Have you heard? (POTS subtypes)

[Sea otter]

Have you heard that the leading dysautonomia experts no longer subscribe to the theory of POTS subtypes? This is because most people with POTS present with features characteristic of several subtypes and patients should be treated based on their individual symptoms, not a specific "type". 

[MikeO]

My clinic said they don't care about the OH subtypes as knowing won't change the treatment. My argument has always been knowing what portion of the ANS is not working well is telling for other issues that most of us experience. 

[Pistol]

@Sea otter yes, the subtype makes no difference in symptoms but it CAN make a big difference in treatment. For example - hyperadrenergic POTS causes symptoms due to excessive vasoconstriction. Neuropathic POTS, or for example POTS caused from EDS, cause symptoms due to excessive vasodilation. Therefore the medications to treat the symptoms would have to be different - I take calcium channel blockers and alpha&beta blockers, which would make neuropathic POTS worse. And Midodrine or Florinef would badly affect me but be very helpful to someone else. 

So, in my experience subtypes do matter in certain cases. Problem is many physicians are not aware of the subtypes.