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Why Does Pots Go Away?


ipad

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As a 15 year old teenage boy who may have POTS, I have wondered, why does POTS mysteriously go away? If everything goes according to plan, my POTS (if that's causing my symptoms) will gradually disappear until I am asymptomatic, apparently around my mid 20s.

Does this actually happen to teenagers who have POTS?

If yes, does anyone know what is going on in the body that produces this effect?

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My medically uneducated best guess would be hormones. During the shift to "adult-hood" there are wildly fluctuating hormone levels that effect everything from hair growth to blood volume levels. I would also venture a guess that this is why women (whose hormone levels fluctuate) tend to have POTS more often.

Did you have exercise intolerance as a younger child (age 6)?

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No, I don't remember having exercise intolerance as a kid. My symptoms all started when I entered puberty.

Maybe this has to do with the hormone aldosterone? Maybe that's why teenagers react so well to Florinef? My endo is testing all of my hormones, so we'll see if I have an issue with aldosterone. I am currently on no meds.

Maybe teenagers with POTS make an insufficient amount of aldosterone during the years of puberty?

Does anyone else have any ideas?

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That is great that you had no previous exercise intolerance. I've always had it, and still have it now.

The explanations I've seen for puberty onset is the rapid fluctuations of hormones (testosterone, estrogen, growth hormone, etc.) causing "spurts" in growth that cause differing ratios of blood volume to muscle mass, as well as a rapidly shifting center of gravity. During puberty, the heart's size and pumping capacity also changes.

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I'm fifteen too- I really hope this will happen to us. All of my doctors have told me they think it will go away and it would be so awesome if they are right!! :)

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As a 15 year old teenage boy who may have POTS, I have wondered, why does POTS mysteriously go away? If everything goes according to plan, my POTS (if that's causing my symptoms) will gradually disappear until I am asymptomatic, apparently around my mid 20s.

Does this actually happen to teenagers who have POTS?

If yes, does anyone know what is going on in the body that produces this effect?

Well it's great that you got diagnosed early. I first start noticing my POTS symptoms when I was 17, I'm currently 23 and still have POTS. I have improved since when I first got it, I noticed my nausea/vomiting went away after a while. Mostly the lightheadedness/headaches/dizziness lingered. Exercise improves these symptoms for me.

To your question why does POTS go away. Well, first and foremost you have to understand that this is like looking into the ocean and trying to guess what is at the bottom.

It's a difficult question to answer because as it stands POTS isn't a singular thing, there appears to be different "flavors" of POTS. Hyperadrenergic pots, low flow pots, high flow pots, autoimmune pots, MCAD related pots, connective tissue disorder related POTS, heck there was a patient who had a big ole' inferior vena cava that presumably caused her POTS, not to mention deconditioning induced POTS. And probably many other types.

My own personal opinion is that underlying a lot of these cases is an autoimmune cause. There is a fairly long explanation as to why I think this and I would make this post way too long if I delved into it.

Basically, from the evidence presented to me, I feel that there are autoantibodies/cytokines that are disrupting the NET (norepinephrine transporter) from having adequate levels in POTS patients. It is conceivable that as one ages, changes naturally occur within the immune system that can lead to a mitigation/remission of POTS.

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Another explanation I've read in the past as to why teens get it around puberty is similar to what Firewatcher noted about the growth spurts, including changes in the autonomic system. Basically it's been theorized that you "outgrow" your autonomic system and it takes time for it to catch up with the rest of you. My POTS neuro says kids recover more often in part because their nerves are more likely to regenerate than in us older folks.

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Chaos-- could you apply that theory to pregnancy and extreme weight loss? I sometimes wonder if all the hormones, weight that was gained and lost quickly threw my body for a loop. I went from 115 to 180 to 110 to 165 to 108 in two years! Had an 11 pound and a 10 pound baby! I read somewhere that people can get pots after gastric bypass.. 165 to 108 in 4months couldn't have been easy on my body :(

Otherwise, I'm tending towards hormones being a culprit for me. I hope everyone who has pots out grows it! Or that our bodies find a way to adjust to it

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I agree with Firewatcher and others and was told by Dr. Grubb that hormones play a huge part of it for adolescents. My daughter was young (almost 11 yrs.) when she be ame sick with POTS. Dr. Grubb said in his experience that the younger the patient gets it, the better chance they have of getting rid of it all together. My daughter gradually improved over 3 and a half years, then crashed big time and for awhile, was back to being bedridden for most days. Now, she's been doing much better again since the end of the school year. I think some of her issues stem though from her hypothyroid issues. I'm still trying to find a good doctor for that!

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