Anxiety, Hyper Pots And Nor-Epinephrine

[Joann]

Just wanted to chime in that I also get delayed reaction to exercise. This thread makes me feel a little better, just knowing I am not the only one. I have told my doctors how several hours after doing stairs or exercise I will get extremely ill and they look at me like I am crazy! I guess I should be used to that look by now! LOL.

I agree with several of the posters, it makes me afraid to do more than walk, because I am so afraid I will pay for it later. Do any of you notice that after you have triggered that response, that it is more easily triggered for quite a while?

[issie]

• kitt,

I take an H1 and H2 and also my gastrocrom at night before bed. (I also take a few natural supplements too.) That combination keeps me from having the night time awakenings and I don't have the tremors from the surges in the night. If I don't take them ---I have all the ugliness of mast cell release in the mid night and NE surges with tremors and it makes for a very long night. And even longer day the next day.

Issie

[ramakentesh]

rspry, I too suffer from quite severe anxiety symptoms. I always thought the anxiety was psychological, but it's seeming more likely to be attributed to high levels of norepinephrine. Now, of course norepinephrine has been shown to increase a type of learning known as "fear" learning which is implicated in phobias. In the presence of high levels of norepinephrine, it would be a safe assumption that this makes us susceptible to developing phobias which of course have a psychological as well as physiological basis.

Step 1 would of course be to reduce the norepinephrine levels.

However in POTS it isn't necessarily the concentration of norepinephrine, because POTS is associated with low norepinephrine transporter. Essentially what the NET does is remove norepinephrine from the nerves, terminating the signal. So you can see that if we have low levels of NET, then that will lead to a situation where even normal or near normal levels of norepinephrine is going to have the same effect as high levels of norepinephrine as it's staying in our nerves longer than it should.

There are drugs that can indirectly target norepinephrine and its effects, I'm waiting on seeing a good enough neurologist before I see what I can do with it.

Causes of anxiety in POTS:

* Release of epinephrine to counteract reduced cerebral blood flow (as occurs when too much hypotensive meds are given to hypertensive patients)

* involuntary postural hypocapnia

* reduced cerebral blood flow may in itself cause anxiety

* low blood volume (shock patients commonly report anxiety as a symptom)

* reduced cerebral sodium (again causes symptoms of panic and anxiety)

* and ofcourse everyone's favourite - elevated NE levels.