New Study: Low CO2 causing POTS; anyone else with metabolic acidosis?

[firewatcher]

New Study by Dr. Stewart about low CO2 levels causing POTS.  http://jaha.ahajournals.org/content/7/13/e008854.long

I'm not sure I understand what they tested (serum CO2 or blood-gas,) but my BMP's have always shown low CO2 levels indicating high anion gap metabolic acidosis. Anyone else?

Any insight on this study is appreciated.

[Bluebonnet08]

That is so interesting!  Thank you for sharing.  My CO2 is always low on the lab tests.  When I was having severe tachycardia, my cardiologist told me to breathe into a brown paper bag.  It did seem to calm it down a bit, which would make sense if this study is correct, as that increases CO2.

They are mainly proposing that low blood volume, low blood pressure, and low CO2 are causing POTS from what I understand?  This could explain why IVs help to some extent, raising the blood volume and blood pressure.  It also says exercise raises CO2 which is why some people feel better doing that.  Maybe I didn't read it closely enough, but is it saying WHY our CO2 is low?  What is the mechanism causing that?  Also, what can we do to fix it?  Would love to know that.

I found this part interesting- it would explain why when we start to get into a crash state with multiple attacks, it further depletes us.  In other words, once I get into a state that I start having attacks, it seems like more attacks come.... this explains why....:

"Our study suggests that postural hyperventilation is not a compensatory mechanism for POTS; rather, it causes POTS. The respiratory pump (increased intra‐abdominal and decreased intrathoracic pressures) does not improve CO in subjects with POTS14 because reduced blood volume and extrathoracic pooling of blood severely hamper venous return. On the contrary, if hyperpnea occurs at high operating lung volumes,53 thoracic blood volume may be even further reduced.54"