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How To Deal With Pots Fatigue

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Management Of Pots And Associated Conditions

Managing fatigue in POTS

Non-Pharmacologic Strategies

Regardless of the underlying mechanism causing POTS, there is decreased venous return to the heart. The management of POTS, therefore, is aimed primarily at improving the effective circulatory volume and enhancing venous return.

Patients are generally advised to avoid factors that are associated with exacerbation of symptoms such as sudden changes in posture, prolonged recumbency, high environmental temperatures, large meals, and vasodilating or sympathomimetic drugs.107 Most of these factors mediate their effect through vasodilation with consequent blood pooling and decreased effective circulatory volume.

Adequate water and sodium intake are essential to maintain the intravascular blood volume. Patients are usually instructed to consume 6480 oz of fluids and as much salt as their taste buds can tolerate. Adequacy of fluid intake is generally judged by the regular production of clear, non-yellow urine. If quantification is needed, adequacy of salt intake is assessed by measuring 24-h urinary sodium excretion an output if at least 170 mmol/day is desired. While some physicians use intravenous saline infusions in an effort to provide temporarily symptomatic relief, such treatment is costly and risks infection and blood clots, and is not advised. Oral intake of fluid and salt is preferred.

Medications for Blood Flow

Medications for Gastrointestinal Function

Exercise is an important, if not critical, treatment strategy in POTS.

Typical Presentations Of Pots

Each patient with POTS is unique, but their stories often sound similar.26 There is no quantitative system for scoring symptoms to diagnose POTS, but POTS can be considered as a diagnostic possibility when an adolescent has chronically bothersome fatigue associated with dizziness and, often, a constellation of other symptoms including nausea, pain, and a sense of altered mental clarity .

Age

POTS can occur throughout adolescence, but the majority of affected individuals report symptoms beginning within a year or two of the beginning of puberty . Similarly, symptoms often fade or resolve by the end of the process of the physical changes of puberty.

Genetics

Anecdotally, POTS is more common in Caucasians than in adolescents of other races. In addition, approximately 15% of affected adolescents have a close relative who had similar symptoms during adolescence or young adulthood. This suggests that there might be a genetic predisposition toward POTS in at least some individuals, but no differentiating gene has been identified.

Physical Features

Many adolescents with POTS have hyperextensibility, and some are thought to have benign joint hypermobility syndrome or EhlersDanlos syndrome.46 It is not clear whether the elastic soft tissues actually predispose to the development of POTS or if the lax tissues simply allow further increases in vasodilatation that make it more likely for hyperextensible individuals to report more venous pooling and dizziness when they get POTS.

Is Pots More Common In Certain People

There are no established risk factors for POTS. However, it is known to run in families, so it could have a genetic component. Researchers have also established a link between POTS and Ehlers-Danlos Syndrome . So if you have one of these conditions, you might also have the other.

A big group of those diagnosed with POTS is young women and teens. However, this doesnt mean they are more likely to develop this condition.

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Pots: A Little Known Cause Of Extreme Fatigue

Everyone knows what being tired feels like at the end of a long day. But some people experience fatigue so severe and so seemingly random that its hard to describe. If that sounds familiar, there could be more going on than daily stress.

While there are many causes of fatigue, one of them is frequently missed and misdiagnosed: postural orthostatic tachycardia syndrome . Physical medicine and neuromuscular specialist Tae Chung, M.D., answers questions about POTS and extreme fatigue as one of its symptoms.

Personal And Medical History

POTS: A Little

The health care provider will take a careful personal and family medical history, and perform a thorough physical examination and psychological assessment. The provider will ask questions such as:

  • When did the fatigue first begin?
  • Does anything make it worse or better?
  • Is it better at certain times of the day?
  • Does physical or mental activity make it worse?
  • What are your other symptoms?
  • Has anyone else in your family experienced similar symptoms?
  • Is your personal and professional life stressful?

The provider may also ask about any changes in weight or recent illnesses. You should tell your provider about any drugs you are taking, including over-the-counter medications, and vitamin, herbal, or dietary supplements. You may be asked to keep a diary for several weeks to record your activities and symptoms.

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What Are The Long

The long-term effects of POTS can vary depending on the severity of symptoms and how well the condition is controlled. Some patients may experience fatigue, fainting episodes, difficulty with exercise or daily activities, and decreased quality of life. In severe cases, POTS can lead to heart failure or stroke. However, many patients with POTS are able to manage their symptoms and live normal, active lives.

What Should You Do During A Pots Flare Up

If you have a POTS flare-up, the first thing you should do is sit or lie down. This will help your blood pressure and heart rate stabilize. Drink plenty of fluids, especially water, and avoid caffeine and alcohol. If youâre feeling dizzy or lightheaded, try to raise your head higher than your heart. You can do this by propping yourself up on pillows or sitting in a recliner. Taking a hot bath or shower can also help. If your symptoms are severe, call 911 or go to the emergency room.

POTS flare-ups can be unpredictable and frustrating, but there are things you can do to manage your symptoms and prevent trigger. With the CareClinic app, you can track all aspects of your health in one place so you can identify patterns and get the information you need to make informed decisions about your care.

