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I read a lot about people mentioning adrenal rushes with POTS. I was wondering what you do about your adrenals? Is there something that can help treat the adrenals, if you're not in complete Adrenal failure. Also how do you tell it affects the adrenals? I mean what tests have you had done? I had my cortisol level taken and it came out a little high,(1 point) twice. In the morning after fasting 8 hours. I was under no particular stress both times. Last time I had it done it was much lower in the mid range. Same situation, morning, fasting 8 hours, no particular stress. I don't understand why this would be. . I have Hypoglycemia and i know that also usually means problems with adrenals. Yet I have done the cortisol tests and the docotrs say that would show a problem. If the Adrenals are working overtime with the HYPO wouldn't that mean you're going to be having a problem, even if it doesn't show up in a morning cortisol. I mean I know I get more anxious at particular times, like right before a HYPO crash- helps keep me from crashing anyway.;) As soon as I eat it goes away. I have a bit of trouble understanding the adrenals so bere with me. Wouldn't that mean that it's not always going to be at the same level. My DHEA was okay in a test also. I had heard that was related to Adrenals. I'm just wondering if there aren't some other test that might show something?

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You're talking about a number of different things here and I can try to sort them out based on my experience and what I have been told by my physicians (electrophysiologist and endocrinologist). Also, what I have read about POTS.

Regarding cortisol levels, unless you have Addison's Disease or Cushings syndrome, it is very difficult to diagnose problems with cortisol levels because it is still so poorly understood. Cortisol levels vary from day to day even moment to moment in response to various things, so one or two measurements or even many measurements, are often not useful in diagnosing anything, or in determining whether you need supplemental cortisol.

I also had some cortisol levels measured and it was found to be "high"--but apparently doctors don't know what to do with this information if anything. It appears that POTS patients have overly responsive adrenals (actually an overly responsive sympathetic nervous system) and this could be why we often have "high" readings of cortisol.

Regarding hypoglycemia--have you been diagnosed with hypoglycemia or are you saying you exhibit the symptoms of hypoglycemia? I also thought I had hypoglycemia, until I was tested--several times--with several glucose tolerance tests. My sugar never went below normal. Yet, I would have episodes, after not eating for awhile, where I would sweat, feel anxious, get a very rapid heartrate, get shaky, feel spaced out. My doctors told me that this is a common POTS symptom. Apparently it has to do with, again, over-responsive nervous system that kicks in the adrenal response: slight changes in blood sugar occur and the body over-responds. Now that is not to say that you do not have hypoglycemia--you may--and if it hasn't been confirmed, you may want to consider getting tested for it.

DHEA is another one of these things about which modern medicine understands little--as far as what is a normal level--according to my endocrinologist.

So, in summary, the one test I think you might want to have, if you haven't, is a test for hypoglycemia. If you have had a positive tilt table test, you probably have POTS, which would account for the symptoms you describe. Hopefully, as is the case for most of us, you will improve with time.

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