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Finnmin

White Line Test

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I was wondering if it's common for POTS patients to test positive for Sergent's White (Adrenal) Line Test, since my husband certainly does.

Medical Dictionary: "A pale streak appearing within 30-60 seconds after the skin is stroked with a fingernail, and lasting for several minutes; regarded as a sign of diminished arterial tension."

I tested my husband when I didn't know about POTS and thought he might have adrenal fatigue. I myself (and every other family member I have been allowed to scratch for scientific purposes) get a red line, so there's definitely something different about my husband. I would like to know if POTS can cause this, or is my husband battling with some other condition as well. He also gets Bier spots ("ischemic angiospastic spots") on his otherwise purplish hands and feet.

If you have POTS and happen to read this, would you be kind to do this test and post the result? 

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That's so cool!  I have only preliminary diagnosis, awaiting tilt table test for confirmation.  White line for me.  I get white spots on my lower legs while standing for a few minutes, might also be Bier's spots.

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Interesting.  I tried and also got a white line.  

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I've been reading and seems like Bier spots plus white line would indicate "defective adrenegic receptors" - which are the little guys that beta-blockers act upon.  I'm especially interested because it seems that an alpha agonist could work too.  There's an alpha agonist that is used to treat ADHD and anxiety, after my tilt table test confirms POTS I'll will ask about these treatments - and now I'll better understand what they're talking about!  Cool!  Thanks @Finnmin!!!

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Super interesting, BuffRockChick!

I also get the Bier spots, though I never knew it was weird to get them or that there was a name for them!  That makes a lot of sense for me, since my form of POTS is hyperadrenergic and I am currently on a beta blocker, which helps a lot.

Yes, thank you Finnmin!

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White line for me too. Now I have some reading to do and I'm going to scratch my S.O. when he gets here to see if I get a different result. Poor guy, he has no idea he is about to be a medical experiment.

Kim 

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I did it again when hubby got home and had a red line.  He had none at all, my son had white.  (My son might have POTS but isn't complaining of dizziness or fatigue.  He has increase of 40 bpm upon standing, but it was a poor test because he fidgeted so much.)

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I have this sometimes, and sometimes not. I think it has to do with circulation. I get this simultaneously when my hands/finger nails have a more blue/purple~ish color. When they are normal pink color I do not have this. I notice that I do not get it after exercise, and after warm water/shower it also dissapears. Also I am more likely to encounter this in the morning rather than the evening.

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The white spots along with the red or purplish mottled appearance on the hands and feet may be what Dr. Raj refers to as "dependent acrocyanosis". If you google his name and the term, a picture comes up. This is very common in Pots patients and he says it has to do with blood pooling and the way the blood flows under the skin. 

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So many white lines here! This certainly might point to defective adrenergic receptors at least in some POTS patients. The only time my husband got a red line was when he was feeling exceptionally good, he went out to enjoy his rare moment of orthostatic TOLERANCE and it made him crash. 

Thank you Clb75, I'll look into dependent acrocyanosis tonight.

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I thought I was crazy! I will have to look more into this. About 6 months ago I noticed my skin doing it. If I scratched my arm it would turn white instead of red and I thought it was the weirdest thing. Tried to show my dermatologist at the time but it wouldn't do it for her. It isn't all the time for me though. 

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