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Sometimes I am going thru my day not feeling too bad emotionally and then for no real good reason I get very agitated and almost anxious. Altho I have had anxiety attacks at different times of my life and this definately is not what this is. My body just seems over amped (really wound up)!! It isn't like my mind is stressed..it is like my body is stressed. Does this make sense?

What are adenian surges and can this cause this?

Thanks...

Erika

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This is an excellent question. You describe exactly what my son feels as well. I have read so many different articles and they confuse me. Some say that all POTS patients have increased adrenalin levels and others say that only people with hyperadrenergic POTS has high levels of it. I'm a bit confused so I can't wait to see what the responses to your question are.

My son's doctor did tell us that what seems like ADHD symptoms are actually "cognitive symptoms of POTS". He does seem more hyper when his symptoms are flared up-purple legs and such. He says that he is exhausted but he is hyper and anxious at the same time?? It calms him down to give him extra fluid sometimes.

Serena

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Erik- I have hyperadergenic POTS. My rushes are so severe that I feel like I am going to die (for hours) any way Mayo clinic told me it was important to get a blood test to find out what kind you have to know how to treat it best. The checked my epinephine (ignore spelling please) levels after I was lying down for a half of an hour and then had me walk around for 10 min. I didn't even feel the "surges" but I had a huge increase in thoses stress hormones when I stood up. It might hel pyou to have this test done and If you what more info about it PM me and I will look it up. They do suck though! I play mind games with myself now so I am able to survive them better :rolleyes:.

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I was told at Mayo that I have mildly hyperadrenergic POTS. I experience mood swings throughout the day, and when I really think about it they're usually related to being up too long. Sometime, though, it seems the adrenaline keeps pumping night and day for days or weeks on end. It's usually precipated by a stressful event (last time was a dr's appt :rolleyes: ). I get the flushing too, which is usually mild but can be severe. Talking even brings it on. Also I get tremors, high BP with standing or talking, sleep disruption and jerks, feelings of doom, palpitations, and a general wired but tired feeling.

The surges I get in adrenaline are truly one of the worst symptoms of POTS for me because they affect your emotions so much. I think Kayjay has a great idea to play mind games during these times. I just try to displace myself from my emotions and body by distracting myself. Knowing that my adrenaline levels are only mildly elevated, I can't imagine how the other truly hyperadrenergic patients feel. :)

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There is a misconception about the symptom of anxiety being the realm purely of 'hyperadrenergic POTS'.

In many disorders were orthostatic circulatory control is disrupted one of the mechanisms your body may use to counteract this is to shoot off adrenalin and norepinephrine. So potentially any patient with POTS or reltaed disorders can experience these 'surges'.

Hyperadrenergic POTS refers to types of POTS where sympathetic excess is perceived as the primary problem rather than blood pooling. Some doctors believe that the anxiety involved in POTS is not from norepinephrine excess, but adrenaline - and adrenaline reuptake is not considered implicated in POTS.

All i can say is that I get significant and terrible surges when my POTS is bad but as it improves they go away. Its a matter of riding them out.

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I don't know if I have hyperadrenergic POTS or not, but if I don't take Paxil -- which helps calm down my sympathetic nervous system -- I have what feels like a panic attack that never ends. It's horrible. Intolerable. I could also barely climb stairs, and my pulse would go up to more than 160 beats per minute. Plus hands and feet tingling, severe diarrhea, weight loss. Needless to say, I restarted the Paxil. :P

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My Beta Blocker (2 to 3 times a day, 20mg of Propranonol) has helped me with these.

If I have an argument or something (I already get hives from being too emotionally upset) I get flustered and red and horrible feeling with a pounding HR.

But the Beta Blocker has helped the everyday annoying surges and to control my HR so I can be more comfortable. My doctor says that the 40mg-60mg I take is fairly low...many people take two to three times that much. My dose seems to be enough to help me (but not put my HR in the 60s which my PCP commented that people on BBs for heart disease go for). I just need them to help with Tachy/Surges/that horrible feeling that your wound up inside.

Thanks for posting this. Sometimes I feel alone with this weird symptom!

Any idea why BBs help my surges, anyone? Anyone else use them for this?

And can someone explain how anti-depressants help? I've never tried one.

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I take Toprol XL. It helps with the hr. But I still fall apart like a mens warehouse suit if I am up and around too much.

I would love to try an anti-depressent to perhaps even me out more. But I took prozac and really started crying more....not sure why so I stopped it. I tried the Cymbalta like I said but my hr got crazy.

I just never feel relaxed. Which I can take but it is the really wired, amped feeling and I am easily agitated that I hate!! :blink:

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I take Toprol XL. It helps with the hr. But I still fall apart like a mens warehouse suit if I am up and around too much.

I would love to try an anti-depressent to perhaps even me out more. But I took prozac and really started crying more....not sure why so I stopped it. I tried the Cymbalta like I said but my hr got crazy.

I just never feel relaxed. Which I can take but it is the really wired, amped feeling and I am easily agitated that I hate!! :blink:

My brother tolerates Lexapro. I have a feeling some type of Dysautonomia runs in the family or at least the capability to trigger it...I've not tried one yet. My former EP mentioned Cymbalta but never got around to trying it.

I'll bring this up when I see a specialist in November at Stanford. I'm curious now!

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The surges can be a direct result of norepinephrine, increased sympathetic outflow, or adrenaline being used in a poor attempt to compensate for impaired blood flow. What ever the reason, the can be quite disabling - I believe many of the stomach issues with POTS can actually also be a result of this excessive sympathetic activity.

GABA agonists and beta blockers are best - GABA by reducing overall sympathetic tone and beta blockers because they block the beta (and to some degree fear related) effects of norepinephrine and epinephrine. BTW - in inappropriate sinus tachycardia and a smaller group of hyper POTS patients, there are autoimmune antibodies that attach to and activate beta 2 receptors - they could potentially create anxiety as well as tachycardia.

Ive found Kava to be a god send when i was bad - even a beer can take the edge off. Its a shocking feeling so what ever works is fine in my opinion.

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BTW - in inappropriate sinus tachycardia and a smaller group of hyper POTS patients, there are autoimmune antibodies that attach to and activate beta 2 receptors - they could potentially create anxiety as well as tachycardia.

Hey Ramakentesh,

Do they have a test for that? And is there any particular treatment? That's really interesting.

I wouldn't be surprised if I had something like that going on, given my other autoimmune diagnoses.

amy

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  • 3 weeks later...

I get these surges periodically, usually just for a few hours after I exercise or get stressed out, but occaisonally for days or weeks at a time. I'm in the midst of one right now, actually.

For the first time ever, it prevented me from sleeping last night. All night, my heart was pounding and I felt flushed and hot, especially in my chest. Just felt "on" in a way that made sleep impossible.

I'm wondering, if these might be caused by norepinephren as well as adrenalin, would a norepinephren re-uptake inhibitor make it worse or better? Is the problem that there's too much NE around, in which case an inhibitor would make it worse, right?

I take wellbutrin, and when my symptoms first flared up last week, Dr. Grubb's office suggested that I up my dosage to 300 mg per day. Would that make this heart racing/pounding/surges thing worse?

I'll try Kava; anyone else have any other suggestions about how to calm this down - I hate being this "pumped up" or whatever so many hours in a row. My heart and I need a break!!

Thanks in advance for any suggestions/input.

Steve

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