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http://en.wikipedia....ion#cite_note-1 Endothelial dysfunction is a systemic pathological state of the endothelium (the inner lining of blood vessels) and can be broadly defined as an imbalance between vasodilating and vasoconstricting substances produced by (or acting on) the endothelium. Normal functions of endothelial cells include mediation of coagulation, platelet adhesion, immune function and control of volume and electrolyte content of the intravascular and extravascular spaces. Endothelial dysfunction can result from and/or contribute to several disease processes, as occurs in septic shock, hypertension, hypercholesterolaemia, diabetes, it can also result from environmental factors, such as from smoking tobacco products and exposure to air pollution. I found a test to check for this. If there is another test for this let me know. This may be a big help for all of us. It affect every level of POTS. The test http://www.itamar-me...om/EndoPAT.html Prevention and treatment Endothelial function can be improved significantly by exercise and improved diet. A study published in 2005 has determined that a positive relationship exists between the consumption oftrans fat (commonly found in hydrogenated products such as margarine and the development of endothelial dysfunction. Other factors have been identified as improving endothelial function and include cessation of smoking, loss of weight and treatment of hypertension and hypercholesterolemia amongst other things. Some studies have found antioxidants,potassium and arginine supplementation to restore impaired endothelial function.
A lady I know whose kids have MCAD and POTS compiled some really interesting research, would love opinions on this (sorry if its already been discussed, I searched the forum and didnt find much): "OK, I wonder if I may be on to something here. At the very least, I’m learning a lot. Please post your thoughts. We know that Nitric Oxide levels tend to be high in POTS patients, as seen here: Cutaneous constitutive nitric oxide synthase activation in postural tachycardia syndrome with splanchnic hyperemia. http://www.ncbi.nlm....pubmed/21642500 (Splanchnic hyperemia is blood pooling in the stomach) Flow-mediated vasodilation and endothelium function in children with postural orthostatic tachycardia syndrome. http://www.ncbi.nlm....pubmed/20643249 Nitric Oxide also is shown to be increased in patients with migraines: Increased asymmetric dimethylarginine and nitric oxide levels in patients with migraine. http://www.ncbi.nlm....pubmed/21359872 Nitric oxide supersensitivity: A possible molecular mechanism of migraine pain. http://psycnet.apa.o.../1994-14066-001 And in patients with CFS/ME: Kindling and Oxidative Stress as Contributors to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome http://www.ncbi.nlm....les/PMC3022475/ (This is an excellent and thorough article that points to oxidative stress as a factor in autonomic function.) As well as Multiple Chemical Sensitivity: Elevated nitric oxide/peroxynitrite mechanism for the common etiology of multiple chemical sensitivity, chronic fatigue syndrome, and posttraumatic stress disorder. http://www.ncbi.nlm....pubmed/12000033 In fact, Nitric Oxide’s role is multifaceted, and an excessive amount can lead to neuronal injury: Nitric oxide in health and disease of the nervous system. http://www.ncbi.nlm..../pubmed/9246670 Neurobiology of nitric oxide. http://www.ncbi.nlm..../pubmed/8978984 Including Mitochondrial dysfunction: Nitric oxide-induced mitochondrial dysfunction: implications for neurodegeneration. http://www.ncbi.nlm....pubmed/12543245 Nitric oxide, mitochondria and neurological disease http://www.sciencedi...005272898001686 So what causes high levels of Nitric Oxide? Histamine? Quite possibly: Nitric oxide: a regulatory mediator of mast cell reactivity http://journals.lww....st_cell.47.aspx Nitric oxide accounts for histamine-induced increases in macromolecular extravasation http://ajpheart.phys...6/6/H2369.short Nitric Oxide and Histamine Induce Neuronal Excitability by Blocking Background Currents in Neuron MCC of Aplysia http://jn.physiology.../2/656.abstract Nitric oxide production in human endothelial cells stimulated by histamine requires Ca2+ inﬂux http://www.ncbi.nlm....pdf/9480877.pdf"
interesting to note that endothelium regulates this and as noted in Wikipedia certain drugs that are Cholinergic may dilate or constricted depending whether the endothelium is damaged. How many of you know if your endothelium is damaged? BTW is regulates Nitric Oxide... This may be one reason some of us react differently to certain meds even if we have the same type of POTS... Regulation of vascular resistance There are many factors that alter the vascular resistance. Many of the platelet-derived substances, including serotonin, are vasodilatory when the endothelium is intact and are vasoconstrictive when the endothelium is damaged. Cholinergic stimulation causes release of endothelium-derived relaxing factor (EDRF) (later it was discovered that EDRF was nitric oxide) from intact endothelium, causing vasodilation. If the endothelium is damaged, cholinergic stimulation causes vasoconstriction. A cholinergic drug, also known as a cholinergic agent, cholinergic agonist, or a parasympathomimetic drug, is any drug that functions to enhance the effects mediated byacetylcholine in the central nervous system, the peripheral nervous system, or both. These include acetylcholine's precursors and cofactors, acetylcholine receptoragonists,acetylcholinesterase inhibitors and cholinergic enzymes: Acetylcholine receptor agonistsAlvameline Muscarine (muscarinic receptors) Nicotine (nicotinic receptors) Pilocarpine (M3 receptors) Suxamethonium (muscle type receptors) Acetylcholine receptor antagonistsScopolamine Dicycloverine Tolterodine Oxybutynin Ipratropium Mamba Toxin (MT7) Pirenzepine Telenzepine Acetylcholinesterase inhibitors (abbreviated AChEIs)Donepezil Galantamine Huperzine A Neostigmine Physostigmine Rivastigmine