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Thanks for your response Pistol. I live in Canada and we don't have any centres specializing in Dysautonomia, and the doctors are a little behind on this matter compared to the US. But I will try to get an appointment with a cardiologist to get to the bottom of this. B12, Vit D, etc have all been tested and are within normal limits.

I've been measuring my pulse difference between laying and standing, and the difference is 30 bpm at 2,5, and 10 minutes after standing (my blood pressure more or less stays the same). So I definitely have POTS. I'm trying to establish which type though: My blood doesn't pool in my limbs when standing during the day. In fact my veins are invisible and nurses always have trouble finding my veins to draw blood. But then after 9 pm the veins in my limbs slowly start filling up and I feel pressure in the ones in my legs, but here's the kicker - that's when most of my symptoms resolve and I feel much better and relaxed, and my tachycardia is reduced. I have no body fatigue. My limbs don't feel heavy. But I have shortness of breath and, strangely, nasal stuffiness after standing or walking too long. I'm dizzy and have brain fog and inability to focus most of the day, much of which is relieved by night time (and of course laying down). I feel shaky and have tremors all over my body. If I stand too long my knees start shaking. I'm sensitive to noise and bright light. I have severe anxiety and lack of motivation, also relieved by night time. My hands and feet sweat and are pale and clammy until night time. My limbs are pale during the day. When I've tried the recommended salt and water intake in the morning, it goes right through me. My plasma sodium is alway on the high side in blood tests. Big meals and heat don't give me symptoms. Alcohol gives me tremendous relief from a lot of my symptoms, including brain fog. The veins in my limbs start sticking out and I feel much better. Male, 49. I would much appreciate any input I can get on this, thanks.

Is it a heart rate increase of more than 30 BMP after 10 minutes, by comparing the pulse you have lying down and the pulse you have after 10 min of standing, or is it the comparison between the pulse when you first stand up and and the pulse you have after 10 min of standing?

I hear you BuffRockChick. Between my severe mood disorder of late, 9-5 job, and 50% custody of my 2.5 yr old, I'm trying very hard to muster the time and energy to find a way to get back to playing and singing music. I'm in fact an amateur musician, and when I write and compose music it takes me away so powerfully that I basically become symptom free. To the extent that when I'm done and pull myself away from it and "come to" I get the same rush of dread and anxiety I get when I first open my eyes in the morning in a vulnerable state.

I'd love to be manic rather than dissociative anxious any day. All Fetzima is going right now is giving me palpitations all night and keeping me up. I almost have no doubt I have POTS, I mean right now as we speak my standing pulse is 122 and my BP is 100/80 and I'm completely calm. Those numbers only mean POTS. But I seem to be able to exercise, so I do think most of my symptoms are neurogenic but likely aggravated by mild POTS. In fact my mental symptoms right now are serious and I need to pick a good med to go on quickly. I've read about liquorice root but don;t quite have the knowledge to know how to go about using it for POTS, what time of day to take it, and how it would interact with SSRI/SNRI I'm even tempted to pick up smoking (quit 20 yrs ago) to raise my BP.

May I ask what that SSRI was?

Within my control? I tell you I drank 6 g of salt in 2 lt of water every morning I got up for a few days which I ended up urinating all out by 10:30 am at work, so obviously that method isn't going to help me. Been curious about liquorice tea, I've read it can almost do what Florinef can. Been too chicken to try it given it can mess with your adrenals and potassium. Might still try it. Things not within my control: Get more sleep. This has been difficult since my divorce and my 50% custody of my 2.5 yr old. Strum my acoustic guitar and sing loud from my belly. I'm convinced 20 yrs ago this is how I got over my original POTS rut. I think standing and singing for hours on end did something to my vagus nerve and got me over the POTS to the point where my body was almost autonomically normal. Can't do that right now because I live in an apartment. I've been tempted to drive to a rural road and do this out in the boonies. Thanks to POTS brain fog I'll need lyric sheets to remember what to sing, but they'll get blown off in the wind. Been thinking about laminated lyric sheets. That's how far I've come with the miscellaneous stuff. But I do think a good SSRI will go along way, because neurotransmitters control not just your mood but also you autonomic response.

