What Is POTS??

What Is POTS??

Sunday, April 30, 2017

Melanoma Monday


May is Skin Cancer Awareness Month. People who have POTS often have autoimmune disease as an underlying cause. And people with autoimmune disease have a higher risk for all types of cancer including skin cancer and lymphoma. 

I can tell you from personal experience, it's not fun to have chunks carved out of you and then have to wear makeup to cover the scars. I have a couple of scars that are bad enough that I tell people I have been in a knife fight. 

Wear your sunblock people. 

Skin cancer risk in autoimmune connective tissue diseases


Skin cancers associated with autoimmune conditions among elderly adults

Merkel Cell Carcinomas--Autoimmune Disease

New England Journal of Medicine--Risk for Nonmelanoma Skin Cancer Associated with Immunosuppressive Treatment of Autoimmune Disease

Diagnosis and Treatment of Basal Cell and Squamous Cell Carcinoma

Basal Cell Carcinoma--The Most Commonly Occurring Form Of Skin Cancer

Monday, April 17, 2017



People with autoimmune diseases have a particularly hard time keeping their skin moisturized and protected. And people with Sjogren's Syndrome have an even harder time because their body doesn't produce moisture to start with.

All of the options in the moisturizer aisle can seem overwhelming. They all make claims about what they will do for you. But there are particular ingredients you need to look for. I don't like to just go by advertising or word of mouth. I want to know what is in any products I use and they science behind it. I suppose that is because my Father was a chemist who worked until he retired at Proctor and Gamble. He often discussed with me the products that they made and why they were superior to others at the time. When I was a teenager, I actually tested out some of their products before they were on the market as a volunteer.

The following information on the difference between creams, lotions, and ointments come from the website of the National Eczema Association. They have a list of approved moisturizers there.


Ointments are semi-solid greases that help to hydrate the skin by preventing water loss. Petroleum jelly has no additional ingredients, whereas other ointments contain a small proportion of water or other ingredients to make the ointment more spreadable. Ointments are very good at helping the skin retain moisture but they are often disliked because of their greasiness.


Creams are thick mixtures of greases in water or another liquid. They contain a lower proportion of grease than ointments, making them less greasy. A warning: creams often contain stabilizers and preservatives to prevent separation of their main ingredients, and these additives can cause skin irritation or even allergic reactions for some people.


Lotions are mixtures of oil and water, with water being the main ingredient. Most lotions do not function well as moisturizers for people with dry skin conditions because the water in the lotion evaporates quickly.


Ingredients fall into three categories. Humectants such as glycerin and urea absorb water from the air and hold moisture in the skin. Other humectant ingredients to look for are hyaluronic acid, alpha-hydroxy acids, sorbitol, propylene glycerol, and sodium lactate. Emollients like mineral oil, lanolin and petrolatum fill spaces between skin cells to replace lipids and smooth and lubricate the rough skin. Other emollients to look for are jojoba oil, isopropyl palmitate, propylene glycol linoleate, squalene and glycerol stearates.Occlusives such as petroleum jelly and cocoa butter, are oily substances and they form a film on the top of skin which seals in cracks and prevents moisture from escaping.

Water: This is the main ingredient of moisturizers, and it serves to carry oil-based ingredients onto and into the skin, but oil-based ingredients also help lock water into the skin


Ceramides are waxy lipid molecules that are found in skin cell membranes that help prevent moisture loss. They are involved in things like programmed cell death of cells. Ceramides in your moisturizer will help maintain and repair your skin barrier, so that moisture stays sealed in and it helps your body's natural moisture defenses. That is especially important for people who have eczema and psoriasis because studies have found that they have fewer ceramides than people who have normal healthy skin.

Cerave, as the name implies has ceramides in it. It also has Dimethicone, Hyaluronic Acid, Glycerine.
If you follow this link you can get a coupon for it from their website: Cerave Coupon The Itch Relief type also contains Pramoxine Hydrochloride which is an external analgesic, Shea Butter, Tasmannia Lanceolata Fruit Extract,

Curel says it has a proprietary ceramide-rich formula.


Peptides are chains of amino acids. Amino acids include the 22 proteinogenic ("protein-building") amino acids, that combine into peptide chains ("polypeptides") which form the building-blocks of proteins. In this case, the peptides and amino acids are involved in building proteins in the skin.

Products that contain short chain amino acids can penetrate the top layer of skin and stimulate the cell production.

Collagen is an important protein in skin. It is involved in the thickness and pliability(stretchiness) of skin. Collagen breaks down for things like environmental factors (sun and stress, chemical exposure) and age. This causes wrinkles. Peptides stimulate the production of collagen thereby reducing wrinkles

Elastin has the ability to stretch and return to its original length—like a spring or rubber band. Elastin is the major component of ligaments (tissues that attach bone to bone) and skin. In people who have connective tissue disease, it is common for collagen and elastin to become injured by inflammation. So if you have MCTD or SLE Lupus or Sjogren's Syndrome, Scleroderma, Rheumatoid Arthritis, or Psoriatic Arthritis your collagen is probably not functioning properly.

If a product has that in it, it's probably something we could use.

Hyaluronic Acid

Hyaluronic Acid works by binding to moisture. It can hold up to 1,000 times its weight in water, making it an excellent natural skin plumper. Hyaluronic acid helps your skin repair and regenerate itself after suffering from dryness, environmental stresses, or irritation. It helps the collagen and elastin in your skin stay moist and helps it to keeps it elasticity. It is also lightweight and isn't oily, which is good if you are acne-prone.
Fatty Acids

Fatty acids come in things like Olive oil, avocado, almond oil, and shea butter which are essential fatty acids that help lock in moisture. Your body needs fatty acids for fuel to do things like produce moisture. But it doesn't produce it on its own, so you have to either ingest it or apply it topically. Foods that have Omega-3 fatty acids in them are things like salmon, mackerel, walnuts, soy, flaxseed, and safflower oil. I take a supplement that combines fish oil, flaxseed oil and borage oil in it.


Glycerin is a simple polyol compound derived from sugar alcohol. It is colorless and odorless. Glycerin and glycols help to retain water in a product, in hair or the top layers of skin by drawing moisture in and then retain it. Glycerin can actually absorb moisture from the air.

Ethylhexyl glycerin

Ethylhexyl glycerin (oct oxy glycerin) is a topical skin care ingredient and deodorizing agent, often indicated as a conditioning ointment in the treatment of eczema. As its name suggests Ethylhexyl glycerin is made using glycerin.

Sodium PCA,

Sodium PCA is used in lotions and hair care products because it is naturally in skin cells and it binds to water in cells and that means it is great for water absorption.

Caprylic/Capric Triglycerides

Caprylic/Capric Triglycerides is a mixed triester derived from coconut oil and glycerin. It comes in the form of an oily liquid and is sometimes mistakenly referred to as fractionated coconut oil. Caprylic mainly works as an emollient, dispersing agent and solvent.)

Piroctone Olamine

Piroctone Olamine is used to treat skin conditions and dandruff. It is an antifungal.


