All etiologies of POTS can display 'hyperadrenergic' features. Neuropathic POTS patients can display these features. POTS patients with low-flow POTS and elevated Angiotensin II would meet the definition of Hyperadrenergic POTS. The patients in the adrenergic autoantibody studies with the highest titers for alpha receptor antibodies had hyperadrenergic features.
The same amount of 'Hyperadrenergic' as 'neuropathic' POTS patients had small fiber neuropathy suggesting the possibility of a common primary etiology. This is why several docs including Dr Raj arent super keen on people 'subtyping' a group of disorders with unclear etiologies.
All of this suggests that there is no fixed medical consensus on the etiology of 'Hyperadrenergic POTS' as a distinct diagnosis or pathology and that it is a presentation.
Lastly - as an aside, Norepinephrine and adrenalin are different. This is important because hyperadrenergic POTS patients generally have elevated norepinephrine (which is preferential for alpha 1 and alpha 2 adrenergic receptors) rather than epinephrine (which is preferential for beta 1 and beta 2 adrenergic receptors).
Ramakentesh or anyone else, do you mind sharing the journal article that goes over what type of drug is good for what kind of adrenal hormone response? I have high neuroepinephrine and my doctors put me on a beta blocker and I’m thinking it’s the wrong drug. Could you send me a PM or reply here?
Hyperadrenergic POTS (hyperPOTS) An overview of a POTS subtype
in POTS
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Ramakentesh or anyone else, do you mind sharing the journal article that goes over what type of drug is good for what kind of adrenal hormone response? I have high neuroepinephrine and my doctors put me on a beta blocker and I’m thinking it’s the wrong drug. Could you send me a PM or reply here?