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Hypovolemia


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I know this is probably a stupid question (although I know that no question is stupid.) but why do people woth POTS develop hypovolemia? If you indeed have nerve damage then why would that cause hypovolemia? Hope someone knows as this question has been naggin me greatly. Thanks in advance!

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Here is a description from potsplace.com:

Hypovolemia (low blood volume) sometimes occurs in POTS patients. Reduced plasma renin activity often accompanies the low blood volume. Reduced levels of renin release consequently result in reduced secretion of aldosterone. This would be expected to impair renal sodium conservation thereby contributing to hypovolemia (Streeten, 1999). Findings suggest that the impaired renin release may possibly result from sympathetic denervation (Jacob & Biaggioni, 1999). Physicians believe hypovolemia and inappropriately low levels of plasma renin activity may be important pathophysiological components of orthostatic intolerance (Jacob, Robertson, Mosqueda-Garcia, Ertl, Robertson & Biaggioni, 1997).

Also, I think (but am not sure) that people get hypovolemia from other medical causes, then develop POTS-like symptoms from the hypovolemia.

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In many of your posts you keep asserting "nerve damage" with POTS--that is the case for some (ie. receptor problems, die off, or failure to innervate (migrate)), but absolutey is not established as being the case for many with the diagnosis. While you believe your case of POTS may be due to nerve damage, it is faulty logic to apply all the symptomology to nerve damage.

Please see the mechanisms section for more information:

http://www.dinet.org/what_are_the_mechanisms_of_POTS.htm

Nina

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I agree with Nina. In my own case I'd assumed that I had nerve damage, but my tests from Mayo indicate that I don't (or that any damage had healed by the time that I got to Mayo). I am glad that I don't have the damage. Unfortunately, I still have plenty of POTS symptoms, though.

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Humm...very true Rita...but if you dont have nerve damage (or I mean if it healed)then what is causing your symptoms...did they bother to tell you that? I'm not a big fan of places like Mayo if ya didnt notice. They just treat ya like a rodent in some experiment.

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The autnomonic nervous system is not as fully understood as you would suggest by asking Rita yoru question--if you read the "mechanisms" section, you will see all the hypothosized issues that may lead to symptoms. Keep in mind, as we understand the body better, over time, we may get answers to the questions you're asking, but as it stands now, it's not possible for many of us to know WHY we have autonomic dysfunction.

Just a few years ago, many believed that POTS and OI were due to patients becoming physically deconditioned. For nearly all of us, that's not the case. In fact, during my ANS testing, I was found to be very fit, to the point that my doctor was startled enough to send me a letter telling me how fit I was and that I definitely was NOT deconditioned.

Bottom line is that for most of us here, it's a matter of adjusting to the fact that our bodies have permanently been effected and learning to live with the changes. Once all the treatable factors have been ruled out by you and your doctors, that's what we're left with. Additionally, knowing why doesn't logically lead to a fix--such is the case with ganglionic antibodies--knowing you have them doesn't lead to any treatment as yet.

As I'm writing this, I'm trying not to be frustrated in my tone, as this same discussion has come up repeatedly with several former members (or perhaps the same member registered under different names?). If you want to read the myraid of replies to these similar posts, you may look up the members veryblue and thisblows. You seem to share some of the same issues, such as the ablation, your age, your level of physical activity and the types of questions you have.

So, I guess this leads me back to the fact that you need to work in conjunction with your doctor to rule out the possible culprits. From your previous posts, it's possible that you've got something other than ANS dysfunction given the inconclusive TTT, abnormal cortisol etc, or it could just be that the TTT was not done properly and/or interpreted properly. The answers to your questions lie in the realm of getting an accurate diagnosis first; it's not clear, based on the issues you report, that you fit the profile of autonomic dysfunction.

Nina

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Nina, You are absolutely amazing. You seem to have infinite energy despite all your medical issuesl, your career, and your education. Hat's off to you!

I think all of us on this forum should give Nina loads of kudos for her work on this forum. Her explanations, as is the case with the message ahove, are on point and demonstrate her skill in conveying informaiton and her depth of knowledge.

I salute you, Nina! :lol:;):P:):):)

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True Nina that it dosent matter in terms of treatment the how you got sick, but I am under the impression that it does matter in the prognosis. If I can really find out that I had an autoimmune reaction (hence the autoantibodies test) to my stomach virus/bacteria whatever, then I can be highly assured that I will recover, givin the fact that I have no deeper underlying connection/predisposistion to autonomic problems as I can assure you that nobody in my family has ever shown problems like this (or any problems to be honest...I have the healthiest family history of anyone I know...no cancer, diabetes, genetic diseases, heart disease...only mild high blood pressure on my dads side). That being said, and the fact that I have never been sick before, I think I have a great chance of recovering and am just looking for support until the day I do. As far as seeing a doctor, I have. He is not an autonomic specialist per se, but he did study at Mayo Clinic under doctor Low and said that I might possibly have a mild post viral/bacterial automimmune thing going on and he assured me I would recover with time as he has had other POTS patients much worse than I was and they are healthy productive members of society now days. He also said that sudden onset POTS is very likely to recover...isn't that what you said too? I'm just here looking for hope/support to keep my spirits up that I will recover and get well and work hard and help patients that are suffering from these diseases and donate money to helpful foundations and so on. Another reason I like being here is that I can obtain a lot of information about dysautonomias so I can use that more in medical school. Thats why I ask so many questions! Hope this clears things up for ya. We dont hold grudges around here do we?

Tasha

Oh yeah Veryblue...I would love to talk you as you seem almost identical to me...veryblue where are you??

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I don't have any family history either. I have pots, I've had it much of my life, I deal with my symptoms, I try to keep my stress at bay as best I can since that exacerbates problems, and I get on with my life. I wouldn't consider any of the tests you're talking about; the answers wouldn't affect treatment anyway. Time for a glass of gatorade.

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Veryblue will not be replying to your post. She's no longer a member of the board. However, I also think you should be aware that the same issues have come up before many times, particularly with her, and your arrival is short on the heels of Veryblue's departure.

It's not that I, or folks here, mind answering questions--but we are all a bit limited in how we can spread out what time and energy we have on a given day.

I don't want to inhibit people from asking questions, but to DO want to help folks to be thoughtful about how many questions are posted at a time, and to prioritize so that your most pressing concerns get addressed first, and you post the less pressing stuff when the board is slower. Heck, I've had my runs of days where I posted several threads because it was just my turn to have a really cruddy week of symptoms... and have been so grateful just to know that the others here really do understand. Other weeks, it's my turn to give support.

I don't have a grudge toward you at all and I understand the questions. Every time a new person joins our forum, we recycle through the basics--and that's just part of a forum lifecycle. In our younger days as a forum, i made sure to answer all newbies here--however, we have some veterans who do a fabulous job of welcoming new folks and answering their common concerns, so, admittedly, I'm not as diligent with that as I was in the past. All are welcome here, as long as they follow the rules of the board, don't monopolize, and are generally kind to others--folks are welcome to disagree, but only to do so respectfully (ie. no flaming, cursing, etc.).

It sounds like your doctor has already given you the answer you're looking for and that you know you had sudden onset, so that already puts you in the group who have better chances for spontaneous recovery, which is great for you.

:lol: Nina

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I thought it was interesting that a study was conducted that found that 80% of CFS patients had hypovolumia - low blood volume - so as low as 50% normal (an amount that would probably cause hypovolumic shock and death if takne out all at once).

I would be interested in the amount of cases of POTS where low blood volume was a problem - i know im one - i dont get any blood pooling other than to my head when i bend over.

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