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Mayo's New Classification Of Hyper Pots Subtype


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Because I recently got my lab results and my NE was over 1400, I wanted to know why. I began reading older Dinet posts and the new Mayo Pots paper posted by Issie.

In rereading the new Mayo paper that Issie posted, I found an interesting delineation Mayo is now making on hyper pots patients. In reading old Dinet posts it seemed that Vandy and Grubb were saying hyper pots patients had an EN level >600. Mayo disagreed. In reading this new paper Mayo is now dividing hyper pots patients into two groups. Those with NE >600 as 30% to 60% of pots patients and those with NE levels between 1000 and 2000 as a subgroup of 5% to 10% of patients.

Quoting: Between 30% and 60% of patients with POTS have evidence of increased central sympathetic drive, as reflected by standing plasma NE levels of 600 pg/mL or more...(goes on to say more)

These patients have been categorized into a primary or central hyperadrenergic subgroup with plasma NE levels often between 1000 and 2000 pg/mL that compromises approximately 5% to 10% of cases and a heterogeneous group of secondary hyperadrenergic POTS. (goes on to say more)

The paper goes on to say (quoting):Secondary hyperadrenergic POTS has also been associated with mast cell activation disorders.

The paper says much more on hyper pots specifically about NET and specific auto-immune issues under the hyper-pots topic, (first page of paper)

Anyone have any thoughts on this?

Here is the link to the Mayo paper Issie posted.


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Kitt- have you had this test more than once? The first time my standing NE was 1001, but when re-tested it wasn't nearly as high (I forget the exact number, possibly not even over 600). So I don't know if I'm hyper POTS - I'd like to repeat the test. I just wonder if people have shown consistently high levels on repeat testing.

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The cardiologist I'm seeing has treating dysautomia before. Even though I already had a pots diagnosis, he did a two week holter monior, (unusual to wear one for more that 24 or 48 hours), en echo, stress echo, a TTT, and after a very negative reaction to 2 different BB"s , and because of his knowledge about other illnesses I have, he suggested he I may have hyper pots with mca.

All of the catecholamines were off, not just the NE. He tested for a pheo and those numbers were normal.

My NE is not 'borderline' so don't understand why he would reorder them, but if he suggested it I would.

I see him tomorrow, and will share what I learn.

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