Postural tachycardia syndrome (PoTS) is a poorly understood condition that can cause debilitating symptoms such as dizziness, brain fog, and digestive issues, particularly affecting women, according to medical experts. Many general practitioners (GPs) may not be familiar with the syndrome, making diagnosis challenging.
PoTS affects the autonomic nervous system, which regulates involuntary bodily functions like heart rate, blood pressure, and digestion. In individuals with PoTS, standing up causes an abnormal rise in heart rate, which can lead to dizziness, a racing heart, weakness, and even fainting. Other common symptoms include extreme fatigue, headaches, brain fog, and changes in sweating.
A simple test can help identify potential PoTS. It involves measuring heart rate and blood pressure while lying down and then repeatedly after standing. In adults with PoTS, the heart rate typically increases by at least 30 beats per minute within ten minutes of standing, without a significant drop in blood pressure.
Smartwatches can also provide clues, with some patients' readings showing a sudden spike in heart rate upon standing. Another potential indicator is unusually flexible joints.
While there is no cure for PoTS, lifestyle adjustments and medical treatments can significantly improve symptoms. Increasing fluid intake to two to three liters per day can help maintain blood pressure. Some individuals may benefit from increased salt intake, but this should only be done under medical advice. Compression garments can also help by reducing blood pooling in the lower body, easing the strain on the heart.
For some, medications prescribed by specialists may be necessary. Although no drug is currently specifically licensed for PoTS treatment in the UK, medications that slow heart rate or increase blood pressure or volume are used off-label and tailored to individual needs. However, access to PoTS specialists can be inconsistent.
Experts stress that persistent dizziness should not be ignored. If a clear pattern to the onset of dizziness exists, especially when standing, it is important to discuss PoTS with a GP. The condition has gained more attention in recent years, with increasing numbers of diagnoses being reported.
In a separate but related note, a recent inquest highlighted the potential for preventable deaths if timely treatment for blood clots is not administered. The case of Joan Branson, wife of Richard Branson, underscored the importance of prescribing anticoagulants, or blood thinners, to older adults who are at higher risk of developing deadly blood clots and strokes. Despite fears of increased bleeding risk due to falls, studies suggest that the risk of stroke outweighs the bleeding risk in most cases.
Additionally, Dr. Ellie addressed a reader's question about recurrent gout attacks. Gout, a form of arthritis caused by urate crystal buildup, can cause sudden and severe joint pain. If gout attacks are frequent, doctors may recommend urate-lowering medication like allopurinol. Monitoring urate levels and adjusting medication dosage is crucial. Lifestyle factors such as weight loss and reduced alcohol consumption can also help. If gout symptoms persist despite treatment, it's important to reconsider the diagnosis, as other forms of arthritis can mimic gout. Joint aspiration or imaging techniques like ultrasound, X-rays, or CT scans can aid in confirming the diagnosis.