Locochalcone is a molecule contained in licorice root extract which helps control oil production and is anti-bacterial as well as anti-inflammatory. In short, it helps calm and soothes skin.


Dimethicone is used as a moisturizer to treat or prevent dry, rough, scaly, itchy skin and minor skin irritations (e.g., diaper rash, skin burns from radiation therapy). It softens and moisturizes the skin and decreases itching and flaking.

Triethanolamine (TEA)

Triethanolamine (TEA)This emulsifier helps to blend the oil/water mix that makes up moisturizer.

Vitamin A

Vitamin A is usually in the form of retinol or retinoic acid in moisturizers. It is anti-aging. It works by stimulating collagen production, which fills in lines and wrinkles

Vitamin C & vitamin E

Vitamin C & vitamin E are antioxidants and they help repair cellular damage caused by sun, pollution and free radicals that are created during oxygenation.

Magnesium Aluminum

Magnesium Aluminum Silicate is a naturally occurring mineral derived from refined and purified clay that is used primarily as a thickener in cosmetics and beauty products. It is an off-white powder used in the pharmaceutical manufacturing process as an absorbent; anticaking agent; opacifying agent; slip modifier; and an aqueous viscosity increasing agent. But magnesium is considered as ”the mineral of beauty” in traditional Chinese medicine. Magnesium deficiency results in lower levels of fatty acids on the skin. This results in less elasticity and moisture and that, in turn, causes dryness and inflammation. If you take magnesium to boost the levels in your cells, it helps protect the cells and detoxifies them and encourages healthy skin tissue growth. It helps in DNA replication and repair. It also prevents free radical damage and inflammation.

In a 2007 study cited in the “American Journal of Clinical Nutrition,” Magnesium was discovered to help reduce inflammation caused by an excess amount of E-selectin and C-reactive protein.

When the skin is injured or damaged or when acne-causing bacteria enter the skin, E-selectin is produced. This results in acne inflammation. Magnesium helps reduce E-selectin’s effects and prevents the inflammation.

Magnesium aluminum is sometimes called Kaolin or China Clay.

At the Skin Store website I found this:

Kaolin (also know as China clay, hectorite or magnesium silicate) is a naturally occurring soft clay. In cosmetics, kaolin helps to cleanse and exfoliate dead skin cells and debris from the surface. It adds absorbency, texture, and bulk to cleansers.

...Because it’s safe nature and has great absorbency and soothing properties, it’s quite the popular ingredient in formulas designed to purify

Kaolin wages war on acne and breakout-prone skin by improving the skin’s balance and decreasing levels of pore-clogging oils, dirt and toxins. General skin inflammation, caused by the usual environmental factors can also be addressed with kaolin cleansers. Kaolin increases circulation to the impacted areas of skin, helping to stimulate healing and to reduce irritation. Using a cleanser that contains kaolin prior to applying makeup can help to control oil production and prevent unwanted shine.”http://www.skinstore.com/blog/skincare/beauty-glossary-kaolin/

Eczema is associated with a magnesium deficiency. If you have a deficiency of magnesium your body will produce histamines. Those histamines will cause you to be itchy and have red blotches or hives on your skin. They are caused by blood vessel swelling that causes fluid to leak into the skin and other tissues.

Taking supplements gives some people diarrhea. But if you can take it, it helps avoid kidney stones and calcification in the joints too. It also good for circulation and high blood pressure. Doses less than 350 mg daily are safe for most adults. When taken in very large amounts, magnesium is POSSIBLY UNSAFE. Large doses might cause too much magnesium to build up in the body, causing serious side effects including an irregular heartbeat, low blood pressure, confusion, slowed breathing, coma, and death. Magnesium strengthens bones; maintains nerve and muscle function; regulates heart rhythm and blood sugar levels, and helps maintain joint cartilage.http://www.arthritis.org/living-with-arthritis/treatments/natural/vitamins-minerals/guide/magnesium.php

I know some people apply magnesium oil directly to their skin. But I don't know about the safety of it.

Vaseline, Intensive Care, Cocoa Radiant, With Pure Cocoa Butter, Non-Greasy Lotion is one of my stand-bys. It has Glycerin, Triethanolamine, Dimethicone, magnesium aluminum, shea butter and cocoa butter in it. And of course vaseline.

Eucerin Calming Cream and the Eucerin Eczema Relief Body Creme is good lotion it has Oatmeal, Ceramides, Caprylic/Capric Triglycerides, Castor oil, Piroctone Olamine, Licochalcone, Ethylhexylglycerin.

                          "Moist" Is A Disgusting Word - Here's Why


After you have considered all of the other ingredients, don't forget the sunscreen. You need an SPF of at least 30. I happen to think people with Lupus SLE and Sjogren's should use the highest they can get. If it isn't in your moisturizer, you may have to use a separate one. I have some for sensitive skin that I use and that have pretty high SPFs.

I haven't tried it but just by virtue of the fact that it also hydrates this one seems promising.

And since I know the spray on is good, I might try these:

A facial moisturizer with an SPF 50 seems like a pretty good idea. I love my Oil of Olay products, but as far as SPF is concerned, I think this is the highest SPF. Olay Complete Daily Defense All Day Moisturizer With Sunscreen SPF30 Sensitive Skin

If you have ever given birth then you are probably familiar with Palmer's Cocoa Butter products for stretch marks. But they make products for your face now and they are excellent. If they can help with stretch marks they have got to be doing something right. If you compare the ingredients to the ones listed above, you can see that they are very good for your skin. And I have some of them and they worked pretty well. I used the serum and day cream in the day and the night cream, obviously at night during a time that my face was super dry.

They have an SPF 15. Some of them say they promote collagen production and they contain antioxidants, a peptide complex, and vitamins A, B1, B2, B3, C and E. It depends on the individual product. Among other ingredients they contain, Hydrogenated Palm Glycerides, Theobroma Cacao (Cocoa)Seed Butter, Dimethicone, Butyrospermum Parkii (Shea) Butter, Oenothera Biennis (Evening Primrose) Flower Extract, Aloe Barbadensis Leaf Juice, Hydrolyzed Milk Protein, Glycerin, Triethanolamine. The night cream contains Natural Cocoa Butter, Retinol and Antioxidant Vitamin E.

They also have a gel oil for the body with an SPF 15 and cocoa butter, vitamin E, shea butter, jojoba oil. Palmer's Formula Moisturizing Gel Oil, Cocoa Butter, SPF 15

Last but not least I just discovered a new moisturizer line that sounds interesting. Garnier SkinActive Moisture Bomb “WATER-LIGHT FORMULAS. ANTIOXIDANT-PACKED HYDRATION.
Including formulas that feature goji berry and pomegranate, our refreshing gel cream, SPF 30 lotion, and all new super hydrating sheet masks blast dryness away, flooding skin with long-lasting hydration for a softer, healthier-looking complexion.”

Lupus, The Skin & Hair - Dr Abby Macbeth

Friday, April 14, 2017

What is Raynaud's (ray-NOHDZ) disease?

What is Raynaud's (ray-NOHDZ) disease?

