For hyper people.

[Outaker]

Rauwolfia’s effects on the heart include decreasing myocardial excitability, inhibiting atrial-ventricular conduction, and extending the refractory period of the heart rhythm.1

Much of the medicinal effects of Rauwolfia serpentina and Rauwolfia vomitoria have been attributed
to the hypotensive indole alkaloid reserpine.2Additional alkaloids found in Rauwolfia roots include the indoles ajmaline, ajmalicine, raubasine, imethylajmaline, methylisoajmaline, hydroxysarpagine, yohimbinic acid, and isorauhimbinic acid.3 The constituent ajmaline is thought to be antiarrhythmic.4

Before the advent of the current pharmaceutical options for hypertension (beta blockers, calcium channel blockers, and angiotensin-converting Inhibitors), reserpine was a mainstay in the management of hypertension. Reserpine acts via the CNS to reduce sympathetic tone, increase parasympathetic activity, and help normalize blood pressure, especially when because of stress and sympathetic nervous responses, as it may partially block adrenaline receptors.5 Reserpine’s ability to block adrenoreception on blood vessels can reduce stress-induced vasoconstriction contributing to hypertension or heart palpitations.

 

[Pistol]

@Outaker - I believe Rauwolfia is the same as Yohimbe which is listed under medications effective for certain types of POTS in the literature. 

[Pistol]

@FileTrekker - yes, I know what you mean. It is true that the tachycardia in dysautonomia is driven by a different mechanism than other types. I have heard of some patients undergoing ablations for POTS without any effect at all. I also know of one unfortunate individual who agreed to have his sinus node disabled to stop the relentless tachycardia and now is totally dependent on his pace maker. The sad reality is that - still - many cardiologists are just so unfamiliar with the mechanics of POTS and attempt to treat the tachycardia as the CAUSE and not the result of POTS. Or they disregard the seriousness of the tachycardia as perceived by the patient, in other words they wave it off by saying that it is not serious or that it is not important. I have only met a few doctors that were open to the concept of POTS and therefore able to learn from and with their patients. These few doctors ( cardiologists and PCP's ) have been able to help POTS patients - and thankfully accept POTS patients - because of their open minds and ability to treat the whole person and not only One or Two symptoms. 

[Pistol]

I have seen both cardiologists and neurologists, even a neurologist within a major autonomic clinic. They all missed my diagnosis of hyper-POTS because they only were looking for the typical, most common POTS problems that they were familiar with. Once I did not present the typical picture of POTS they dismissed my - severe - symptoms as something else. In other words: they put a big red bow on me and sent me back to my PCP. Did not want to touch it. But I see more and more progress in the medical community's willingness to accept POTS - a lot of this is because it now gets taught in medical schools, so younger physicians are more likely to recognize POTS. My sister in Germany - who also has my type of POTS - saw several supposedly autonomic specialists and was dismissed by all of them. Then she moved and needed to find a new PCP and - boom! Jackpot!!! He is a young PCP but so open to and willing to learn about POTS that it was like a true miracle to her. Today she is on many of the treatments that I was ordered because he was willing to try them and she is greatly improved. So - you are right, cardiologists may not be the best type of physicians but neither are neurologists, necessarily. It is a open-minded and compassionate physician able to see the whole body-mind-spirit connection of a patient that will be most helpful to POTS patients, no matter what field of expertise he practices. 

[bombsh3ll]

If you pee an inordinate amount and/or have symptoms of hypovolaemia (google hypovolaemic shock) like many with POTS, an evaluation by an endocrinologist may also be valuable. I believe that in most POTS cases the tachycardia on standing is compensatory for a reduced central blood volume & cardiac output. This can be due to either overall hypovolaemia like in my case, or blood being unavailable due to pooling in the lower body. 

Blocking it just to make the numbers look better makes no sense and can certainly make things worse. Also one's heart rate does not necessarily correspond to how well/unwell they feel. A high heart rate on its own with no symptoms, provided the rhythm is normal and the heart is structurally healthy & underlying causes such as thyroid disease etc are ruled out, is not necessarily an illness or requiring treatment. 

B x

[Outaker]

6 hours ago, FileTrekker said:

What is Rauwolfia? I'm not sure why anyone would even be taking it / want to based on that?

How does it relate to reserpine  / what is that?

Rauwolfia drains norepinephrine which prevents huge surges in blood pressure.