How Can You Have Both Pots And Cfs?

[Courtney812]

I am wondering how you can have both

POTS and CFS only because to have cfs the fatigue can not be caused by another illness. And POTS (which causes fatigue) is indeed another illness.

Pots causes extreme fatigue in my opinion with the heart rate shifts, low blood pressure among other things.

Can someone please explain this to me better?

[xRobin]

Hi Courtney,

Those are really good points!

I can only speak for myself, here. I don't think having a different cause for fatigue such as POTS or even something like depression rules out a CFS despite what the case definition says, if other symptoms are present. Because CFS is a diagnosis of exclusion they look for stuff they can treat first. It's kind of like MCAD or EDS. POTS can present as a manifestation but is not necessarily the whole story.

CFS is more than just fatigue, it usually presents with a constellation of symptoms that are a little different than the POTS profile (though, again, there is overlap) such as insomnia, tender or swollen lymph nodes, headaches, frequent sore throats, post exertional malaise, bowel issues and neurosensory issues such as light and sound sensitivities. (I get fevers, too.)

To me, CFS is feeling like I have an infection. In fact, when I actually get an infection I'm not always aware of it, it feels like simply a worsening of symptoms. I haven't heard POTS described this way. People with POTS are tired and weak, they get shortness of breath, blood pooling, dizziness, lightedheaded, etc., and while I could be wrong you don't often hear people with POTS saying they feel like they have influenza without the cough.

But, lacking other symptoms beyond typical POTS it doesn't make sense to consider CFS.

CFS preceded POTS for me almost two decades. In fact, I passed a standing test at a time when I was so tired and sick I couldn't walk more than a block. Now that I have POTS, too, it doesn't make sense to say that is the cause of my fatigue when I still have all of the prior symptoms of CFS.

A lot of the recent research for CFS recently suggests there is likely a strong immunological component, low level of neuroinflammation, and possibly the involvement of various viruses. Both the immune system and the nervous system can affect autonomic function, so it's possible POTS and other types of OI common in CFS are a downstream effect rather than a cause.