ramakentesh

I think your kind of making assumptions about what your veins and arteries are doing for a start. Most vasoconstrictors work on alpha 1 receptors (midodrine, phenylephrene) and serotonin receptors (DHE) which are expressed more in the microcirculation than anywhere else or in the case of serotonin receptors specific for the veins. Blood pressure readings are almost meaningless in POTS since they tell you very little about regional blood pooling, increased microcirculatory filtration, brain perfusion and most importantly stroke volume. When i take vasoconstrictors my standing blood pressure lowers and I feel better.

Curing lightheadedness is the million dollar question! Sometimes medications like midodrine or phenylephrene can help. Licorice can sometimes. Caffeine can sometimes for short period.

POTS itself causes vasoconstriction of the eyes or so I was told so slightly increased Intraocular Pressure - mestinon can helps POTS and improve this symptom potentially. Worth considering. I also get this symptom but I have ank spond which causes weird eye inflammation.

There is a new autoimmune mechanism in the process of being published. POTS seems to occur occasionally in those with Sjorgens, Hashimotos, Crohns and inflammatory arthritis (Rheumatoid, psoriosis arthritis (sorry about spelling) and Ankylosing Spondylitis). Out of interest does your POTs wax and wane or flare and remit? Secondly have you been on TNF inhibitors for Crohns?

Hope you get some relief.

It is very unpredictable. I was told of a patient that had it constantly for 12 years then just one day woke up almost in remission. My cousin experienced what may have been pots at 15 and recovered - mine came on at 26 and has waxed and waned since then

All great tips. My only comment re exercise is that absolutely going out and gaining yourself even in a setting of improved general fitness via a headed exercise regime (which is key) can cause me to crash. once in a crash I have to start exercise from scratch for some reason. its always great to hear positive ideas and they seem to mirror my own coping mechanisms

These are all great questions and its unclear for many of them.

Most like me assume it will do the opposite.

Haha. Yes I've got a collection of about twenty potsies who with pots do very well on old Sudafed. Thanks for sharing.

thought id bump - a very helpful thread

I find fasting seems to improve my symptoms.

yes it definately can for some. seems pretty unpredictable

essential hypertension of a persistent nature might give a clue...

Yes. It also just makes me feel better too.

Sounds like a bad one. Volume loading via ORS or saline ivs could be helpful. Alternatively you might consider talking to your doc about increasing dose of florinef? I know that lying at night feeling. It *****. a few times licorice tea early in a flare can short circuit it somehow.

I'll believe in leaky gut when someone can tell me how food matter leaking into a person's blood stream doesn't result in septicemia and when they explain how these particles cross the blood brain barrier... the gut is involved but its probably different.

You can add: Phenylephrene - central and peripheral alpha 1 agonist and vasoconstrictor (now being fairly commonly prescribed although it is not restricted) Synephrine - peripheral alpha 1 agonist made from bitter orange Diosmin - vasoconstrictive via indirect mechanism Methylsynephrine - vasoconstrictor once used for postural hypotension and now as a dietary supplement for weight loss. Experimental.

Bumpy bump

If they could work this out we would be in for much more effective treatments

Keep them coming.

Short term fluctuations increasing blood pressure are not generally regarded as of medical significance. Low blood pressure spells are probably more dangerous. Sustain hypertension is another matter.

Peripheral blood pressure reading do not tell you about stroke volume or cerebral blood flow.

I call them pots migraines. Pretty common but get checked out.

Overall blood pressure measurements don't always tell you much about how much blood is getting to your brain, stroke volume, cerebral auto regulation and alpha receptor action. Treating pots or oi successfully usually resolves Bp fluctuations at least in the dizzy set.