ricsch

Hello, I was diagnosed with POTs after a tilt table test almost a year ago and had a few questions for forum members. First I'll start with a little background. I'm a 25 year old male and my symptoms started about 7 years ago with a little intermittant brain fog, fatigue, and just feeling "out of it" mentally. At this time lying down for a while would clear it up and I would only have episodes every couple weeks or so. This began progressing over the next couple years until the fogginess was nearly constant. Now lying downs seems to help a little if I'm very symptomatic, but never returns me to normal. I went through tons of testing like most people here and didn't turn up much until the tilt table test about a year ago. My tilt table test was only mildly positive (a little over 30 bpm increase), which has my current cardiologist questioning the diagnosis. I do not believe I had a significant blood pressure increase during the tilt table, and I know I did not have any blood drawn during it to check catecholamine levels. Drugs I've tried: Propranolol (seems to help a little in small doses), Fludrocortisone (no change), Midodrine (sometimes seems to help, sometimes not, jury is still out) Symptoms: Brain fog, extreme fatigue (exhausted but not sleepy), irritability, hurts in my head to think, eye floaters, heat intolerance (showers, heat make symptoms worse), excess sweating and urination, have had heart palpitations infrequently Caffeine and stimulants seem to make my symptoms much worse when I am having a bad day, along with dehydration. Since I have had what seems to be typical treaments for regular POTs, I have been beginning to wonder if hyperadrenergic POTs is what I may have, if it's POTs at all. This is due to my slow onset of symptoms, and lack of improvement from treatment with the usual drugs. I did have a regular seated serum catecholamine level come back mildly elevated (norepinephrine and epinephrine roughly 20% above upper limit), but a "normal" 24 hr urine metanephrine test (haven't seen the actual numbers). My blood pressure is generally a little elevated (130/85 is probably average, I'm healthy weight as well), especially before I was started on propranolol. So my question was what kind of symptoms do those who have been diagnosed with hyperadrenergic POTs differentiate them from regular POTs? Do those with hyperadrenergic POTs get bad brain fog as well? What seems to aggravate your symptoms or make them better? I have read some of Dr. Grubbs papers, so I have an idea, but I wanted to hear symptoms from actual people. Just trying to figure out if this is something I should pursue next time I see my physician. Thanks everyone!

Hello, I'm new to the forum as I just joined due to failing a tilt table test. I am a 24 year old male and have been having debilitating symptoms since 2009 and have had a million tests which have not shown much until this tilt table test. I was just looking for some help interpreting it as I do not see my doctor for another couple weeks. I realize that I really have to attend my doctor appointment to get his interpretation, but I was trying to educate myself a little on the results with the help of some people who were more knowledgeable than myself. I never did fully lose conciousness when my blood pressure and heartrate dropped, however I slumped over and almost vomitted. I am more concerned with my heartrate increase upon rising and if it appears that I may have POTS. I am hopeful that I finally have some answers for all of my suffering as my symptoms have significantly delayed my career plans and I am supposed to begin medical school this August which I will have to put off once again if I do not get improvement in my symptoms. Thank you in advance for anyone that helps me out. Once again, I realize that this is only advice and I will not get the official interpretation until I see my neurologist. Here is a link to the results: http://i.imgur.com/3MATUeNl.jpg