New Article Linking Oi To Renal Vein Entrapment(Nutcracker)

[sue1234]

This came out in May 2012:

http://www.ncbi.nlm.nih.gov/pubmed?term=newly%20identified%20symptoms%20of%20left%20renal%20vein%20entrapment

This is just the abstract. To read the full article, which I think you should, as it gives all the orthostatic symptoms and cortisol values, you need to type into Google:

"left renal vein compression+orthostatic intolerance"

The very first PDF link is the full article. I did not know how to link the article, as it has nothing on top to copy and paste. I'm not real tech savvy!

Let me say, I'm not saying everyone with POTS has Nutcracker Syndrome. But, read the whole article and see the familiarities of the symptoms with some of our symptoms. And, think about the odd labs we have in the renin-aldosterone system, etc.

Anyway, I thought it was very interesting, in the fact that the backflow of blood somehow possibly engorges the adrenal system, causing a problem with it working correctly. If I understand it correctly, the abnormal flow could cause the cortisol system to go wrong, and I'm assuming it is postural. In other words, I think when one is upright, the altered flow KEEPS the adrenal gland from providing adequate cortisol for the situation.

It kind of makes sense. I am okay(mostly) sitting, but standing up all **** breaks loose. I can actually understand the whole picture:

Everytime you stand, the renal vein is more compressed. This backflow, or lack of flow, alters how the kidney and adrenal are functioning. If there is too much backflow, maybe this is why some of us have low ADH? Maybe our body thinks we have too high of a b/p according to the kidney sensors? Then, standing for X amount of time really makes the kidney think the b/p is too high, so maybe the body kicks in whatever makes your body immediately vasodilate to lower it. That's the point I always reach within 10 or so minutes of being upright.

While this is happening, in real time, the brain is NOT getting adequate perfusion, so it is screaming for blood flow via the adrenaline system.

And so the cycle continues, all day long.

I also read the other day that this backflow could cause excitation of the adrenal, causing too much release of the catecholamines, which I could totally see happening too. It's like a circus going on in there!

So, can anyone see this happening? I have an awesome new internal medicine doctor, and I'm going to show this article to him. What the heck......I will soon be at my 7th year of having this, and I am desperate to find the reason.

[HopeSprings]

Your explanation makes complete sense. And as my ultrasound showed that vein does get compressed when upright. I'm waiting for urinalysis results to see if I still show blood in my urine and then I'm going to get a copy of the U/S on CD and forward it to the Vascular Dr. in NYC recommended by the other useless Vascular Dr. I saw. It's interesting because when the test was done, the tech could see my heart start to beat very fast on the ultrasound when I stood up. Ha - proof!

[sue1234]

So Naomi, how did you get someone to order the ultrasound, AND to do it correctly? I am going to ask my IM doc, but I'm not sure how to go about it.

[HopeSprings]

I brought a few articles on Nutcracker Syndrome to a vascular surgeon, including the section on NCS from the dinet "causes of POTS" page. I showed him the section that said the ultrasound should be done in the four different positions. He had an in house person who does all the testing, including ultrasounds. The tech had never done a renal ultrasound in all these different positions. Anyway, all were done, except "prone" - which is fine. The Dr. said the vein does get compressed when I sit and stand, but he didn't know if this meant anything. He doubted it, but recommended I take the ultrasound to another Dr. who might know more. I don't know if guy #2 is going to know anything either! So there's the problem - you have to find someone who would know how to interpret the test results. Try searching your area for someone familiar with the condition - it's no easy task.

[sue1234]

I see that this article was first mentioned by Futurehope back in May when it first came out, so sorry about saying this is "new". When I posted this yesterday, I had found the whole article, and that's why I could more think the whole scenario through. Reading the whole article gives you a much better picture of what all the patients are going through and what conclusions the researchers have regarding how this affects orthostatic intolerance.