It is a condition that causes some of the areas of your body, usually but not always the extremities, such as your fingers and toes — to feel numb and cold when they become cold. Stress can also cause symptoms.   When you have Raynaud's disease the smaller arteries which supply blood to your skin narrow, decreasing the blood flow to affected areas. This is called vasospasm.

More women than men have Raynaud's disease. It is also called Raynaud's phenomenon or syndrome. People who have it usually just say, “Raynaud's” without the other descriptive words. People who live in colder climates are more likely to have it.

If you have Raynaud's, your treatment is largely dependent upon how severe it is and also any other conditions you may have. It isn't usually life threatening, but it does affect how you live on a day to day basis.

Simple things can bring on an attack, like digging around in your freezer for that roast you know is in there somewhere. It doesn't take long for your hands to turn colors and hurt. And it gets worse when you take your hands out of the freezer and the circulation comes back into them. Other things like going out into the cold or putting your hands into cold water can cause the same symptoms.

Some of the symptoms include:

Cold fingers or toes
Color changes in your skin in response to cold or stress
Numb, prickly feeling or stinging pain upon warming or stress relief

Your fingers or toes get cold and then they turn white. Then they progress to blue and start to feel numb and cold. And then when you seek to warm them up, and the circulation starts to come back into them, they become painful, with throbbing and tingling and they turn red. Some people like me don't have all three color changes. I usually don't turn blue. But that may be because I avoid getting my hands and feet cold. They may never get cold enough to cause the change from white to blue. But I have had them do that years ago. It can take as much as 15 minutes for the blood flow in an affected area to return to normal.

There are other areas of the body besides the fingers and toes that can be affected by Raynaud's. Your ears, lips, and nose can be affected.  Raynaud's can even affect the internal organs. And even more embarrassing areas like your nipples and your rear end. Yes, now you can tell your husband that “turkey butt” is a medical condition and you can't help it.

I purposefully chose photographs that don't look too severe. Not everyone looks like they are ready for amputation when they have an attack of Raynaud's and if you look at the severe cases you might not recognize it in yourself. If you have bad discoloration you can google it and come up with photos.

The exact cause of Raynaud's hasn't been determined yet. Something causes the blood vessels in the hands and feet to overreact to cold temperatures or stress. This overreaction is called vasospam. During vasospasm the arteries that supply blood to your fingers and toes spasm due to cold exposure or stress and narrow which causes a decrease in the blood supply. This eventually causes the arteries to thicken which further limits the blood flow.

Raynaud's phenomena in real time.

There are two classifications of Raynaud's.

It is also called Raynaud's disease and it's usually isn't caused by some other medical condition. It usually begins earlier in life than Secondary Raynaud's between 15-30 years of age. There seems to be a genetic predisposition to Primary Raynaud's. Approximately 1/3 of patients with Primary Raynaud's have a parent, sibling or child who also has it the disorder.

It is also called Raynaud's phenomenon and is less common than Primary Raynaud's. and it usually is caused by something else. It is usually more serious. Onset is usually around the age of 40.
There are two main types of the condition.

Things that cause Secondary Raynaud's are Connective tissue diseases like Scleroderma, Rheumatoid Arthritis, Sjogren's syndrome, and Lupus. Scleroderma can cause a hardening or thickening of the blood vessels. Sjogren's, Lupus and RA cause inflammation of the nerves that cause the blood vessels to constrict. Up to 1/3 of Lupus patients have Raynaud's. And 15-30% of Sjogren's patients have Raynaud's. I have both Lupus and Sjogren's so it was probably inevitable that I would have Raynaud's.

Hardening of the arteries also called atherosclerosis and high blood pressure in the lungs called primary pulmonary hypertension also cause Raynaud's. These things can be exacerbated by smoking because it causes the blood vessels to constrict.

If you have Carpel tunnel syndrome causes numbness and pain in your hands due to pressure on the nerves. This can cause your hands to be susceptible to temperature changes and lead to Raynaud's. Operating tools which vibrate can cause you to develop Secondary Raynaud's.

Raynaud's disease is also associated with dysautonomia. With regard to Postural Orthostatic Tachycardia, Neurocardiogenic Syncope and Orthostatic Hypotension, an interview on Dysautonomia International had this to say:  “We do not know how many POTS, NCS or OH patients have APS, but Dysautonomia International recently funded a research project designed by Dr. Svetlana Blitshteyn to try to shed some light on the topic of autoimmune markers and autoimmune conditions in patients with POTS.  Dysautonomia International will make an announcement when Dr. Blitshetyn’s study results are released.” And in the article, it says that Raynaud's disease is a symptom of Antiphospholipid Syndrome. So you can say that Raynaud's is associated with dysautonomia.What Dysautonomia Patients Should Know About Antiphospholipid Syndrome Postural Orthostatic Tachycardia SyndromeA Dermatologic Perspective and Successful Treatment with Losartan

That's not too surprising. People with dysautonomia and POTS have problems regulating temperature in general and blood flow problems because of inadequate pressure in the blood vessels. And POTS, like Raynaud's disease, is associated with autoimmune diseases.


Beta blockers, migraine medications, ADD/HD medication, and cold medications can all cause Raynaud's or make it worse because they cause constriction of the blood vessels.

There are also some chemicals that can cause Secondary Raynaud's.

It can become severe enough that you need to seek medical help. You definitely need to see a doctor if you get a sore on one of the areas affected so that you don't end up with an infection and lose an appendage.

Some people have a permanent reduction or blood flow which causes their fingers and toes to become deformed. If a complete blockage of an artery occurs, you can get skin ulcerations and ultimately gangrene, which is why it is important to see a doctor if you get a sore on an affected area to avoid having an amputation.


There are things you can do for Raynaud's. Wearing warm clothes, socks and gloves in cold weather are essential. Ear muffs and masks and scarves to keep your nose warm are also good ideas. Some people wear the socks and gloves when they are sleeping. And the gloves come in handy when you have to get into the freezer, but I personally never remember to do it. Avoid getting cold in the first place. Smoking is a no-no. Avoid stress because it can bring on an attack. And exercise increases circulation.

If you get cold, go inside and warm up. Two things that you should do are almost instinctive for people to do. Wiggling your fingers and toes and rubbing them to get them warm. You can also put your hands in your armpits and swing your arms to increase blood flow. You can run warm water over them too. Just don't get the water too hot.


And there are medications that help.

Calcium Channel Blockers relax the small blood vessels which help avoid the vasospasms. Common drugs in this class are Procardia, Norvasc, and Verapamil and Nifedipine.

Alpha blockers like prazosin and Cardura work by counteracting noradrenaline also called norepinephrine. This hormone causes blood vessels to constrict.

Vasodilators Nitroglycerin works as a vasodilator and comes in a cream and will facilitate the healing of ulcers. Losartan, which is a high blood pressure medication, and Viagra, as well as antidepressants like fluoxetine, can help treat Raynaud's.

