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Hypermethylation Of Norepinephrine Transporter Gene

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Ramakentesh had told us that the Baker Heart Research Institute people have been working on this topic. Here's a link to one of their articles on the relationship between epigenetic changes to the norepinephrine transporter gene and various illnesses, including POTS. An epigenetic change is a potentially reversible alteration in gene function, without a change in the sequence of base pairs in the gene. In other words, the gene is probably "spelled" correctly, but there might be extra chemicals stuck to it that will keep the cell from using it to make the particular protein for which the gene provides the recipe.

The article suggests that this kind of epigenetic change (specifically, extra methyl groups [a carbon with three hydrogen atoms] stuck to the on-off switch part of the gene) could result in panic disorder, essential hypertension, and POTS.

If your doctor insists that your POTS is due to an "anxiety disorder," print this article out and take it with you to your next appointment. It explains that the anxiety and the POTS could both be the result of a chemical abnormality in an important gene. So neither condition is "all in your head."


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Thanks, Ithomas, especially for your explanation which I understood a lot better than the extract?!

Maybe when the full article comes out regarding hypermethylation of the gene affecting NET in POTS patients, you can "translate" for us.

Are you in the medical field by any chance?

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hey lthomas521,

how were you diagnosed with the hyperadrenergic form of POTS? just curious cuz i think that is what they are investigating as the cause of my POTS. also, are you symptomatic?

interesting article by the way..

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I have high norepinephrine when I stand up, but no other neurological abnormalities that they can find. I 've had documented low blood volume, which I'm trying to correct by salt, water, and licorice. The main thing that helps me is B vitamins, in large doses, which suggests to me that I have some sort of metabolic or mitochondrial problem.

I'm able to work, because I have a sit-down type of job. I can't really do housework or gardening or anything that involves prolonged standing up or repeated bending over. If I try, I get a migraine. My main problem is fatigue and lightheadedness. I haven't fainted in years.

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just curious how you are symptomatically. i too have high norepi (either epi or norepi) while standing upright and also have high dopamine levels while upright. since there are so many different causes to pots, it is interesting investigating how people respond symptomatically and how specific symptoms can sometimes vary from patient to patient based on what is actually causing pots from individual to individual (such as hyperadrenergic state pots vs. peripheral neuropathy pots vs. norepi transporter deficiency pots, etc).....i dont get the dizzy/light-headed thing really, once in a great while. my BP is like 94/60 standing, but i really dont feel dizzy/lightheaded. ....

sometimes i wonder if the people who have the higher heart rates compensate better from a higher cardiac output (blood being more quickly distributed as compared to a lesser output with a heart rate of say 120).....seems like a higher rate would be able to help correct fallen or fallING bp and so perhaps these people with higher rates (in general) dont feel as light-headed/dizzy. my heart rates are like 180-200 standing. but who knows, i cant speak for everyone and i'm sure there are people who have "higher than average" heart rates for the pots criteria who still feel very pre-syncopal/dizzy....just seems to click that a higher heart rate would be a "better" compensatory mechanism as compared to someone who has the "typical" 120 upright heart rate and whose BP starts to fall out. .....makes sense, less cardiac output from a "lower" tachy rate, less compensation to hold a stable pressure, therefore less effort from the heart to maintain pressure.....i'm sure this theory has been disproven.

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can anyone explain what the difference is between adrenaline, epinephrine and norepinephrine?? are they all the same? thanks for any info,


Radha -

You may want to read the NDRF Handbook - it's a great overview of the autonomic nervous system in dysautonomia - it explains all the neurotransmitters. You can download a free PDF copy at:


Basically, no, each of the chemicals is different and plays a different (sometimes similar) role in different parts of the body.

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Guest Julia59


Thanks for the article---I printed the full text version of it. For years and years I have suffered from panic attacks---they would last up to 5 hours--------terrible---they truly are.

Anyway, you can see my signature line so you know what I'm diagnosed with. I would always get tachycardia with those attacks, but not necessarily from the OI---I don't know because I've been on a beta blocker so long now. I could deal with all the other POTS symptoms other then the panic attacks.

The fatigue runs a close second though. When I get overly fatigued, I feel on the verge of a panic attack, and I worry because being so fatigued I often wonder how I would handle a full blown attack.

I was told I have hyper-adrengic POTS---until I asked them to order the blood work to prove that was the type of POTS I had. My norepi--and epi levels were in the normal range, but my dopamine levels were high. About three times what they should be sitting, and oddly they went down upon standing, but still higher then normal. I was told it wasn't a big deal. But given the state I've been in lately---I'm not so sure about that.

Given the many things I'm diagnosed with---I don't know what is causing what. However, I was told once that the compression on my cervical spine and brain stem has been here so long---that my sympathetic nervous system is very irritated. Sometimes all my husband has to do is lightly touch the middle of my back when I'm in the midst of a panic attack---and I feel like going through the roof.

I found the article very interesting, but some of it was difficult to understand---so I'll read it a few more times until my brain will comprehend it fully.

Julie :0)

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Guest tearose

thanks for the article!

It is always good to learn what the latest research is.

Hopefully I will understand it better after I read it a few more times!

I too only have issues with the norepinepherine and not seratonin so I have to decode what relates to my condition.

I'll have questions later...


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