Hypo-adrenergic POTS--People with this type make more norepinephrine and epinephrine than normal people. NMH (ORTHOSTATIC HYPOTENSION) is most likely to occur is you have a decrease in norepinephrine and an increase in epinephrine. POTS is the opposite, it is most likely to result from an increase in norepinephrine and a decrease in epinephrine. About 33% of patients have this type.
Hypovolemic POTS--Blood Volume and urine sodium is low.About 33% have this type. Hypovolemia is Hypovolemia (also hypovolaemia or oligemia) when your body is in a state of decreased blood volume. More precisely, you have a decrease in volume of blood plasma. It is what happens inside your blood vessels due to things like bleeding or dehydration.
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. Symptoms of hypovolemia are tachycardia, low blood pressure, and lack of adequate blood flow which causes paleness of the skin and/or capillary refill on the forehead, lips and nail beds. This is the time it takes normal color to return to the skin or nail beds after pressure is applied. Other symptoms include feeling dizzy, faint, nauseated, or very thirsty. These are similar to the symptoms of shock.
Patients can have more than one type.
There is a genetic predisposition in some patients. Someone else in your family may have it. In my husband's family, his mother had it, but never got a diagnosis. And in my family, my father had it. There are major genetic things going on with my case. My father also had Parkinson's and it is genetic in our family. And in addition to this, my father had Rheumatoid Arthritis and a few secondary autoimmune conditions. I, in turn, have,SLE (Systemic Lupus Erythematosus), Sjogren's Syndrome and other autoimmune conditions.
Typically, when you read about autonomic dysfunction, you read about a connection to Joint Hypermobility Syndrome or EDH(Ehlers-Danlos syndrome hypermobility type) . But they are autoimmune in nature, so Lupus and Rheumatoid Arthritis are not a stretch.
Parkinson's Disease is also common to read about in conjunction with autonomic dysfunction.
Other things that are connected are anemia, tumors, lightning injury(my husband was hit by lightning twice, see Page about it over on the side and read post about it here for more links), mitochondrial disease, porphyrias.
Don't forget to check out the videos at the bottom on POTS. You have to scroll down to find them.