Fish oil has fatty acids in that are supposed to make you less susceptible to cold.  Studies have shown that it didn't help people who have Secondary Raynaud's. You have to be careful when taking high doses of fish oil because it acts as a blood thing and increases your risk of bleeding, particularly if you take blood thinners, like as warfarin (Coumadin), clopidogrel (Plavix), or aspirin. Discuss it with your doctor.

Gingko is also supposed to be helpful by opening up the blood vessels. One study showed that Raynaud's patients had less pain if they took 160 mg of ginkgo per day. DO NOT take ginkgo if you have a history of seizures. Ginkgo can also increase risk of bleeding, especially if you take blood thinners. Talk to your doctor.

Evening primrose oil also contains a  type of fatty acid which keeps your body from making chemicals that narrow blood vessels.  Studies have shown that taking Evening primrose oil will lessen the severity of attacks as well as the frequency. EPO can make seizures worse in people who already have them and they shouldn't take it. And just like fish oil, there is a risk of bleeding with it.

There is a form of vitamin B3(niacin) called Inositol hexaniacinate. It may reduce the number of Raynaud's attacks. But it requires high doses and needs to be monitored by a doctor.

Taking Magnesium supplements opens the blood vessels, but there haven't been any studies to show if it works. Some people get diarrhea from taking it, so take it with a meal to help avoid this problem. It can also interfere with some medications like high blood pressure medication and antibiotics, so your doctor needs to be aware if you are taking it.

Biofeedback to lessen the effects of stress on your body may help lessen the frequency of attacks. Accupuncture is another treatment option that helps by improving blood flow to the affected areas. There is also a specific kind of biofeedback called Thermal Biofeedback that studies have shown works.

Surgery and injections

When lifestyle changes and medication don't help enough, sometimes things like surgery and injections of chemicals are the next line of treatment.

There are nerves in your feet and hands that control vasoconstriction and dilation. There is a surgery called a sympathectomy, in which these nerves around your blood vessels in your hands or feet are cut to stop the over-constriction. For some people it is helpful.

Botox injections can also block the sympathetic nerves and block the over-constricion.

For more information visit this link for a guide to Raynaud's
Raynaud’s Guide: The Cold Facts on Raynaud’s

These are links to my sources:



Raynaud's Awareness

Pathophysiology Raynaud's Disease  

Monday, April 10, 2017


I've been thinking about suicide, not for myself, but suicide in the news and how suicide affects people with chronic illness. There was a recent incident in the news about an 11-year-old boy who committed suicide. When I was 12, my very first boyfriend, who was only 13, committed suicide and it colored the rest of my life. facebook-prank-leads-11-year-old-boy-commit-suicide/

My maternal grandmother was chronically ill most of her life. She eventually gave up and became catatonic. She was 1/4 Cherokee Indian and Native Americans used to go off by themselves and will themselves to die when they believed they had become a burden on their society. I believe in my heart that is what she did.

Other members of my family were bipolar and I am familiar with threats to just give up and die, quit taking medication, shoot themselves, burn down the house, etc. It's one reason I am determined never to do that to anyone if I can help it. 

The areas of personal knowledge that I have come to experience with regard to chronic illness are: heart disease, diabetes, COPD, Parkinson's Disease, Crohn's Disease, Systemic Lupus Erythematosus, Sjogren's Syndrome, Chronic Kidney Disease and Kidney Failure, Postural Tachycardia Syndrome, Rheumatoid Arthritis and Osteoarthritis, Migraines, Depression, Bipolar Depression and several other illnesses.

In people with chronic illness, there doesn't have to be any clinical depression involved. People with chronic illness become suicidal because of poor quality medical care because their illness is difficult to diagnose and to treat; being told by everyone around you from doctors to friends and family that your illness and symptoms are all in your head; decreased mobility; poor memory, confusion and other cognitive function that decreases their quality of life; lack of support and love from the very people who are supposed to be there for you; and due to that, feeling isolated and alone; feeling like you are a burden; and an overall loss of hope.

“Comorbid conditions that pose risks for suicide, especially depression, are prevalent in people living with chronic pain. The true numbers of failed attempts and successful suicides are unknown and may never be determined. Yet risk factors for suicidal ideation are so high in this population that it must be assumed that some proportion of those who die of drug overdoses might have intended to end their lives, not just temporarily relieve their pain.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3125689/

“Between 2005 and 2007, emergency department visits for drug-related suicide attempts increased by 30% and there was an overall 55% increase in opioid-related attempts.”

Those are staggering statistics when you think about it. Since those statistics were released, the United States has had a heroin epidemic. I happen to live across the Ohio River from America's Death Capitol, Huntington, WV. In America's drug death capital: How heroin is scarring the next generation

In modern society, suicide is considered to be a deviant act and believed to be a sign of severe mental illness or something done on impulse or out of despair. But for many people, committing suicide may appear to be the only way out of their situation which is causing their suffering be it mental, physical or both.

In 2007, statistics showed suicide was the 11th highest cause of death in the United States. More than 34,000 people die due to suicide and over 376,000 people visit emergency rooms due to self-inflicted injuries annually. Among those who died, one-third tested positive for alcohol and one in five showed evidence of opiates including prescription drugs and heroin.

And between 1999 and 2014, suicide rates have jumped 24%.

Among the risk factors for suicide is a family history of suicide, history of childhood abuse, previous suicide attempts and history of mental disorders, which include depression, alcohol and substance abuse, impulse disorders. aggressive behavior, isolation, loss of jobs and/or family, physical illness and access to the means to kill themselves, along with a reluctance to seek help because of the stigma that is attached to mental disorders.

People commit suicide because they see it as an easy way out and a permanent solution to a problem. I feel hopeless as if it is their only option and an escape from the emotional pain that they're in.

                                     CLICK ON GRAPHIC FOR LARGER VIEW

It is not hard to see that people who are living with chronic pain have much in common with these people. People with chronic pain often experience hopelessness and isolation due to that pain. Socially they experienced losses that include their job roles and family roles. And then due to their pain their prescribed opioids. And when the pain becomes too much the opioids are handy.

Having already experienced being overlooked and ignored by the medical community because of hard to diagnose chronic illnesses, these people are often reluctant to seek psychiatric treatment. Unfortunately, many of them have already been accused of having mental problems or drug seeking tendencies, they don't want to seek treatment for their illnesses. One survey found that 50% of chronic pain patients had seriously considered committing suicide due to the pain.

“These findings highlight the importance of pain as a potentially independent risk factor for suicide, particularly among those with head pain or multiple forms of co-occurring pain. Individuals suffering from chronic pain may be particularly appropriate for suicide screening and intervention efforts.”

Studies have found that the relationship between pain and suicidal ideation are affected by sleep disorders and catastrophizing. Catastrophizing is an exaggerated and negative focus on pain that leads to depression intensifying the pain and disability. The level of depression and pain catastrophizing was a pretty good predictor of the degree of suicidal ideation and poor pain coping skills were also associated with suicide independent of the level depression and pain severity. This study found that improving sleep and pain coping skills may reduce the incidence of suicidal thoughts and attempts.

