POTS Syndrome and Chronic Fatigue

Discussion in 'Fibromyalgia Main Forum' started by Empower, Dec 16, 2005.

  1. Empower

    Empower New Member

    I was wondering how many with CFS were also diagnosed with POTS.

    It makes so much sense...The symptoms are VERY similar to mine.

  2. twerp

    twerp New Member

    I don't think I've heard of it...

    Thanks & Hugs,
    Twerp
  3. Empower

    Empower New Member

    POTS: An overview

    Medical disclaimer Make a difference




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    Standing up is something most of us take for granted; we've been doing it since childhood. Our bodies automatically adjust to the pull of gravity by increasing vascular tone, heart rate and cardiac output. Blood vessels contract, heart rates increase and our systolic blood pressure remains the same or decreases slightly while diastolic pressure increases slightly (Brunner & Suddarth, 2000, p. 546). Our bodies operate in perfect homeostasis and we stand up with little effort.

    However, the simple act of standing up can be a challenge for some people. There are disorders that affect the body's ability to appropriately adjust to the pull of gravity. When the body cannot effectively adjust to upright posture a person is said to have orthostatic intolerance. Postural orthostatic tachycardia syndrome (POTS) is a disorder characterized by orthostatic intolerance.

    Postural orthostatic tachycardia syndrome is defined by excessive heart rate increments upon upright posture. A person with POTS will experience heart rates that increase 30 beats or more per minute upon standing and/or increase to 120 beats or more per minute upon standing (Grubb, 2000). These exaggerated heart rate increases usually occur within 10 minutes of rising.

    While the hallmark of this disorder is an excessive heart rate increment upon standing, patients often exhibit numerous symptoms of autonomic nervous system dysregulation. It is the autonomic nervous system (ANS) that regulates the needed adjustments in vascular tone, heart rate and blood pressure upon standing. The ANS is also responsible for regulating a multitude of other organs and functions throughout the body. Some of these functions include temperature, pupil dilation and constriction, salivation and the digestive tract. A patient experiencing ANS dysregulation may experience abnormalities in the many organs and functions the ANS regulates.

    Patients can be affected by different varieties of POTS. The distinct varieties may have numerous causes. Patients with the hyperadrenergic variety are affected by excessive sympathetic activity that is not turned off appropriately by the baroreflex (Grubb, 2000). These patients often have high serum catecholamine levels, decreased norepinephrine clearance, and resistance to the norepinephrine releasing effect of tyramine. They also experience more migraines, cold and sweaty extremities and have an excessive response to isoproterenol.

    Those said to have partial dysautonomia have a system trying to compensate for a lack of venous constriction through excessive catecholamine output (Grubb. 2000).

    Some physicians also believe there is a brain stem dysregulation form of POTS that may lead to total autonomic failure (Grubb, 2000).

    Regardless of variety, POTS patients generally fit into one of four categories upon becoming ill: constitutional, post-viral, postpartum and those whose symptoms became noticeable after their body was exposed to a severe stressor (Grubb, 2000).

    Constitutional patients have been sick all their lives. Post-viral patients developed POTS after an illness believed to be viral in nature. Postpartum patients developed POTS after giving birth. Most of the remaining patients developed POTS after being exposed to bodily stressors, such as surgery, trauma or chemotherapy.

    Regardless of category, POTS is a chronic illness that can be debilitating at times. POTS patients use about three times more energy to stand than a healthy person (Grubb, 2002). It is as if these patients are running in place all the time. Research shows that POTS patients' quality of life is similar to those with congestive heart failure and chronic obstructive pulmonary disease (Benrud-Larson, Dewar, Sandroni, Rummans, Haythornthwaite & Low, 2002) Most patients will have to make some lifestyle adjustments to cope with this disorder.

    It was once estimated that nearly 500,000 Americans had some form of orthostatic intolerance, which made standing up a challenge (Robertson, 1999). However, with research advances and growing physician education the number of patients found to have POTS symptoms is steadily rising.

    POTS patients tend to be between the ages of 15 and 50 (Grubb & McMann, 2001, p. 65). Women are 5 times more likely to develop POTS than men (Grubb & McMann, 2001, p. 65). POTS does run in some families. The onset can be sudden or gradual. The quantity and severity of symptoms varies from day to day.

    POTS symptoms are sometimes correctable if an underlying cause is discovered. Researchers are attempting to identify and treat the mechanisms and causes of POTS. Research shows that most patients will eventually be able to stand up with fewer symptoms (Low, 2000). Most POTS patients can look forward to experiencing improvement with proper treatment.

    References
  4. Sheila1366

    Sheila1366 New Member

    My nephew had it,had surgery and had it fixed.he had no symptoms of fatigue before they found it.He had to have a physical and thats when they detected the racing heart.It was beating out of control.Dr. pulled him off the treadmill so quickly that is scared everyone in the room.

    My daughter has the vasovagul spells plus FM/CFS.Her Rd recommended she go and see an endochronoligst.Her heart was checked it it was fine.She had the tilt table study it was a nightmare.

    I hope you can get some help for both problems.I know it worries you having something wrong with your heart.but I know it can be fixed and my nephew is doing just fine.

    Take care,
    Sheila
  5. vickiw

    vickiw Member

    I have both. My POTS is not all that bad compared to some other folks. It's worse some days than others.

    Typically, I have a resting pulse of 70 (prior to getting up in the morning). During the day, my pulse is usually around 82 when sitting. When I stand up, it goes up to between 100-130.

    I started on Inderal (a beta blocker) this week for the POTS. I was surprised at the difference it makes in terms of comfort. I can stand longer without feeling faint or the overwhelming need to lie down. It doesn't help with the overall CFS though.

    Vicki
  6. Solaris_Starr

    Solaris_Starr New Member

    I have had it for yrs. At first the doctors keep telling me it was anxiety! to calm down or try and put me on antianxiety meds! I knew it was not the case, I think I know the difference between having anxiety and POTS! It got to the point I could only stand for very short periods at a time. I could no longer bend forward or crouch down, lift my arms above my head and it was happening when I would be sitting as well!

    Well, finally I got a Pots test, a holter, and and 24 hr BP cuff and saw an internist. Of course all the symptoms were there and there were no excuses now! Doctors were very matter of factly, not making any more of a fuss than that. Told me laughingly that it was not big deal and I was not dying, so get on with my life!!!! What the F_ _ _! Are they kidding???

    My cardiologist told me, just take a tsp of salt in the morning if it bothers you that much!!!!!! RETARDS! and sent me on my way????

    What planet am I living on? To this day I am still trying to find a doctor who takes this seriously and treat me for it! Where are these doctors?????? What country are they in so I can go there! Don't come to Canada if you want good medical help, they are so stupid here, very backwards, kind of like a third world country! Or maybe it's just this province?????

    To this day I have to live like this.

    sorry about the rant,

    Hugs
    Solaris
  7. Tantallon

    Tantallon New Member

    I have severe problems when standing, I feel really, really ill after just a couple of minutes or so.

    I'm going to bed but will read this again tomorrow. Thanks for the info.

    Cheers,
    Sue.
  8. lenasvn

    lenasvn New Member

    My brother have POTS and is getting a (heart)surgery to correct this (he lives in Sweden). It is taken more seriously over there. I'll see if I can get some info about it.
  9. Sandyz

    Sandyz New Member

    I`ve been wandering for awhile if I have this. I have had a fast heartbeat for about a year and a half. I do feel weak when I stand and my heart rate goes up a lot. I also have chest pain when the heart is beating faster. Is chest pain a symptom of that? I know its just another symptom my doctor doesn`t take me serious on. Its very frustrating.

    Sandy