What is POTS?
POTS is a syndrome, which means it's a group of symptoms and medical findings that frequently occur together. Symptoms that occur when standing upright are the hallmark of POTS. Orthostatic intolerance is the medical term for these symptoms.The most prevalent complaint is that
Standing causes lightheadedness or dizziness (fainting may occur in more severe cases)
fatigue
shakiness
concentration problems (also called brain fog)
heart palpitations (a sense of rapid, pounding, or irregular heartbeat).
Headaches, digestive issues such as bloating and constipation, sleeplessness, heat intolerance, and difficulties exercising due to shortness of breath and fatigue are all common symptoms of POTS.
Who is affected by POTS?
Women between the ages of 15 and 50 are the most commonly affected with POTS. However, it has only just been discovered in other people who have been infected with COVID-19. Long-term COVID sufferers (also known as "long haulers") may experience a variety of symptoms affecting numerous organs, including the brain, lungs, and kidneys. POTS is a form of extended COVID.
What is known about the process of recovery?
According to research, around half of those diagnosed with POTS will recover or improve within a few years.
If POTS is not addressed, it can lead to a vicious cycle in certain people. People tend to spend more time in bed, avoiding things that trigger symptoms, which starts the cycle. Muscle mass in the legs deteriorates, cardiac capacity decreases and the volume of circulating blood decreases as people become less active. Standing upright becomes even more unpleasant as a result of these changes, resulting in even more time spent in bed.
Some persons who are trapped in this loop may become incapacitated over time. They can't do simple domestic chores without feeling dizzy and fatigued. Many people take vacations from school or work.
What is the cause of POTS?
The fundamental cause of POTS has yet to be discovered. It usually occurs after a period of bed rest due to an injury, surgery, or a viral illness such as mononucleosis or the flu. POTS has just been discovered in certain persons who have had COVID-19. These people may experience weariness, lightheadedness, and a fast heart rate even after the acute infection has passed.
Many studies believe POTS is an autoimmune illness caused by an overactive immune system in the body. When this occurs, the immune system appropriately targets the intruding virus but incorrectly targets the body's own healthy tissues, resulting in unintended injury. This damage is hypothesized to impair the lining of the blood vessels, which loses its ability to tighten or constrict, in response to standing upright in the case of POTS.
While most of us take standing upright for granted, a person with POTS may find it quite painful. What causes orthostatic intolerance in people with POTS? It's helpful to first comprehend the typical reaction to standing:
One-third of a person's blood volume pools below the waist due to gravity.
Because less blood returns to the heart, less blood is pushed out to the rest of the body.
This causes a reduction in blood pressure in the brain (have you ever felt lightheaded or "seen stars" when standing up rapidly after sitting for a long time?).
Sensors in the heart detect the decline in blood pressure.
The sympathetic nervous system (SNS) is activated by these sensors, which tells the adrenal glands to release norepinephrine, an adrenaline-like molecule, into the bloodstream to help solve the problem.
The effects of norepinephrine on the human body
The hormone norepinephrine causes the heart to beat faster and harder, restoring normal blood supply to the brain. It also causes blood arteries to constrict, causing blood to flow back to the heart rather than accumulating in the lower portion of the body. Blood pressure returns to normal after only a few seconds of standing.
However, with POTS, this signal is inefficient, and the blood vessels do not tighten in response to norepinephrine for unknown reasons. Because there is more blood in the lower body, less blood returns to the heart and so less blood is pumped out to essential tissues and organs. To compensate for the smaller volume of blood pumped with each contraction of the heart, the heart beats quicker to maintain normal blood pressure.
Is your fight-or-flight response overactive?
Thousands of years ago, evolution favored individuals that produced large levels of norepinephrine in response to physical danger, allowing them to fight off an attack or flee harm. The nervous system prepares practically every organ for physical exercise and injury by releasing norepinephrine into the bloodstream. The pupils dilate, digestion slows, and the heart races. The fight-or-flight response is what it's called.
People with POTS have much higher norepinephrine levels in their blood than those who do not, resulting in an abnormally fast heart rate and, frequently, a powerful, pounding heartbeat. In addition to these effects on the heart, high norepinephrine levels can affect other organs, such as the digestive system, producing bloating and constipation in the abdomen.
If you have any of the symptoms outlined in this post on a regular basis, you should have your doctor check you for POTS. POTS will be discussed in more detail in a future post, along with its diagnosis, treatment, and daily life.
Related read: IS YOUR MEDICATION MAKING YOU LIGHTHEADED?
Related read: IS YOUR MEDICATION MAKING YOU LIGHTHEADED?
