A Question And Also Update From My Medical Records

[jangle]

I always have a sort of background lightheadedness, but I find that it is triggered by my anxiety disorder. (in places where escaping would difficult i.e. classroom settings)

In the past 6 years that I have gone to school full time, I've had thousands of "nearly" fainting episodes but I haven't actually fainted. I was wondering if anyone else notices their lightheadedness gets much worse with certain triggers and could this be a vasovagal response? (I notice I yawn a lot during my "events")

I ask this because I recently saw the results of my TTT as well as some interesting insights from my doctor. It said that the results of my TTT indicate that I have mild parasympathetic dysfunction. It also said that "inherited POTS can be caused by enzyme deficiencies"

I found that line the most interesting, it is true that I have a family history of autonomic dysfunction. But I have been researching this condition for a while now and I haven't seen anything about enzymes and parasympathetic nervous system dysfunction. I wonder if my doctor had access to some source that I don't, and if he does if it would be possible to supplement that enzyme.

My upright norepinephrine was normal and my TTT said that I have normal sympathetic nervous system function.

This makes sense that my parasympathetic nervous system is dysfunctional as I also have Raynauds. I wonder if there's any specific treatment for the parasympathetic nervous system?

[Maiysa]

Jangle so glad to hear you saw doctor who had some insight. I have autonomic dysfunction but am embarrassed to say that I can't remember if they said it was sympathetic or parasympathetic. Will have look at my records. But I also had raynoud's at one time. I think I was over using my hands in my line of work as an aesthetician which involved some massage of hands and feet. Anyhow, since then the Raynaud's has gotten better. I always found if I stuck my hands in cold water it helped so much. I don't know why. But my hands used to burn they got so inflamed. I feel terrible that I don't have an answer for you about specific treatment, but I'm sure someone on here will be able to help you. Just wanted to give you some support. Hope you are having a healthy day.

[Lemons2lemonade]

Definitely on the vasovagal. I had a class where there was a huge white board behind the teacher and for some reason that bugged me--was fine in the other classes. Another thing that sets it off is prolonged eye contact. Weird huh? I think of it like this: There is a threshold of stress that the body can take before it faints. We might not realize it, but these places or events that are setting us off are normally "stressful" and being dealt with hormonally in our bodies Its only when we already have an accumulation of these hormones to manage blood pressure, and add that little extra for the stress of the situation, that we reach the threshold of what i call a "pots attack" or dramatic exacerbation of symptoms. I drew you a picture but i don't know how to upload it in this message, so i uploaded it to my very "in progress" blog.

http://mysterypiper.blogspot.com/

[Serbo]

Hi - Sounds like based on your research you know more than me about it, but yes i get light headed in some anxiety type situations. iim convinced it's not due to misbreathing. Most often when cognitive load is high, like trying to talk to multiple people at once.

[jangle]

Definitely on the vasovagal. I had a class where there was a huge white board behind the teacher and for some reason that bugged me--was fine in the other classes. Another thing that sets it off is prolonged eye contact. Weird huh? I think of it like this: There is a threshold of stress that the body can take before it faints. We might not realize it, but these places or events that are setting us off are normally "stressful" and being dealt with hormonally in our bodies Its only when we already have an accumulation of these hormones to manage blood pressure, and add that little extra for the stress of the situation, that we reach the threshold of what i call a "pots attack" or dramatic exacerbation of symptoms. I drew you a picture but i don't know how to upload it in this message, so i uploaded it to my very "in progress" blog.

http://mysterypiper.blogspot.com/

LOL Thanks for the picture. It does make sense that everyone has some vasovagal sensitivity, but for us it is entirely too sensitive or over-reactive. I'd think the eye contact sensitivity would be kind of cool if it weren't so awfully painful.

Maisya: It's interesting to think that POTS can be caused by either sympathetic or parasympathetic dysfunction. Either way, I wonder if there could be some underlying enzyme deficiency that is causing our symptoms.

I've tried researching the topic, I know mestinon is an inhibitor of Ach-enzyme and that seems to help POTS patients, but that drug works on both the parasympathetic as well as sympathetic nervous system. I have to think there is an enzyme that is specific to the parasympathetic nervous system, and that is the enzyme that if treated, might yield a treatment for a large segment of POTS patients.

EDIT: I read on Lemon's blog this study:http://www.clinsci.org/cs/110/0255/cs1100255.htm

I'm beginning to think the enzyme we are lacking is the angiotension-converting-enzyme (ACE). A lack of ACE would lead to higher levels of circulating angiotension in our bodies (angiotension I and II). Perhaps if we upped our ACE levels, we would decrease the symptoms of POTS?

[Maiysa]

Jangle, I forgot to mention, I have autonomic neuropathy and hypo orthostatic intolerance and on occasion hyper orthostatic intolerance. I was a very social girl and outgoing, and even was an actor in theatre and lil bits of camera work for a while and nothing..nothing made me nervous. But now if I get too excited good or bad, I pass out but mostly I get so woozy that I feel very drunk for about 5-15 minutes and can't really carry on a conversation. But lying down always helps and cold water. IT's very embarrassing. And now when I meet new people I get even more nervous because just a tiny tiny amount of positive excitement will make me woozy. I met my sisters in laws for the first time a few months back and we were having dinner and I was laughing so hard and I passed out and they had to take me outside to lay me on the bench. I hate it. What a terrible first impression. I was told it is a vagal response. The hospital called it mal vagal, although I can't find anything on it. But sometimes I don't come to and then I start losing oxygen to my brain, they call that a non spinal injury dysreflexia episode. But I don't think anyone knows for sure. Dysreflexia only happens in difficult situations such as medication, flu, fever, traveling...etc. So you are right, it is a vagal dysfunction from what I was told. Although I don't know anything about the enzyme. You must be researching your little heart out.