Those most at risk for suicide are people over the age of 45, women, those with a dependence on alcohol, previous suicide attempts, and previous psychiatric hospitalizations. Other factors are besides chronic illness are frequent suicidal thoughts, a lack of social support, unemployment, having been divorced, and how severe their psychiatric disorders are. Things that indicate an increased risk of suicide are: giving away personal property, a lack of future goals, making a will, and/or having experienced a recent loss.


One of the most disturbing things I read when I decided to write this was that people with high levels of inflammatory markers have high suicidal ideation. That means that people like me who have one or more autoimmune diseases and the inflammatory processes that come with it are more prone to suicidal thoughts. And it can be a vicious cycle because psychological stress, in turn, raises levels of inflammation. Blood Test for Suicide Risk?

An article in the Journal of American Medical Association (Autoimmune Diseases and Severe Infections as Risk Factors for Mood DisordersA Nationwide Study)showed that autoimmune diseases and infections are risk factors for subsequent mood disorder diagnosis.

A prior hospital contact because of autoimmune disease increased the risk of a
subsequent mood disorder diagnosis by 45%. Any history of hospitalization for infection increased the risk of later mood disorders by 62%. The 2 risk factors interacted in synergy and increased the risk of subsequent mood disorders even further. The number of infections and autoimmune diseases increased the risk of mood disorders in a dose-response relationship. Approximately one-third (32%) of the participants diagnosed as having a mood disorder had a previous hospital contact because of an infection, whereas 5% had a previous hospital contact because of an autoimmune disease.


Two of the types of chronic pain with the highest incidence of suicidal thought are migraines and back pain. Pain from migraine & severe headache increases suicide risk I have to say I understand why migraine sufferers have a 4 times greater risk of suicide. I have prayed to die during a migraine. The study showed that even though migraine sufferers also often have depression, it was their pain level that made them suicidal.

“These findings highlight the importance of pain as a potentially independent risk factor for suicide, particularly among those with head pain or multiple forms of co-occurring pain. Individuals suffering from chronic pain may be particularly appropriate for suicide screening and intervention efforts.”

After patients with chronic illness have been screened for depression and suicidal ideation, they should be referred for counseling with a behavioral health specialist. Whether or not they require inpatient treatment basically depends on how severe their depression and suicidal ideation is. It also depends on whether their thoughts of suicide have been vague or if the have had specific plans and also the means to carry out the plans, such as access to medicine in high enough doses to be lethal, or previous attempts, a history of impulse control problems. The level of support from family and friends and their coping ability also are significant. People who are severely depressed and suicidal but also need to take opioids should only have access to small amounts at a time. Their doctor can write their prescription for small amounts and their family members can give them their medicine daily. Overall, having their family involved in their treatment is vital. They also need to be given medication for depression and to help sleep problems. There are other treatments for relaxation and insomnia as well. Efficacy of guided imagery with relaxation for osteoarthritis symptoms and medication intake.


One of the best ways to help people with chronic illness is to listen to them and believe them when they tell you they are sick and how they feel. Telling someone that it is all in their head is not helpful and is downright damaging to them. Help them find medical care and keep looking until they find a doctor with the answers.

Reach out to them by phone or text if you can't see them in person so that they don't feel so isolated and lonely.

Know the signs.

If you think they might be suicidal, ask them and if they say yes, take it seriously. Sometimes suicidal people just haven't been able to bring themselves to say it out loud and need help asking for help.

Help them get help. You really don't want to be wrong.

The following is information and videos for you or anyone you know who is or might be suicidal or having suicidal thoughts.

There are tools to screen for depression and anxiety. They are usually baed on the (DSM-IV TR).

Highest Score is 66. To rate the severity of depression in patients who are already diagnosed as depressed, administer this questionnaire. The higher the score, the more severe the depression.

This one is an interesting assessment for how disabled you are and asks questions about how difficult it is for you to go about your day to day activities. It includes things like difficulty remembering things, concentrating, standing, sitting, getting along with other people, household tasks, school/work, and social activities. WHODAS 2.0 (World Health Organization Disability Schedule 2.0, 36-item version, self-administered.

This website has confidential screening tests for Depression, anxiety, bipolar, PTSD, alcohol or substance abuse and several others.

This news story and video shows you how to flag a video if you see a video of someone planning to commit suicide.

The following URL will take you to a site with a number to text if you are in crisis.

Who can text?

People of all ages – we’re not just for teenagers. Parents, college students, older adults, and anyone else are welcome to text.
What happens when you text us?

You’ll be connected to a trained Crisis Counselor who is ready to take you from a “hot moment” to a “cool calm.” They’ll actively listen to you to help you determine your next steps to stay safe. They won’t offer direct advice, but they can guide you to coping skills.
FreeCrisis Text Line does not charge for the support it provides. Standard messaging fees are waived on Verizon, AT&T, T-Mobile, and Sprint, and texts to 741741 will not appear on your phone bill if you use one of these carriers.

Confidential – What you say stays between you and the Crisis Counselor. If you are in immediate risk of seriously hurting yourself or others, emergency services may be contacted. We are mandated reporters for cases of abuse of a minor.

24/7 - Help is available around the clock – we answer over 90% of texters within 5 minutes or less.

Nationwide – Volunteers from around the country, supporting people in crisis across the country.


                                       16 Minutes- Suicide Prevention Video

                                       Why do chronic pain patients kill themselves?

Monday, October 3, 2016


I recently watched a video that was posted in a POTS support group. The man on the video is a chiropractor, Dr. John Bergman.

The makes it sound like things like beta blockers and tricyclic antidepressants are how POTS is typically treated. Later in the video he seems to imply that he can cure or treat POTS by doing chiropractic manipulation.

He is a teacher at a chiropractic college, but he doesn't specialize in either cardiology or neurology or even internal medicine.

He does teach physiology, an offshoot of biology. But he really doesn't go into how the organs work much. His other field is biomechanics which is more akin to chiropractics than anything to do with neurology and internal organs. He also lists anatomy, but he pretty much skips over how the organs affect POTS.

I don't buy into the idea that you can use chiropractics for the treatment of orthostatic intolerance. And I hope you will consider all of the information here that disagrees with it. There are too many other mechanisms involved and you need to know what is causing YOUR POTS as opposed to someone else's. After you read this post, if you still think chiropractics is the way to go, there isn't much else I can say to disuade you.
Underlying Causes of POTS
What Is Causing Your POTS? And Why It IS A BIG DEAL: A Printable, Sourced Guide

Dr. Bergman gives very rudimentary explanations for the mechanisms that cause POTS. They are not always the same for every patient. That is why it is called a Syndrome vs Disease.

Not all POTS patients have low blood volume. It is very important to identify the type of POTS or the underlying condition that may be causing POTS because it can help  your doctor decide what strategy to take for treatment. Different types of POTS include neuropathic POTS, hypovolemic POTS, hyperadrenergic POTS and POTS to due to de-conditioning. Some people have
more than one of these that cause their POTS. People with neuropathic POTS can have adrenal impairment and sudomotor denervation, which is nerve damage. This is why treatment is never a
one size fits all thing. There are even people who have autoimmune causes for their POTS, like
autoimmune autonomic ganglionopathy
POTS Subtype: Does It Really Matter?
"Another problem with these labels is that they are not mutually exclusive."

