Angiotensin Ii Primer Needed For Confused Member

[Trach]

Ok, maybe it's the brain fog or just pure ignorance, but I have read the studies on angiotensin II and then the basics but my background is in finance and accounting and I am lost.

Would someone please give me a basic explanation about angiotensin II? How does it affect vasoconstriction? How does it relate to ADH levels? I am sooo..... Confused.

How did it affect pregnancy complications? Does it have anything to do with blood clotting?

[ramakentesh]

The research evidence suggests that a small portion of POTS patients have elevated serum angiotensin II. These are predominantly female patients with lower than normal body mass index. How this plays into the pathophysiology of POTS is not agreed on in the research and the rest of the stuff is conjectural theories posted on this site.

[Trach]

So since I have a higher than normal body mass index I would not fit in this category?

I am confused because my POTS (and my daughters) was described to me as a possible dysfunction of the brain stem or something around that area of the brain. We definitely have a genetic component.

Thank-you for your reply. I appreciate your help.

[issie]

There is really only one way to find out - have your angiotensin II checked. They can do a test for it.

The study that Rama is referring to - showed lower BMI - but, we are all so unique with this illness. It was once thought that we were all alike - time has proven there are significant differences in our presentations. What is thought today - may change tomorrow.

We do allot of speculation here on this forum. We don't always have scientific backing to prove what we are thinking or what could be a possibility. But, some of us like to look at other possibilities - that maybe the doctors are not looking at. Whether in time it will be proven that our "theories" are plausible - only time will tell. We are all in search for a "CURE". The main thing with this forum is that we are all in this boat together and we have a place to go where others understand what we are going through. It's a big support avenue ---we don't feel alone with this. Since it is considered a rare disorder - this is a good place for support.

We've uncovered some pretty interesting info over the years. But, not all of our discussions are backed by science. Allot of it is based on our personal experiences and responses. It really takes time to understand what is being talked about. I've been here almost 2 years and I still have to run to wikipedia and the dictionary for help. A whole lot of it is 'WAY' over my head. But, the more I read, the more things start to click and then one day - I understand what is being said. All of us are at different levels in our understanding of POTS - but, we all started from the beginning. That's what's nice about it here - if we don't understand - just ask. Someone will be able to put it into simpler terminology and we will be able to understand and grasp it. We're all on a JOURNEY, and we're in this together. This illness, makes us pull together.

Angiotensin doesn't really have allot to do with brain stem dysfunction. It affects the blood pressure responses. There are many of us here that have genetic components as a reason for having POTS. Angiotensin is just one of the subjects - that people are looking at as a possible reason for some of the dysfunction. There are many different reasons and causes for POTS. I have Ehlers Danlos -which is a connective tissue disorder - that is inherited and can be one of the causes of my having POTS. But, there are so many dysfunctions associated with this disorder that most people think there are more than one reason causing the dysfunction and we are trying to dissect it and figure out the reasons. It is really confusing even when you sort-of know what's going on. Keep reading and it will eventually come to you - what's being said. Many times, I'm like huh? I don't get it either. Give yourself time.

Issie

[Trach]

Issue thank-you for your explanation and inspiration. I will keep reading! What type of doctor performs the test? I have learned a lot from reading all of the posts. I had never considered that I could have EDS until joining this site, but now I realize I need to be evaluated.

[issie]

A rhumatologist is who would evlautate you for EDS. For the angiotension II test - I'm not sure. There is a certain way that it has to be done and I'm not sure who would order it. For us that go to Mayo - I'm thinking one of our POTS docs - either neuro or cardio. But, it has to do with kidney function also - so maybe nephrologist. I haven't had mine checked.

Issie

[jangle]

As Rama said mostly everything said on angiotensin ii is conjecture on these boards.

However, angiotensin ii anomalies have been studied to impact your vagus nerve's ability to communicate its nerve signals. Additionally it has been shown to be elevated in other excitosympathetic conditions such as hypertension and chronic heart failure. It has been shown to reduce water + salt absorption in the large intestines which might explain why saline (which bypasses the intestines) works for us, but drinking does not. Additionally disturbances in angiotensin ii has been observed in patients with mitral valve prolapse who also frequently suffer from dysautonomia like symptoms as well as astronauts whose angiotensin ii concentrations are elevated from space flight. (Although the astronauts thing is in general no explicit study has been done on astronauts with POTS and their angiotensin ii levels directly.)

Additionally, Dr. Stewart and Dr. Raj separately showed that patients with POTS have elevated angiotensin ii levels. How many and what percentage and what distribution is unknown (it might be possible to have normal serum angiotensin ii, but abnormal concentrations elsewhere in the body - say specific to one organ.)

Additionally Dr. Stewart showed that administering an angiotensin ii blocker to patients with POTS seemed to normalize their blood parameters relative to a control group.

Exercise has also been shown to reduce angiotensin ii levels, and it is well known that exercise assists roughly half of POTS patients. Additionally, in the animal studies only half of the mice seemed to have this reduction in angiotensin ii levels. Again, the exact relationship wasn't studied.

i.e. The relationship between people who exercise, people who exercise and have reduced angiotensin ii because of it, and people who exercise and have reduced angiotensin ii because of it and their POTS symptoms.

So in a way it's all stacking up, but sorely needing some EXPLICIT studies.

[issie]

I think it has merit too and I'm trying to work on this as a possible cause myself. Good explanation for stating your case, Jangle. But, it may be that the angotension levels are elevated for a reason and lowering them may cause other problems. I know when I lowered mine with the Lorsartan - it wasn't at all good. That's when I started questioning this approach.

Issie

[Trach]

Issie - I am in the process of being referred to a rheumatologist and also have an appointment with a geneticist who specializes in EDS and vascular diseases- elevated homocysteine levels (a family mutation I need to be tested for). Is that overkill?

Jangle & Rama - during my testing, my vagus nerve was found to be functioning ok. The test was based on blowing into a tube. I was surprised I passed because usually I almost pass out or get a massive headache whenever I blow up a balloon, but I actually felt good the day of the test.

So if a persons vagus nerve is functioning, the less likely angiotensen II levels will be elevated?

[issie]

If it's EDS 3 that can't be tested gentically - but, if there are other gentic issues a genticist might be in order. See the rhemey first and then decide.

[Trach]

Thank you Issie!

[jangle]

Trach, those are your reflexes, which can be ok. My vagus nerve reflexes were ok, however, my cardiac response to deep breathing was nearly flat, indicating my vagus nerve is dysfunctional. So while my reflexes are ok, my overall functioning is not good.

Also, Issie, I wonder if your very low levels of aldosterone might have had something to do with your bad experience with losartan. Maybe the further decrease "crossed the line" sort of speak and made you have just way too low of levels. Perhaps such a thing would only work if one's aldosterone is normal or near normal levels.

[Trach]

Jangle, what test did you have that indicated your vagus nerve was dysfunctional?

[jangle]

I had to do deep breathing on a timed counter while they had electrodes counting my heart rate variability and other parameters. I don't know exactly what went on but my health record said it was abnormal.

[Trach]

Ok thanks I remember that one.