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Pots: Why Does This Happen

During position changes, gravity pulls approximately 20% of the circulating blood volume down to the lower extremities. In response to this position change, blood vessels constrict to increase circulating blood volume and increase blood return to the heart.

Patients with POTS experience poor blood vessel constriction during position changes. This leads to blood pooling in the lower extremities. Blood pooling in the lower extremities results in decreased blood flow to the heart, brain, lungs, and abdomen. When there is low circulating blood volume, it may cause the heart rate to increase rapidly to compensate.

What Happens In Pots

How Fibromyalgia and Chronic Fatigue Are Related

Normally when you sit up or stand, gravity pulls some of your blood down to your belly area, hands and feet.

In response, your blood vessels quickly narrow and your heart rate increases slightly to maintain blood flow to the heart and brain, and prevent blood pressure dropping.

This is all done without needing to think about it, by the autonomic nervous system the nervous system in charge of automatic body functions.

In PoTS, the autonomic nervous system does not work properly. There’s a drop in blood supply to the heart and brain when you become upright and the heart races to compensate for this.

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Practice Good Nutrition And Hydration

Make sure to stay hydrated during and after workouts, and fuel up correctly post exercise.

Keep a stock of your favorite electrolyte replenisher drinks, like Liquid I.V. or Pedialyte. These products work great to restore electrolytes lost through exercise so that the body stays hydrated. I always have these in my pantry and even in my purse for emergencies!

Eating well after a workout is just as important as staying hydrated. Not fueling your body with the right food can contribute to fatigue after exercise. So what should you eat post workout?

According to Healthline, a post-workout meal should include protein and carbohydrates. Adding a little healthy fat wont harm your post-workout recovery, but it may slow down digestion. For the best results, aim to eat your post-workout meal within 45 minutes after exercise. Perfect examples of post-workout meals include Greek yogurt with berries and granola, or a roasted chicken sandwich on whole grain bread topped with veggies. A smoothie is another great option, like my mango and berry protein smoothie!

Adding Sodium To Your Diet

One reason that people with POTS feel lightheaded upon standing is insufficient circulating blood volume. Drinking more fluids will help, but the key to keeping the fluids in circulation is sodium.

For reasons not fully understood, many people who have POTS need up to three times more sodium than the standard limit recommended by the US Dietary Guidelines, which is 2,300 milligrams a day . Some of my patients can consume this much sodium by eating salty foods such as tomato juice, broth, pickles, and olives. Others prefer to use high-sodium electrolyte drinks or take salt tablets.

David opted to start with a glass of tomato juice every morning and a 1-gram salt tablet with lunch, in addition to adding salt to his meals. Even though David could easily meet his sodium needs by eating highly processed junk foods, I recommended he avoid these because of their low nutrient value.

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Bladder And Bowel Incontinence

Since the autonomic nervous system controls digestion, urination and defecation, autonomic dysfunction can affect these processes, causing issues such as incontinence.

It can certainly feel a bit uncomfortable to try to explain that no, you cant hold it, and yes, you really need to go to the bathroom now. But with over 17 million people in the United States dealing with urinary incontinence every single day, know you are far from alone.

The autonomous dysfunction needing to pee at random and suddenly when Im in a flare. Celia E.R.

Sudden bowel incontinence being unable to control my bowels. One minute I am fine with no urge to use the restroom and the next I either have to race to the bathroom or it is too late. It is so embarrassing and sometimes I have to carry more clothing with me in case I have an accident. Hannah W.

My friends make a joke about how I always have to have the entryway to a bathroom anywhere we go but its tough too because I am always having to leave to pee. Although Im glad we can find some humor in this wild chronic illness life. Alyssa A.A.

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Can Stress Trigger A Pots Episode And Why

Pin on ANS

Stress is a common trigger for POTS episodes. When youâre stressed, your body releases hormones that can affect the autonomic nervous system. This can lead to symptoms like increased heart rate, sweating, and headaches. For people with POTS, stress can also trigger a drop in blood pressure, which can cause lightheadedness and dizziness.

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Other Measures That Help

In addition to salt, compression, and exercise, I recommended that David try

  • placing a small board under his mattress that raises the head of his bed by a few inches
  • using a symptom tracking smartphone app to help identify triggers for POTS symptoms
  • avoiding identified triggers, such as skipping meals insufficient sleep hot baths and saunas and high-carbohydrate meals.

When its not possible to avoid triggers, it helps to learn to anticipate and manage symptoms. For example, in hot and humid weather, cooling vests or scarves can help reduce symptoms. Catching a cold or stomach bug can also cause symptoms to flare, and many women find that symptoms worsen in the days leading up to their menstrual periods. During these vulnerable times, a person may need to intensify salt and compression routines and, when necessary, take a day off from exercise.

A Call For Awareness & Understanding

Some estimate that roughly 500,000 people in America suffer from POTS however, with the difficulty associated with receiving a diagnosis theres no telling how many patients have POTS and dont even know it. While we dont have any short-term or easy solutions for these problems or homeopathic cures to provide, there are a few points worth making.

