yogini Posted June 5, 2012 Report Share Posted June 5, 2012 Rama, where do you get the stat that so many POTS patients are hypovolemic? I thought most had normal blood volume. There are other mechanisms that can cause low BP - neuropathy, EDS, etc. Quote Link to comment Share on other sites More sharing options...
issie Posted June 6, 2012 Report Share Posted June 6, 2012 Theoretically ARBs could also increase volume over time.Most alpha agonists like midodrine promote low blood volume.Why would an ARB increase volume?Why would an alpha agonist - like midodrine cause low blood volume?Are there any studies saying this?Issie Quote Link to comment Share on other sites More sharing options...
L4UR3N Posted June 6, 2012 Report Share Posted June 6, 2012 Salt seems to help me out in the short term, though I'm not sure about long term. It seems to cause more edema which further depletes the intravascular space. I dont regularly salt load, but I certainly dont restrict it either. I usually reserve the salt loading for times of "crisis" when I need a quick bail out. Quote Link to comment Share on other sites More sharing options...
ramakentesh Posted June 6, 2012 Report Share Posted June 6, 2012 Rama, where do you get the stat that so many POTS patients are hypovolemic? I thought most had normal blood volume. There are other mechanisms that can cause low BP - neuropathy, EDS, etc.http://www.mc.vander...x.html?ID=12580 - from David Robertson and he would know. POTS patients dont normally have low BP. Neuropathy may be what is promoting low blood volume so low blood volume doesnt necessarily exclude other pathological factors. Sympathetic activation also promotes low blood volume as in essential hypertension. But why dont these patients faint?Why would an ARB increase volume?Why would an alpha agonist - like midodrine cause low blood volume?Are there any studies saying this?Ofcourse there are studies. Patients with elevated serum angiotensin II levels were found in the studies by Dr Stewart to have paradoxically low Ald and renin as I have demonstrated previously. Correcting the ang II levels or responsiveness would in theory stop the renin supression. You should read those studies since you are so interested in Aldosterone. It is established that midodrine would promote volume loss like all vasoconstrictors do:http://www.google.co...tjEvJ0Bv5AOaOwA Quote Link to comment Share on other sites More sharing options...
issie Posted June 6, 2012 Report Share Posted June 6, 2012 I have recently been reading that mast cell degranulation can increase Angiotension II levels - so thinking that may have a bearing on this issue. www.mastcellmaster.comI try to read whatever I get my hands on - thanks for the article.Issie Quote Link to comment Share on other sites More sharing options...
ramakentesh Posted June 6, 2012 Report Share Posted June 6, 2012 I thought it was the other way around. But elevated ang II in POTS is associated with reduced ACE 2 activity at least in the skin. Quote Link to comment Share on other sites More sharing options...
HyperPOTS8 Posted June 11, 2012 Report Share Posted June 11, 2012 Hi Arizona girl,I too have hyperPOTS with a supine norepinephrine level of 1300 and upright 3300. I take clonidine patch 0.4 mg every 5 dats plus oral clonidine prn. Despite this my BP is suboptimally controlled and with adrenergic surges (which can occur with going to my kids' ballgames, etc) it will go very high (max 193/127). Would you be willing to share your experience with using labetolol in a titrating fashion? I also have other autoimmune illness and believe my hyperPOTS may be autoimmune as Dr Grubb mentions on his recent YouTube video. I saw you are trying IVIG. Has it helped your POTS?Thank you Quote Link to comment Share on other sites More sharing options...
kayjay Posted June 11, 2012 Report Share Posted June 11, 2012 It may be wise to have your sodium levels checked and then decide what to do. Mine was low and I was told that I was drinking too much plain water. I drink v8 now. A certain amount may help you hold onto water. I always seem to feel better when my wedding ring is tight. If it is slipping off of my finger I increase my salt. Quote Link to comment Share on other sites More sharing options...
kayjay Posted June 11, 2012 Report Share Posted June 11, 2012 I should also add that the research on salt as a cause of high blood pressure is questionable. I have a child with high blood pressure and his doctor at Children's Hospital of Philadelphia told me that salt is not an issue for many people. I wonder if you would do better adding sea salt to your food and drinks instead of taking a pill. Tummy trouble is not helpful when you are trying maintain your electrolyte levels. Quote Link to comment Share on other sites More sharing options...
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