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Hello all, 

I am diagnosed with MCAD, possible Hereditary Alpha-1 Tryptasemia, and experience POTS off and on. Is this poTsible? :-) When I had the TTT my results were normal. I was not symptomatic that day, however, there are days where I am symptomatic and my BP stays elevated at least 30bpm for more than 10 minutes upon standing. The TTT doctor is a general medicine doctor who says she knows very little about MCAD but says if you have POTS it's ALWAYS the same - there are no good days where you wouldn't have the 30BPM or more upon standing for up to 10 minutes. Can anyone shed light on this? I have a quality wrist BP cuff and am able to take my own measurements when symptomatic so that's how I know this occurs with me. 


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Welcome to the forum.

POTS symptoms can definitely vary from day to day.  Some people have POTS symptoms in the AM and they can resolve in the evening.  Some have worsening of symptoms associated with their menstrual cycle. I have experienced this and many others on the forum have described this too.  Whether treatment is needed for occasional or erratic symptoms would be an individual decision.  It could be that just increasing fluids on more symptomatic days would help, and be enough.  It would depend to a great extent, probably, on how severely affected you are.   If there is an underlying cause or trigger identified, treating that could improve your POTS symptoms. 

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