One of the first things he says is that doctors don't know what causes reduced blood flow returning to the heart. He quotes a NINDS Postural Tachycardia Syndrome Information Page But the dysautonomia information network gives an explanation for it. POTS mechanisms: dysautonomia information network It could be that no matter how fast the heart beats if the blood vessels in the lower body don't constrict enough to raise blood pressure, not enough

Beta blockers-- also known as beta-adrenergic blocking agents are drugs that block norepinephrine and epinephrine (adrenaline) from binding to beta receptors on nerves. Now just from that definition, you can understand that something is wrong with the adrenaline system or the receptors. He is indicating that they are bad for all patients and that they are routinely prescribed for all POTS patients, which they aren't. He says he watched a video or a speech where a Mayo Clinic doctor was saying that beta blockers work for most patients and that they work much better than calcium channel blockers. It is true that they work better than calcium channel blockers. But not that all doctors give them to all patients. And it isn't recommended to give ACE inhibitors or diuretics, but he has a slide up and makes it sound as if that is how it is commonly treated.  At least some of the doctors at the Mayo Clinic say to try nonpharmacologic treatments before beta blockers. Postural orthostatic tachycardia syndrome and chronic fatigue in adolescents: Working toward recovery

      "Beta blockers, including propranolol, block the receptors that are responsible
        for the effects of epinephrine and norepinephrine (catecholamines produced
        by the sympathetic system).We have shown in a placebo-controlled trial that
        propranolol decreases heart rate and acutely improves symptoms in patients
        with POTS. Interestingly, we found that symptoms were more improved by
        low dose rather than high dose propranolol."
Vanderbilt Autonomic Dysfunction Center--Propranolol

"The use of beta blockers in POTS is controversial, but we have seen many patients, including those who have previously failed  beta blocker therapy, have success with propranolol.
They shouldn't be prescribed for all patients. However, some do benefit from a low dose."

"Some patients, particularly, those with partial dysautonomic POTS, improve on small doses
 of beta blockers (e.g. metoprolol 25–50 mg once or twice daily), but the majority feel
worse on beta blockers." "The combined alpha1/beta blocker labetalol is useful in some
patients, as beta-blockade alone may worsen symptoms due to unopposed alpha-receptor
stimulation. A starting dose of 100–200 mg twice daily is used, and the maximum dose is
400 mg twice daily."
Postural Orthostatic Tachycardia Syndrome (POTS): A Diagnostic Dilemma

Well, logic would tell you that for some people they will work and for some they will make things worse. That's why it's good to find out what is causing the POTS. For those who do take them, the goal is to find a dosage that slows down the tachycardia without lowering the BP too far. Sometimes it is a very low dosage. He says that it is recommended that beta-blockers be used to treat POTS and that isn't true. It is only used for some patients, not all. The above link basically talks about how it is necessary to find out what the cause of the POTS is in order to treat it properly.

Dr. Bergman points out that the heart rate speeding up is a good thing because it is your body's way of making sure blood gets to your brain and says it doesn't make sense to use beta blockers because they will slow your heart rate down and then you will get less blood flow to the brain. But he leaves out a very important fact: Studies show that long-standing persistent tachycardia in certain conditions has a potential to induce a dilated cardiomyopathy (or an enlarged and weakened heart). Tachycardia-induced cardiomyopathy can result from prolonged periods of rapid heart rates. Granted these studies were on people that had tachycardia from things like Afib or ventricular tachycardia, but it is believed that the same thing can happen from the tachycardia in POTS. Basically,where he was wrong was in indicating that the heart rate just raised and not that it raises too high, which is why it sometimes requires treatment. A resting heart rate that is over 100 bpm is tachycardia.High Heart Rate Increases Risk Of Death, Even In Fit People  "resting heart rates over 90 beats per minute tripled the risk....
Every 10 to 22 additional beats per minute in resting heart rate raised the likelihood of death by 16%, overall, according to the authors." Myth: A Normal Heart Rate Is 60-100 beats per minute.
 Many doctors think it should be lower. About 50-70 beats per minute is ideal, says Suzanne Steinbaum, MD, director of women's heart health at Lenox Hill Hospital." 5 Heart Rate Myths Debunked But aside from that, you won't necessarily have low blood because of a lower heart rate. Busting 5 Myths About Blood Pressure and Heart Rate He says that anything that reduces oxygen to the brain, i.e. a lower heart rate is bad. He uses the example of a giraffe and says that the giraffe would have to have a higher heart rate to get oxygen to its brain. But having a high heart rate isn't good either. "Circulatory shock, commonly known as shock, is a life-threatening medical condition of low blood perfusion to tissues resulting in cellular injury and inadequate tissue function. The typical signs of shock are low blood pressure, rapid heart rate, signs of poor end-organ perfusion (i.e.: low urine output, confusion, or loss of consciousness), and weak pulses." Shock (circulatory) And then he says that water and appropriate nerve supply are the way to treat POTS. But those things can't always be fixed so easily either.

But it also necessary to understand how the autonomic system works and that it is not entirely controlled by the spine. You can't just fix the spine and think that will fix the whole system.

For instance, if you are one of the people who have serum auto-antibodies to alpha-3-acetylcholine receptors of the peripheral ganglia then you can't alter the autoimmune response by spinal manipulation.

It causes increased noradrenaline due to impaired clearance or decreased uptake of noradrenaline by the synaptic cleft. The synaptic cleft is a gap between neurons somewhere in your body. Not in your spine. Here's a video of how that works.
(Given how dumb that guy thinks people are, it's kind of amusing that the video
called A level biology. This is just basic biology/anatomy.)

The Brain—Lesson 2—How Neurotransmission Works

Hyperadrenergic state means that more adrenaline than usual is released, and then on top of that, it isn't reabsorbed like it should be. Again, you have both a gland that is being overactive as well as nerve receptors not working right either, i.e. some sort of neuropathy.

Selective serotonin reuptake inhibitors. The reason for those is because the nerves are not working properly and they basically reabsorb the serotonin before they should.You need the serotonin to help with vasoconstriction. And contrary to what he implies, it doesn't all originate in the gut. And some people are born with a genetic difference that causes their serotonin problem.

SSRIs will make existing bipolar worse, and that sometimes means that someone who was misdiagnosed with depression will suddenly become much more manic. But it doesn't cause them to be bipolar. That is an outdated idea. DSM-5 now says that it isn't the medicine it is that they were
misdiagnosed because bipolar often presents with several bouts of depression.