I live in Canada, and the medical system is not as flexible as it is in the US, you can't just go to a doctor and ask for a tilt test. There's a guy an hour from my City who does a tilt test, 12 month waiting list. My doctor's already fed up with me and has me screened by reception when I call unless I want to see her about going on psyche meds. I'm sure I have some form of POTS, though I'm puzzled as to why my body doesn't feel weak and I can exercise. After the pool I can sit in the sauna for 10 minutes and be fine, though I can tell my pulse is over 100. It's during the drive home when I begin tightening my chest and getting dizzy. Whether this is POTS or anxiety at this stage is really an academic discussion and may not help me (though I'm curious as ****). Since POTS and anxiety both get prescribed SSRIs, I want to know in experience of people on this site, which one is best for POTS, so I'll two birds with one stone. I don't actually hyperventilate as a distinct event. I just know I keep my diaphraghm tight all day long and hyperinflate my upper chest ALL DAY LONG and feel zonked out. It may be a counterproductive attempt by my body to keep my blood pressure up, which obviously isn't working. Much like you, I begin to feel normal after 8 pm, my breathing moves lower and becomes deeper. Once I've had my after dinner glass of wine I basically feel human for an hour or so and then go to bed.

Hello everyone, I'm new to this site and am hoping I can get some insight into my condition, and more specifically some information on proper medication. History (male, 47): 1997 - contracted mild hepatitis overseas which resolved on its own, but I went on to have constant dizziness, difficulty concentrating and severe anxiety. Pulse gradually changed from pronounced and slow to fast and weak. Was put on an SSRI (Fluvoxamine) and wasn't able to work for a year due to these symptoms. Was diagnosed with chronic fatigue syndrome. Gradually "adapted", went back to work, but pulse remained high. Developed panic disorder and agoraphobia. And sporadic bouts of IBS. But more or less pretty high functioning over the past 20 years and began to seriously doubt the chronic fatigue syndrome diagnosis and began exercising routinely and drinking alcohol with no ill effect. BUT my pulse remained high and in fact over the last 2 years was routinely over 100 and BP around 130/90, which I suspected was my Hyperadrenergic POTS phase. Last summer I had a bad flare up and began showing symptoms I had in 1997, which remain. My standing pulse can be around 90 and my BP will be 90/70 routinely, which is shocking for a male my age. I've quit the Fluvoxamine since it's no longer working. But I don't sweat or get nauseous when I stand, I can walk for miles, runaround, pick up my kid and carry him no problem, my body feels no fatigue. I'm just lightheaded, severely anxious, and can't concentrate. So to this day I don't quite know if I have POTS or not. And I happen to be pretty flexible for a male my age, while standing I can bend over and touch the ground with my hands and bend my wrist to have my thumb touch my wrist. My left knee started grinding and being painful years back, and I ignored it and kept exercising and the pain went away, sign of slight leg instability was told. But I've never had a joint dislocate and don't have stretchy skin. I'm just really flexible. Maybe I have joint hypermobility and POTS, maybe I don't (though I strongly suspect I have at least one of them). I seem to constantly hyperinflate my chest and breath shallow and fast, since my flare up, which I suspect is a combination of anxiety and low blood pressure. My doctor wants me on an SNRi or SSRI to solve my problems. It seems these meds also happen to help with POTS too. She's put me on Fetzima, which has the strongest Norepinepherine reuptake inhibition of any SNRI (she feels I have a mood disorder, very likely but I feel it's because of the other stuff I've mentioned). Say I have POTS and Joint Hypermobility as well (your input would be appreciated though). I'm wondering what is the best SSRI/SNRI in your experience for this condition? Is Fetzima a good idea for this condition and should I stick with it a couple of weeks and see what happens, or is serotonin the neurotrasmitter I should be really targeting? Cheers.