Are you sick of standing? You could be sick

Do you experience discomfort when standing up and the only way you can get relief is by lying down? Does your heart race a lot during this time of discomfort? Well if your answer is yes then there is a possibility that you could be suffering from POTS syndrome. This is a condition that many people suffer from unknowingly.

POTS is an unusual condition in which your heart rate speeds up by 30 or more beats per minute with little or no change in blood pressure. Such an increase in heart rate may mean that your cardiovascular system is working as hard as it can to maintain blood pressure and blood flow to your brain. According to the Rare Diseases Clinical Research Network, POTS affects about 500,000 Americans, most of whom are women under age 35.

“POTS is typically not life-threatening, but it is life-altering,” says Svetlana Blitshteyn, MD, clinical assistant professor at the University of Buffalo School of Medicine and Biomedical Sciences and director of the Dysautonomia Clinic in Williamsville, New York. It’s also characterized by lightheadedness when standing, notes the National Institute of Neurological Disorders and Stroke. POTS may have multiple causes, Dr. Blitshteyn says.

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Medical experts have still not understood the POTS syndrome but they do know the things that would trigger its occurrence for instance menstrual period, excessive heat, dehydration, alcohol among other triggers. They have also identified abnormalities that are associated with the condition.

The cause of postural orthostatic tachycardia syndrome (POTS) is poorly understood. However, episodes often begin after a pregnancy, major surgery, trauma, or a viral illness and may increase right before a menstrual period.[1]

Many researchers suspect that the condition may have more than one cause. The following abnormalities can be associated with POTS and may play a role in it’s development:

  • Impaired function of nerves in certain muscles, especially those in the legs and feet.
  • An abnormal decrease in the amount of blood circulating in the body (caused, for example, by blood pooling in the abdomen and legs).
  • Too little blood returning to the heart when moving from a lying down to a standing up position.
  • Changes in heart and blood vessel function.
  • Abnormal regulation of blood pressure.
  • Increased fight-or-flight response.

Although most cases of POTS occur in people with no history of the condition in their family, some affected people report a family history of orthostatic intolerance. This suggests that in some cases, genetic factors may play a role in the development of POTS. Some studies also suggest that normal variations (polymorphisms) in certain genes (NOS3ADRB2) may be associated with an increased risk of developing the condition. A change (mutation) in the norepinephrine transporter gene (SLC6A2) has been identified in one family with POTS.

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Since the POTS syndrome is a condition that is still being studied it is important to be able to tell the symptoms. Do note that this is not categorized as a life threatening condition but it greatly alternates your lifestyle. It is therefore important you know the signs so that you can adjust your life accordingly.

PoTS symptoms

  • Dizziness or pre-syncope (almost fainting).
  • Syncope (fainting).
  • Palpitation (awareness of heartbeat).
  • Headaches – orthostatic headaches (due to upright posture)/migraine.
  • Brain fog (difficulty in thinking).
  • Sense of anxiety.
  • Visual problems (greying, tunnel or glare).
  • Gut problems (nausea, diarrhoea, pain).
  • Chest pain.
  • Poor sleep.
  • Purplish discolouration of skin due to blood pooling in hands and feet.
  • Bladder problems.

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There is no treatment for POTS patients. The only thing available is therapy to minimize the symptoms. Certain drugs can be used temporarily. The main therapy mode is aimed at regulating blood circulation problems.

Therapies for POTS are targeted at relieving low blood volume or regulating circulatory problems that could be causing the disorder. No single treatment has been found to be effect for all. A number of drugs seem to be effective in the short term. Whether they help in long term is uncertain. Simple interventions such as adding extra salt to the diet and attention to adequate fluid intake are often effective. The drugs fludrocortisone (for those on a high salt diet) and midodrine in low doses are often used to increase blood volume and narrow blood vessels. Drinking 16 ounces of water (2 glassfuls) before getting up can also help raise blood pressure. Some individuals are helped by beta receptor blocking agents. There is some evidence that an exercise program can gradually improve orthostatic tolerance.

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