropoietin, used to treat anemia via intravenous infusion, is very effective at increasing blood volume. It is seldom used, however, due to the dangers of increasing the hematocrit, the inconvenience of intravenous infusion, and its prohibitively expensive cost.
- Pregabalin or Lyrica, an anticonvulsant drug, has been shown to be especially effective in treating neuropathic pain associated with POTS. In fact, Lyrica was the first and, for its first year on the market the only, prescription drug approved by the FDA to treat fibromyalgia. Some POTS patients also report improvement in concentration and energy while on Lyrica.
- Pseudoephedrine and phenylephrine, over the counter decongestants, increase vasoconstriction by promoting the release of norepinephrine.
- Pyridostigmine, or Mestinon, inhibits the breakdown of acetylcholine, promoting autonomic nervous system activity. It is especially effective in patients who exhibit symptoms of excessive sympathetic activity.
- Theophylline, a drug used to treat respiratory diseases such as COPD and asthma, is occasionally prescribed at low doses for POTS patients. Theophylline increases cardiac output, increases blood pressure, and stimulates epinephrine and norepinephrinetherapeutic index, Theophylline is known to cause a wide variety of side-effects and even toxicity. production. Due to its very narrow
- Women who report a worsening of symptoms during menstruation will often use combined (containing both estrogen and progestin) forms of hormonal contraception to prevent hormonal changes and an aggravation of their condition.