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There are many. Pots is a syndrome with many suggested causes, none definitively proven and many hotly debated.

some suggested etiologies include selective autonomic neuropathy with associated small fiber neuropathy, norepinephrine transporter deficiency which can cause tachycardia and reduced stroke volume, low aldosteron/high angiotensin II, perhaps primary peripheral or central parasympathetic problems and then those with huge norepinephrine release (central hyperasrenergic) which may have an association with mast cell disorders.

still others continue to search for other mechanisms such as deconditioning, cerebral auto regulatory failure, spinal presynaptic denervation, abnormal expression of vasodilating molecules or diuretic peptides, etc.

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