tealndk

HI all, Nice discussion! Ive been a member here but haven't been on for a year...But wanted to chime in as I had just posted something similar on a FB group: the exercise doesn't just condition the body and heart in terms of strength and muscle mass, but what it also does is conditions the autonomic nervous system, and results in increased vagal tone (increased vagal tone = the autonomic nervous system is more able to react to changes in activity and contribute to homeostasis, quickly and efficiently). Hence, since we all (I think) have autonomic dysfunction to some degree, exercise can be hazardous to some especially those who have severe dysfunction, but it does help a little bit in many, with some of our symtpoms. Its too bad that Dr Levines group doesn't actually describe the exercise protocol in those terms, but rather only focuses on deconditioning, which we all interpret as muscle atrophy. Its not the way to explain why exercise helps, though its NOT a cure. I used to work with the big drug companies helping them with cardiac safety testing, for new compounds/drugs. My company created tests that were more able to tease out the changes in heart rate due to autonomic shifts that happen over the course of a day (due to eating, stress, standing, sleeping, dreaming, etc), and that might lead to false positives in terms of new drugs looking like they were dangerous to the heart as they increased HR, and lead to rejection by the FDA. People who are healthy, but do not exercise, do not have good vagal tone. But those who do exercise, and are healthy, have generally excellent vagal tone. An example is that if a person with poor vagal tone rides a stationary bike for say 5 minutes at a vigorous rate, when they stop, their heart rate will not go down for 10 - 20 minutes even after they stopped exercising. But a person who has good vagal tone, who does the same, will have a normalization of the HR within 1 minute of stopping. So think about it - this is why exercise can help some POTSies.. it increases vagal tone and leads to the body being more able to cope with normal changes in activity, and daily life. And that would explain the results of why there was improvement in some POTSies with the Levine protoocl, even when other data points didnt show a benefit. I should add that many of us have an acute onset of POTS, likely caused by some viral/traumatic event... we may have good vagal tone at the time of the onset, but as we recover from this injury and re-balance our organs and systems, exercise can bring back better vagal tone.