He points out that tricyclic antidepressants are on the list of drugs that make POTS worse, but those are an entirely different kind of antidepressant and work differently and he says they are one of the most prescribed drugs. But they really aren't recommended. POTS: What to Avoid He doesn't make clear whether or not he means in general or for POTS. There is no doubt that a certain percentage of people can become suicidal on antidepressants, but it's irresponsible to indicate that everyone or even a large percentage of people will or that they will become bipolar. For one reason, it's difficult to tell if a person who is put on an antidepressant might not have committed suicide regardless of whether or not they were put on medication. There is an increased risk in some studies, but in others there is a decreased risk. Antidepressants and Suicide in Adolescents and Adults

People usually become bipolar before the age of 25. He also says that the tricyclics are one of the most prescribed drugs for POTS. But that isn't true. SSRI and SNRI are the usual ones, particularly Celexa Autonomic Disorders: Syncope Dysautonomia & POTs or Postural Tachycardia Syndrome . That's why that list he was reading off said they would make POTS worse. It was so that doctors would be careful about using tricyclic antidepressants for POTS, not to suggest them for treatment. The dysautonomia information network says to avoid them. And they are quoting Dr. Blair Grubb at the University of Toledo Medical Center. He is one of the leading experts on POTS. So the experts are not recommending them as is implied.

I don't know if he figures the average person doesn't have a very good understanding of the body, or if he himself doesn't. I mean the way he presents the video is that he is trying to make a complicated subject easier to understand. But you don't do that by leaving out part of the information or being inaccurate.

He keeps saying that people just need more water and not beta blockers. Again, not everyone is prescribed beta blockers and some people have POTS because no matter how much water they drink, their body doesn't utilize it properly.

Sodium and potassium in the body are very important and besides controlling water in the body they also help with the voltage in the nerves and outside the nerves.Hypovolemia is related to sodium (salt) depletion which causes loss of water inside the blood vessels and is different from dehydration, which is excessive loss of body water.This basically means that if you aren't adding extra salt to your diet, it won't matter how much water you drink. If for some reason your kidneys aren't releasing ADH (anti-diuretic hormone) then how much water you drink isn't going to help either.

      "Patients should not drink excessive amounts of water because doing so can cause
       essential electrolytes to become diluted in the bloodstream, which may affect heart
       rhythm." POTS: What Helps

You can also find some basic information on how salt and your kidneys affect how your body uses water, despite how much you drink. If you drink more water than your kidneys can handle and the sodium in your body gets diluted it is called hyponatremia. The recommended amount of water
is about 64 oz. or about 2 liters. For men. the amount is higher, about 3 liters. That's about eight 8 oz. cups(13 for men). Preventing and treating orthostatic hypotension: As easy as A, B, C

You might want to drink more if you are in a hot climate or exercising. Then you could drink about twice that if you are a man. It's right after he tells people how much water they should be drinking and how much salt they should consume that he says there shouldn't be one guideline for anyone but different amounts for different people. This is kind of amusing considering for the rest of the video he is basically telling everyone to do the same thing. Even though he says that no two people will need the exact same spinal adjustment, he is still implying that everyone with POTS regardless of cause needs their spine adjusted.

Adrenal fatigue, he indicates that it is only caused by stress. It isn't even a proven medical condition. For those that believe in it, it is hypothesized that in the early stages there is too much adrenaline due to stress and then later not enough adrenaline. The theory is that the adrenaline is just slightly
low and that blood tests aren't sensitive enough to show it. But actual adrenal insufficiency can be found by tests. It is also known as Addison's disease. And that isn't caused by stress. It is an autoimmune disease. You can't cure that by reducing stress.

He says this unrecognized condition of adrenal fatigue causes autoimmune disease. But Addison's
disease an autoimmune disease itself and is often found with other autoimmune diseases like thyroid disease. To put that another way: he is saying that adrenal fatigue causes Addison's disease. Now how in the world does having a slightly lower than normal adrenaline level, (because that is what adrenal fatigue is) cause an autoimmune disease? All of the other symptoms he lists are caused by autoimmune diseases too.

POTS is often misdiagnosed as anxiety/stress  or as this guy indicated it is said to be the cause of
it. It is true that POTS and anxiety are associated with over-activation of the sympathetic nervous system. But POTS happens because of things that are activated by standing or physical activity. But anxiety/stress can occur regardless of  your body position. While he is talking about hyperadrenergic POTS and says that it can be caused by impaired clearance or decreased uptake by the synaptic cleft, he then turns around and says too much adrenaline is caused by physical, chemical or emotional stressors. But he just said that a Postgraduate Medical Journal said it was caused by not being reabsorbed like it should not by too much being released. One type of hyperadrenergic POTS is caused by a tumor called pheochromocytoma. That is most definitely not caused by a chronically stressed state.

He points out that he did a search for vaccines that cause POTS and got 9,440 results, allowing the viewer and his audience to believe that there are other vaccines that cause POTS. And he says not to  take any vaccines even though HPV/Gardasil is the only one that he points out as causing POTS. If you do a search, that is probably the only one you are going to find either. And only 3 states mandate HPV vaccine for school, but he says they all do. He also says that boys have to take it even though it's just to prevent cervical cancer. It also isn't a vaccine for cervical cancer. It is for genital herpes, which can cause cervical cancer and genital cancer in boys and anal cancer in both. Besides preventing genital cancer in boys, the idea is to stop the spread of it because if a boy gives it to a girl she can then get cancer and so can he. I'm not recommending the vaccine, just pointing out how inaccurate the things he says are.

As it turns out he was wrong even about Gardasil causing POTS. So, it doesn't matter what anyone turns up in a search because the CDC determined that it doesn't and the old links are now outdated. "In November 2015, the European Medicine’s Agency completed a detailed review of available POTS data from young women who received HPV vaccines.  The review found that the evidence does not support a causal link between HPV vaccines and POTS." Centers For Disease Control:Frequently Asked Questions about HPV Vaccine Safety I don't know when he made the video, but it was just uploaded a few days ago. So the information was out there for him almost a year ago.

Antibiotics: he names them off as bad too. What do you do if you have an autoimmune disease that causes your POTS and you are on an immunosuppressant and get an infection?

He also says not to use sunscreen and to use coconut oil. Stop Risking Skin Cancer! Coconut Oil Is No Sunscreen.

"Neither coconut oil nor any of the other oils will protect your
skin from the sun's ultraviolet rays so you will need to apply
sunscreen when going outdoors, particularly in sunny weather."

It seems like much of what he says is unfounded information. He could be correct about some things, but I wasn't able to find sources that backed him up, and it was a lot easier to find sources that contradicted him.

He recommends really high doses of vitamin D.(8000 IU per day).

Mayo Clinic: Drugs and Supplements Vitamin D
National Institutes of Health 
(They recommend no more than 4000, but optimally about 1000)
The vitamin D council say about 5000 IU. And it's their business.
National Osteoporosis Foundation 1000 mg https://www.nof.org/patients/treatment/calciumvitamin-d/
Institute of Medicine (IOM), the safe upper limit of vitamin D is 4,000 IU per day for most adults.
But they recommend about 800IU for normal people.
Vitamin D Supplementation
You can get pretty sick if you take too much vitamin D.Mayo Clinic: Vitamin D Toxicity

Then he says chiropractic adjustment takes pressure off of the nervous system. But there is much more to the nervous system than just the nerves.

There are even three different parts to the nervous system, the central(CNS), peripheral(PNS), and autonomic nervous systems(ANS). You can think of it like this: The CNS sends commands out to the PNS. The PNS has receptors that are affected by chemicals and they send information back to the CNS which is the brain and spine.

