What Is POTS??

What Is POTS??

Saturday, August 13, 2016

Things That Help or Hurt When You Have POTS or Orthostatic Hypotension And Contributing Factors

  • Sitting or standing for long periods (shop in off-peak hours. Move your legs around)
  • Warm environments (hot showers, saunas, hot tubs)
  • Sodium/salt depletion 
  • Prolonged bed rest
  • Varicose veins
  • High carbohydrate meals
  • Diuretics, vasodilators, alpha-blockers
  • Alcohol
  This is because they result in venous pooling and hypovolemia. 

  • Stress
  • Excercise
  • Pain
  • Hypoglycemia (low blood sugar)
  • Albuterol
  • Epinephrine
 They will increase catecholamines.

Some helpful things are:
  • Raising the head of your bed
  • Compression Garments i.e. support hose, body shapers/girdles. abdominal binders
  • Waist high are better than thigh high which are in turn better than knee high 
  • Standing with legs crossed
  • squatting
  • sitting knees to chest
  • leaning forward when you are sitting
  • elevating your knees when sitting (try using a foot rest)
  • clenching your fists when you are standing up
All of these use your own muscles to pump blood. 

  • Drink a minimum of 2 liters a day/0.52 gallons/67 ounces
  • Drink at least every 2 hours
  • Avoid sleeping more than 12 hours a day because you can't drink in your sleep
  • Increase your salt according to your taste and add salt tablets
Even though you have exercise intolerance, some exercise is good. Being inactive is bad
  • Avoid excessive bed rest/sleeping
  • Start excise slowly and gradually increase
  • Recumbent exercise bikes or lying on your back are good 
  • Swimming
  • Manual forms of Physical Therapy can be helpful

You need to be treated for any conditions that contribute to your orthostatic intolerance;
  • food allergies
  • anxiety
  • depression
  • pelvic vein incompetence
  • EDS/JHS  ( Ehlers-Danlos Syndrome/Joint Hypermobility Syndrome)
  • Chiari 1 malformations
  • stenosis of the cervical spine
  • Migraines
  • movement restrictions
  • Infection
  • allergies/asthma because inhalants make you worse
Medications: Can be used alone or in combinations

  • Vasoconstrictors: Midodrine, dexodrine, methylphenidate, SSRIs, SNRIs, aescin(horse chestnut seed extract), L-DOPS(Droxidopa) is being used in trials.
  • volume expanders: Sodium consumption or IVs, fludrocortisone/Florinef, clonidine,
  • catecholamine release inhibitors:beta blockers, disopyramide, SSRI's, ACE inhibitors
  • Other treatments include but are not limited to:  pyridostigmine bromide

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