June 19, 2014


PoTS is believed to affect around one in 558 people, based on figures from the USA, but many doctors are still unaware of its existence. It is often misdiagnosed, or attributed to an associated condition such as anxiety, panic disorder, or chronic fatigue.

The new study, published in the online journal BMJ Open today, assessed 84 members of the national support group PoTS UK, and 52 patients diagnosed at an NHS clinic in Newcastle.

Many had been forced to change jobs or give up work by the condition, which causes fatigue and makes many basic, everyday tasks exhausting and difficult.

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The chronic condition causes dizziness, anxiety, nausea, heart palpitations, migraines, and a host of other miserable symptoms when sufferers stand upright. The half-million affected have it as a product of the body’s circulatory system adapting poorly, at times, to evolution.

“When humans stood upright, our system of blood vessels evolved to tighten and push blood upward to the heart and brain when we’re in a vertical position,” said Dr. Blair Grubb, a professor of medicine and pediatrics at the University of Toledo College of Medicine who has published research on POTS. “In those with POTS,” he added, “the system is malfunctioning and their blood vessels fail to tighten when they stand,” which causes their heart rate to surge — making some feel so sick that they climb back into bed. . . .

POTS is often diagnosed using a tilt table test where patients lie prone on a table that’s tilted vertical – to mimic standing – while their heart-rate is monitored. Those with the condition experience a sudden increase in heart-rate of at least 30 beats per minute – or a pulse greater than 120 beats per minute — when they stand upright.

Certain lifestyle therapies are frequently tried before prescription drugs. Patients are also told to drink about eight 8-ounce glasses of water each day and eat 2,000 to 4,000 milligrams of salt to increase the blood volume in their legs and help push blood upward. Wearing compression stockings can also help.

They’re also encouraged to exercise — quite a bit — to, in Grubb’s words, “enhance the effectiveness of the peripheral skeletal muscle pump” which pushes blood up from the legs and abdomen when they rise. He recommends at least 20 to 30 minutes a week of aerobic activity like walking, running, or biking and weight training for the legs, hips, and thighs.

Squats and deadlifts probably help too.