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Ice Cold Hands


julieph85
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My hands turn white and become ice cold and clammy every morning all morning long. This is also when my symptoms are the worst and I feel jittery and short of breath. I think it's from excess catecholamines. Does anyone else get this it is so uncomfortable!

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Hi Julie

Thats one of my worst symptoms and I can totally relate to the jitteriness/ adrenaline rushing......I thinks its because adrenaline constricts the small blood vessels in the hands and feet? I could be wrong....but I have the same episodes.....I have Raynauds too and when I am fighting the excess adrenaline it gets so much worse....sometimes I find wearing gloves help :)

Bren

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I get this and I usually can't eat until at least 11 am if not later. I actually get ice cold all over but my hands and feet are the worst and it usually starts after I eat. I get it again after dinner. I get so cold sometimes that I can not function. After I get past the shivers and the jitters, then I crash and have to sleep from extreme fatigue. For these reasons, I usually try to do anything I need to do between 10-2. I then can get rid of the morning tachy and fog, but, not eat until after I have run my errand so I can bundle up and then sleep.

I find drinking something hot and using a heating pad helps in addition to adding clothing layers and blankets. Sometimes I also hold my hands under hot running water for a while which helps.

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I believe this has been a characteristic associated with hyper-POTS. It's mentioned in a lot of the articles by Grubb, etc. I have this as well.

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Actually its a characteristic of most but not all POTS patients. It can be the result of excessive sympathetic activity and resultant vasospasm as in Hyper or Low Flow POTS or it can be a reflex mechanism in response to abnormal blood flow elsewhere in the body as in Normal Flow POTS.

Sometimes the body can use epinephrine to try and correct the blood flow abnormalities present. However, all it does is further raynauds, anxiety and further thoratic and stomach vasodilation through stimulation of beta 2 adrenoreceptors.

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Rama- Is anyone other than Stewart doing any type of research on the various "flow" theories? Is there anywhere "old" people (like older than 28) can be tested to figure out what "type" they have according to his classifications? I keep trying to figure it out, but like Julie has said...it seems like I fluctuate between all three types at times.

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The main research at the mpment on POTS is coming out of the Stewart / medows group, Vandy (who recently confirmed Stewart/medow's finding of elevated angiotensin II in some of their patients who can be catagorised as low flow), Dr Levine's deconditioning group and a chinese group.

As above, Vandy confirmed high angiotensin II in Low Flow and the Chinese group were the first to find elevated NO in children with POTS.

Some of the doctors quoted on this forum arent actually involved in medical research and their observations are made from clinical experience alone.

The other point I like to make is that there is only two peer-reviewed studies published on Hyperadrenergic POTS, two on Net deficiency, 1 on Mast Cells, and two in relation to neuropathic POTS.

A recent study from Vandeblit suggested that hyperadrenergic POTs is a misnomer as the same portion of Hyper and non Hyper POTS patients failed a QSART test. Mayo's study from 2009 suggested this as well.

There is approx. 10 peer-reviewed studies or more a year coming out of the Stewart/Medows group. Low Flow POTS has about 15 studies published on it ranging from its characteristics, its effects, and its improvement with losartan and intravenous vitamin C. In short, it is the most studied form of POTS ever.

its all still fairly conjectural and none of it has really improved our treatment options yet but the future looks relatively bright (hopefully).

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The strange thing about mine though is that it ONLY happens in the morning and early afternoon. Once I get past 3:00 it never happens and I feel markedly calmer and warmer overall. Dr goodman says that is unusual for pots. Also when the freezing cold and jitteriness happens after I eat it lasts about an hour and then the peripheral vasoconstriction suddenly stops and my face and hands get warm and flushed and I feel better. I just can't let it go that it's something hormonal because of the way it is so dirunal. Also I have a hard time accepting it is from blood flow problems because it happens after even a small amount of food is ingested such as a cookie or a peice of cheese. I feel like it is more related to the sudden increase in blood sugar, like my body is trying to use catecholamines to lower my sugar instead of insulin. Dr g said he believes also there is a hormonal component to it and hopes to do research

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http://diabetes.diabetesjournals.org/content/33/4/369

I have low free t3- is this causing decreased sensitivity to insulin which makes my body use catecholamines to lower blood sugars instead? Also is my free t3 only lower in the mornings meaning my insulin is more effective in the evenings ? Sounds far fetched but maybe....

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You might also be interested to know that insulin has potent effects no the Norepinephrine transporter which is implicated in POTS.

The strange thing about mine though is that it ONLY happens in the morning and early afternoon. Once I get past 3:00 it never happens and I feel markedly calmer and warmer overall. Dr goodman says that is unusual for pots

Unusual to feel worse in the morning and early afternoon? And better as the day progresses? I think its pretty common actually.

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I have hypoglycemia and can feel when I eat ANYTHING... doesnt matter what it is. I can take a small bite of anything and feel it for about 20 mins or so. This happens less and less throughout the day, about until 1 pm then I do a lot better until about 10 pm. Mornings I cant eat anything and usually dont until about noon. Our systems are just so sensitive.

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i was diagnosed with raynaulds phenominon so thats what i chalk mine up to . physical, emotional stress and cold bring it all on. when we lived in az it would be 115 outside and my hands and feet were still icecubes...

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People are always telling me I have cold hands, and a warm heart :) You all are discussing the Endocrine System, which is extremely complicated, and even the doctor's know it is not an exact science. All of the this is horomonal related, and the two things mentioned here were angiotension and catecholamines. From what I have read and understand is that angiotension is released from the kidney, which not only triggers vasoconstriction and high blood pressure, but also releases aldosterone from the adrenal cortex, which increases the catecholamines (epinephrine) from the adrenals, which causes the fight/flight, jitters, flushing, cold hands and cold feet, because your body is making sure that your vital organs have enough blood flow; so when you eat, in order to digest properly, you need the blood flow to your stomach to digest, so your body goes into emergency or fight/flight mode to do this, because we are chronically dehydrated. That is why it is imperative that we drink lots of fluids, all during the day. There are some that even need IV supplementation in order to be able to sit up, because of this. I just make sure I don't expend any more energy than I have to, and pace myself, so that my symptoms are kept at bay, as much as possible. Wearing gloves, scarves, and socks and tights in the winter helps with this immensely. Also drinking warm liquids, and taking warm baths are great, too!! I am on Losartan and have been for years, probably about 12 years, but to be honest, it keeps my blood pressure down, but once the weather gets cold in the winter, I don't thaw out until May, even being on medication. :blink: The flushing, which I always thought was menopause, (symptoms were raging then) along with the palpatations, is what happens after the adrenaline surges that you all are talking about, so you actually work your body up to adversely affect the temperature sensor in your brain in your hypothalmus, which is trying to compensate for the temperature changes going on all at the same time. Note, I haven't even talked about the pancreas releasing insulin to compensate for the simple and complex sugars, while eating, and then there's your thyroid and your ovaries, (testes if you are male) to keep balanced. I guess I forgot the parathyroid!! This is why this is so complicated!! :wacko: It does explain alot of our symptoms, though, and is very interesting, and I am glad that doctors are doing research, and obviously, we are, too :)

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