An extension of this theory: In most conditions where autoantibodies are found that specifically bloke or bind to receptors such as in Thyroid disease and M.gravis, where there are blocking there is also often binding in a spectrum that varies from patient to patient. What this may mean potentially is that there may be a spectrum - some with only blocking and resulting vasoconstriction failure right through as a spectrum to patients where alpha 1 agonising or activating autoantibodies may be present (hypertensive responses or hyper presentations). And more interesting some may have prominent beta 1 activating autoantibodies (massive tachycardia) right through to potentially blocking beta 1 receptor autoantibodies that suppress tachycardia and cause a state of POTS without actual diagnostic tachycardia! Crazy! And ofcourse these autoantibodies may change over time, meaning that a patient miight be hyper in one period and almost hypotensive at another time. The possibilities are quite daunting.