High Flow, Low Flow, Normal Flow Pots?

[LindaJoy]

Hi, everyone. I've had POTS diagnosed since 2005. Yet, I've never heard of high flow, low flow, normal flow POTS. Could someone explain this to me. Sorry if it's all here, but I can't find it in explanation form.

Does this have anything to do with being hyperadrenergic?

Thanks.

Linda

[ramakentesh]

its basically an alternative classification scheme based on calf muscle skin blood flow - high flow meant increased skin blood flow, normal flow meant normal supine skin blood flow and abnormal posturally and low flow means decreased all the time - both supine and upright.

I think this scheme is evolving. There is mention in some of the studies that there appears a grey area particularly between low flow and normal flow - and they were going to look at perhaps delineating into high ang II v normal ang II.

[issie]

There is mention in some of the studies that there appears a grey area particularly between low flow and normal flow - and they were going to look at perhaps delineating into high ang II v normal ang II.

Have you seen the study where they are trying to determine if low flow and normal flow are connected to angiotension levels or is it still in research stage and nothing released yet?

Issie

[ramakentesh]

They are thinking that some low flow dont ave elevated ang II - some do - that is the difference and that the other smight just be part of the spectrum of normal flow.

[issie]

Wish I had seen that response before I answered on another thread a few minutes ago. Since, I've been thinking I'm low flow all along and the ARB didn't work on me and I have low renin/aldosterone levels - in the breakdown from the kidney - that would make angiotension 2 low also. So, maybe I'm one that doesn't have high angiotension 2 levels and thats why taking the ARB to lower it made me worse - not better. If it was already low - can't hardly lower it more - can you. Unless you are lowering it at the heart level - because the heart and liver also produce it. Maybe, that's why the ARB made me feel like I was having a heart attack - it was lowering what was already too low possibly at the heart level. Hmmmmmmmmm????????

Issie

[ramakentesh]

In the study from vanderbilt they used low renin and ald as markers for high ang II despite the obvous paradox - but only ace 2 is faulty. But still others ive spoklen to have low ald and renin but have had normal ang II results from another forum.

[issie]

Okay, so back to wishing I could get that level checked and then we'd know. Right?

[issie]

If it's the ACE2 that's faulty in the low renin/aldosterone groups -then that would explain possibly what I was thinking in regard to the article I found with connective tissue disorders and the connections to autoantibodies to ACE 2 in that group of people (Maybe???) Since having EDS with it - I was trying to see if that could be the connection and if low renin and aldosterone are a part of the picture - then that is me to a tee. But, that study was for those mostly with scleroderma - but it also included people that had pre-eclampsia.

There's a difference in ACE 2 and Angiotensin 2 - different points in the breakdown of things.

Now, you've put my thinking cap on. Hmmmm! Just thinking out loud here. Got any direction for me?

Issie