Sometimes information goes straight to the brain so that the brain can decide what response to have. Other times, information goes to the spine and the spine basically makes the decision before it ever gets to the brain. This is called the reflex loop.

If this was what always happened, then it would make sense for spinal manipulation to work. But it isn't. You can work on the spine all you want, but it won't either make the brain work better or have any effect on those receptors on the other end of the PNS.

There are lots of things that can interfere with this communication system. For instance, the myelin sheath on nerves can be damaged. This happens with Multiple Sclerosis or a severe electrical shock or lightning strike. Myelin serves the same purpose as the plastic coating on an electrical wire. It keeps the electrical charge from leaking into the surrounding tissue. If it's damaged, the signals can fade or disappear. This is called demyelination. They don't get where they were supposed to be going.

He briefly touched on the parasympathetic and sympathetic nervous systems, which are the chemicals switching on some things and switching off some things. Those fight or flight hormones are also
countered by rest and digest hormones that control things like your digestive system.It cannot be helped by working on your spine.

The autonomic nervous system could also be called the automatic nervous system and it is controlled by your brain stem. It controls things like your internal organs. He refers to a journal that calls those organs your viscera.  You would be well advised not to mess with your brain stem by doing some kind of adjustment, particularly in an effort to effect the heart. When he quotes a journal saying that it(manipulating the spine to affect the heart) MAY work, he is quoting a chiropractic journal(Journal of Manipulative and Physiological Therapeutics) and not a medical journal. If you look that journal up it says that this is at odds with classic views of neuroscientists about the potential for somatic stimulation of spinal structures to affect visceral function. http://www.jmptonline.org/article/S0161-4754(00)90076-9/abstract Why do you suppose he chose to leave out that neuroscientists don't agree with this theory?

When he starts talking about the sympathetic nervous system being located in the thoracic spine, that is true. But when it sends out signals, it also needs those chemicals/neurotransmitters like acetylcholine and norepinephrine sometimes called noradrenaline.

Part of the parasympathetic nervous system originates in the sacrum/lower spine and some of it up in the brain stem area called the medulla. It also requires acetylcholine. He says that if you work on one of these areas of the spine it will change the nerve supply and function of the organs.He seems to be talking about the sympathetic area of the spine and forgetting that the parasympathetic system
even plays a part. The reason I say this is because he refers to the thoracic area of the spine and
keeps talking about the "fight or flight" response and stress. But some people with dysautonomia
have problems with the parasympathetic nervous system. If you think of the sympathetic nervous
system as the ON switch and the parasympathetic as the OFF switch. A problem can be just as much a problem of the OFF switch not working as it can be of the ON switch working too much. The sympathetic nerves originate in the spinal area; they are fairly short and close to the organs they stimulate (a few inches in length). When they switch on, they do so quickly and the entire system is "on." The parasympathetic nerves, on the other hand, originate mostly from the brain, but some originate from the bottom of the spine, so they travel much longer distances to the organs which they stimulate (several yards); they are much slower to react and because of this it takes a much longer time for the body's systems to  "turn off." You can easily see from this explanation that because some of these nerves originate in the brain, working on the spine won't fix problems with how they work.

 If you think of this like a telegraph system, then he is talking about working on the telegraph machine itself. But then you still have the wires themselves as well as the telegraph machine on the other end that he isn't taking into account. Then you have to factor in the chemicals and hormones which are basically the electricity running through that wire.

He points out exercise as being a treatment for POTS. The problem is it doesn't work for everyone.
They have also done studies that show why it doesn't work. It is coauthored by Svetlana Blitshteyn
She is another expert on POTS.
       "This study provides the first objective evidence that low ventricular filling pressures
        in patients with POTS are contrary to what would be expected in deconditioned
        patients—high filling pressures.Although the benefits of exercise have been acknow-
        ledged in several studies, almost 60% of patients with POTS are unable to complete
        an exercise training program despite their efforts. Importantly, Oldham et al.
       demonstrate that exercise intolerance in POTS is not caused by a lack of maximum
       effort from the patient but that low ventricular pressures occur despite the maximum
       effort."  Pulmonary Vascular Research Institute.

I can entirely understand not wanting to take medications that might have side effects.
But it is bad medicine to say that it is a viable option for everyone. If you keep an open mind and really want to understand how your nervous system works and watch these videos, you can learn. And once you do, it probably won't seem so much like what he says makes any sense. Just because he is recommending not taking medicine,which works for some patients, doesn't mean that everything else he says makes sense.

You will see that there is much more involved than just the spine. He way oversimplified it. For instance, spinal manipulation might help if you have bowel problems related to your POTS causing a balancing effect on the nerves that supply impulses to the intestinal tract.

 But what about that serotonin that originates in the gut or other neurotransmitters? If those are out of balance, you may still have problems. That doesn't even factor in the enteric nervous system. It works like a secondary brain and has structures and chemicals similar to those in the brain. It has sensory and motor neurons and information processing circuits, as well as glial cells. It uses neurotransmitters: dopamine, serotonin, acetylcholine, nitric oxide, and norepinephrine. It even has benzodiazepines, similar to Valium and Xanax.

The Nervous System - CrashCourse Biology #26

Autonomic Nervous System: Crash Course A&P #13(This one explains how the parasympathetic
and sympathetic originate in different areas of the body)

Sympathetic Nervous System: Crash Course A&P #14 This one explains how hormones and neurotransmitters are necessary to the system. And they have nothing to do with chiropractics. And quite a bit to do with nerve receptors. If you pay close attention it touches on alpha and beta receptors, which are why beta blockers are used. And the adrenal glands, which if there is something wrong with them, cannot be fixed by spinal manipulation or drinking water.

Parasympathetic Nervous System: Crash Course A&P #15 This one explains how your parasympathetic system is supposed to keep your heart rate down. Remember that it doesn't originate in the thoracic area that this guy keeps referring to. And many of them don't even run through the spine. Check out the vagus nerve which goes from the brain directly to the heart, lungs, and stomach. No spine involved.

Peripheral Nervous System: Crash Course A&P #12  The peripheral nervous system doesn't start at the spine. It starts on the other end. And if the receptors, etc. on that end don't work right, they aren't going to send information back to the spine the way they should. And even though the information  goes through the spine, ultimately it should end up in the brain. And the brain should affect the response.

These articles have fairly comprehensive lists of treatments for POTS. It starts out with the
homeopathic or nonpharmaceutical treatments, which common sense tells you should be tried first. http://myheart.net/pots-syndrome/treatments/
British Journal of Cardiology Postural Orthostatic Tachycardia Syndrome (POTS): A Diagnostic Dilemma

I gave a lot of sources because at the end of his video he gave some sources. The first page
and a half of them are about side effects of medicines that I have shown are not always given for POTS and many of which aren't recommended by doctors who specialize in POTS, like cardiologists and neurologists.

Chiropractic manipulation has its place. It eases people's pain and that will help their overall health but in my opinion, it doesn't seem to be good science to say that it can do the things he claims.