On POTS and Autoimmunity

[MTRJ75]

A few good nuggets from an article I read yesterday: 

https://goop.com/wellness/health/pots-and-autoimmunity/?fbclid=IwAR2aPb_ZjmvKSWTGuXFu0IuaCE00B_t3K-2Ms6xvQ-VUdtUo9ptcqrTWuL4

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Some people can’t maintain their blood pressure because their blood vessels fail to tighten. The brain senses this and asks the heart to beat harder and faster to pump more blood upward. But because the blood vessels in the lower half of the body haven’t tightened, all of this is to no avail: Gravity wins, and blood moves downward and away from the brain, causing the brain to receive less oxygen. 

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The lack of oxygen to the brain results in symptoms such as fatigue, trouble thinking, lightheadedness, tunnel vision, and sometimes fainting. When patients are lying down, their heart rate is relatively normal, but when they stand up, they feel extreme fatigue, weakness, shortness of breath, and as if their heart is pounding out of their chest. This makes it difficult to exercise and can also cause anxiety. As with any disease, there are varying degrees of severity.

Okay, but why does our heart still race/pound/skip when sitting or lying down so often? 

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There are several nonspecific blood markers—such as antimitochondrial antibodies, sedimentation rates, and C-reactive protein—that are elevated in people with POTS, suggesting that the disease is autoimmune.

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Alpha-one receptors are important because if you simulate them, they cause blood vessels to tighten. And if they’re blocked by these autoantibodies, the blood vessels are unable to tighten.We found that 90 percent of the patients with POTS whom we tested had very high levels of these autoantibodies in their blood. Of those individuals, 50 percent also had high levels of a different autoantibody that affects a type of acetylcholine receptor called M4, which are found in the gastrointestinal tract and the brain. This evidence strongly suggested that many people have POTS due to an autoimmune issue.

I know some of us strongly suspect AI issues, but I've never heard it stated this confidently before. I've had basic autoimmune bloodwork done a few times, but don't know if I've ever been tested for stuff like antimitochondrial antibodies or alpha-one autoantibodies or any of this other than CRP and sedimentation rates. 

[Guest KiminOrlando]

My antimitichondrial antibodies have been elevated, but they change. My SM was positive, but now negative. 

I think there is something funky with the immune system that seems to throw out random antibodies. 

I'm seeing an allergy and immunologist tomorrow. Maybe I will ask about this.

[dancer65]

Thanks for sharing interesting article x

[MTRJ75]

To add to this: 

https://pubmed.ncbi.nlm.nih.gov/32079137-ganglionic-acetylcholine-receptor-antibodies-and-autonomic-dysfunction-in-autoimmune-rheumatic-diseases/?fbclid=IwAR1CADHMaaVcakTZkV9lqGvMjfBKP1hRYh2U4sUVcd6dV42Gdd8eHRLv-Wk

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Autonomic neuropathy has been reported in autoimmune rheumatic diseases (ARD) including Sjögren's syndrome, systemic sclerosis, rheumatoid arthritis, and systemic lupus erythematosus.

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Autonomic dysfunction, which affects lower parasympathetic and higher sympathetic activity, is usually observed in ARD. The anti-gAChR antibodies may play a crucial role in autonomic dysfunction observed in ARD.