Its fair to conclude that increasing awareness about this mysterious disease not just among those who have POTS but among their friends, family members, and loved ones helps the patients manage their condition and, perhaps more importantly, believe they can overcome a challenging condition.

Its this statistic that motivated us to create the POTS Center. Wed encourage you to share this resource or if not this resource, any medically accurate and helpful resource on POTS with anyone you see fit. You never know who may have POTS but, due to challenges mentioned above, never got the diagnosis that could help them regain control over their life.

About the Survey

The survey was conducted via Facebook Groups dedicated to POTS Syndrome. We asked that only people with an official diagnosis take part however, no additional efforts were made to proof an official diagnosis. Thank you so much to all of those that participated!

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The Remedy To Feeling Burned

If there is an underlying condition in our bodies, such as fatigue with POTS, exhaustion sends us a message that we need to rest and check our health. If simple movements cause extreme fatigue in this case, it is best to consult a clinician who is familiar with this type of physiological response.

Fatigue is caused by disrupting the autonomic nervous systems sympathetic dominance regulation, according to Lindsay Mitchell, a physician assistant with Vital-Side. To put it simply, sympathetic dominance occurs when the sympathetic nervous system actively participates in our immediate thoughts, actions, emotions, and reactions. This functions dominance triggers a ght or ight response in our brain, and its dysregulation keeps us in freeze mode.

She suggests there are ways to deal with this situation, but the individuals idea of safety and comfort will also need to be considered. Lindsay says that to change your physical state, which she calls state-changing exercises. She instructs you to sit up straight to begin this renewal, giving the impression that you are serious about this session. Next, take three seconds to inhale and exhale. She also advises you to visualize the color yellow in your mind to help ght fatigue.

Imagine inhaling the color yellow, which represents vitality and renewal, and spreading it throughout your body. After a few minutes, your heartbeats will be in sync with your brain waves, resulting in a state of harmony in your body.

Why Do We Experience Fatigue With Pots

Whats the Relationship Between Chronic Fatigue, Brain Fog, and POTS?

A variety of factors can cause fatigue. First, it can be a symptom of an underlying condition. Our bodys fight-flight-freeze response can also contribute to fatigue.

When we experience trauma, stress, or a chronic illness, our bodies go into aght-ight-freeze response to protect us from the dangers. Fatigue happens when the bodys freeze response turns on. This results in a lack of energy in the body.

Our hypothalamicpituitaryadrenal axis receives increased cortisol during stressful-traumatic situations, causing an overdrive. This leads to exhaustion and total burnout.

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What Is Postural Orthostatic Tachycardia Syndrome

Postural orthostatic tachycardia syndrome is a condition that causes your heart to beat faster than normal when you transition from sitting or lying down to standing up. Its a type of orthostatic intolerance.

Each word of postural orthostatic tachycardia syndrome has a meaning:

  • Postural: Related to the position of your body.
  • Orthostatic: Related to standing upright.
  • Tachycardia: A heart rate over 100 beats per minute.
  • Syndrome: A group of symptoms that happen together.

Normally, your bodys autonomic nervous system balances your heart rate and blood pressure to keep your blood flowing at a healthy pace, no matter what position your body is in. If you have POTS, your body cant coordinate the balancing act of blood vessel constriction and heart rate response. This means that your body cant keep your blood pressure steady and stable. This causes a variety of symptoms.

Each case of POTS is different. People with POTS may see symptoms come and go over a period of years. In most cases, with adjustments in diet, medications and physical activity, a person with POTS will experience an improvement in their quality of life.

Pots: Diagnosing And Treating This Dizzying Syndrome

Editors note: Second in a two-part series on postural orthostatic tachycardia syndrome . Click for part one.

Most of us dont think twice about standing up. Yet for people affected by a disorder called postural orthostatic tachycardia syndrome , the simple act of standing can provoke lightheadedness and a racing heartbeat. This post discusses diagnosis, treatment, and living with POTS.

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Conflict Of Interest Statement

All authors have completed the competing interest form and declare: no support from any organization for the submitted work no financial relationships in the previous 3 years with any organizations that might have an interest in the submitted work and no other relationships or activities that could appear to have influenced the submitted work.

Psychological Correlates Of Chronic Fatigue

Best Diet for POTS Syndrome ⢠Get Natural Relief ⢠MyHeart

When studying a school-based cohort of 3454 Dutch students, ter Wolbeek et al.2,9,21 attempted to study the natural course of chronic fatigue. Higher levels of depression and anxiety were the best predictors of fatigue severity in both boys and girls. Other factors that correlated with the severity of fatigue were decreased participation in sports and shorter nocturnal sleep on schooldays and shorter nocturnal sleep on weekends . In a follow-up study of these patients 6 and 12 months later, the authors founds that teens who were persistently fatigued had higher levels of depression and anxiety at the beginning of the study as well as slept shorter lengths of time and participated in less physical activity.9 Similarly, 4 years later, an increase in chronic fatigue-related symptoms was predicted by anxiety and decreased physical activity during adolescence.21 In a US population, Smith et al.22 also found that adolescents meeting CDC criteria for chronic fatigue syndrome had higher anxiety and depression scores than healthy adolescents.

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