In my first installment of this article, I introduced you to a condition that I would venture to guess most people are unfamiliar with: POTS or Positional Orthostatic Tachycardia Syndrome.
In this installment, I plan to expose the causes and complications for this life-altering condition.
POSSIBLE CAUSES
The consensus of most researchers is that the primary cause of POTS is poor cardiovascular conditioning. However, others think an overactive autoimmune response may be responsible. This is because research studies have identified two factors that are present among POTS patients: increased immune responses and the production of “auto-antibodies.” We already know that an overactive immune response results in prolonged production of inflammatory substances. These substances, when being produced and not suppressed (or shut off) cause systemic inflammatory responses and will affect other systems in the body.
Individuals suffering from POTS tend to have smaller hearts and a lower volume of plasma, which is the liquid component of blood. So, as I noted in Part I of this article, an overall lower blood volume is a component of this condition, which only makes sense considering that “normal” blood volume is necessary for us to be able to get oxygen to all of the tissues in the body, including the brain, when we change positions.
Secondary causes of POTS or POTS-like symptoms include multiple sclerosis, diabetes, “pre-diabetes,” mitochondrial disease, toxicity from alcoholism, chemotherapy, and heavy metal poisoning. Another interesting finding comes from a study published in December of 2022 in the journal Nature Cardiovascular Research titled “Apparent Risks of Postural Orthostatic Tachycardia Syndrome Diagnosed After COVID-19 Vaccination and SARS-Cov-2 Infection.” The study involved 285,000 participants. Of those participants, there were 4,526 POTS-related diagnoses. The risk of individuals being diagnosed with POTS-related symptoms increase by 33% compared to prior to the receiving the COVID-19 vaccine injection. However, POTS occurred even more frequently in those who had contracted COVID-19.
Overall, however, various infections can trigger the onset of POTS symptoms including other bacterial and viral infections.
COMMON SYMPTOMS
The signs and symptoms of POTS can begin very subtly and insidiously. Being aware of such things as an increase in your heart rate could help you detect the onset of the condition early. An increase of 30 beats per minute of your normal heart rate is an early indicator. Another indicator that something is wrong is a heart rate that increases to 120 beats per minute or more when changing your position from lying to standing.
Understanding that some individuals suffer minor or mild symptoms, about 25% of POTS patients suffer severe, life-altering symptoms which will affect their quality of life.
Further, other symptoms and signs of POTS can be mimicked by other conditions. For example, lightheadedness and dizziness– particularly when changing positions from sitting or lying to standing due to a temporary reduction in blood flow to the brain–is one of the cardinal symptoms of POTS. However, these same symptoms can be caused by prolonged sitting or overmedication with anti-hypertensive (blood pressure) medications.
Another symptom of POTS that is shared with other conditions is severe, long-lasting fatigue, which can interfere with routine daily activities.
Other symptoms include nausea, vomiting, excessive sweating, fainting exercise intolerance, shortness of breath, cold or painful hands or feet, red or purple coloring of the legs after standing up, high or low blood pressure, gut issues, and visual problems.
Some other issues may occur without changing your position to standing. These include headaches, sweating without exertion, insomnia, overall weakness, brain fog, depression, and reduced mental endurance.
Aggravation of POTS symptoms can occur in warm environments, after prolonged standing, with insufficient intake of fluids and salts, after illnesses, following exercise as well as after eating, following menstruation, after alcohol consumption, and after extended periods of bed rest.
Age risk factors for POTS include adults between 20 and 40 years of age. However, many patients, especially males, develop POTS symptoms during their teenage years after periods of accelerated growth. Race also plays a role in susceptibility to POTS, with Caucasian individuals more commonly developing POTS. Finally, approximately 80% of patients with POTS are premenopausal females.
As noted previously, both viral and bacterial infections can increase the risk of developing POTS. Also, traumatic events can elevate the likelihood of developing this condition. This leads us to recognize that there may be a neurologic link to POTS.
A family history of POTS also raises the likelihood of developing the condition. This of course leads us to recognize that there is likely a genetic link to POTS as well. Certain gene variations have been demonstrated to increase the risk of developing POTS.
It is not uncommon for the condition to be diagnosed after pregnancy. However, women suffering from POTS typically have a reduction in symptoms during pregnancy possibly due to the increased blood volume which is developed during pregnancy.
NEXT...
I want you to be aware of the prevalence of this condition and its symptoms so that, if it is happening to you or someone you know, diagnosis and treatment can begin. Moreover, awareness could prevent misdiagnosis, which is often due to its mimicry of other conditions. Next month, I will cover the diagnosis and treatment of POTS, so stay tuned.