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Larry Langdon
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Lyme disease and POTS

Lyme disease and POTS

Circulation is impacted by the disorder known as POTS, or postural orthostatic tachycardia syndrome (blood flow). It involves both the sympathetic nervous system and the autonomic nervous system, which governs and controls essential body activities automatically (which activates the fight or flight response).

Orthostatic intolerance, or POTS, is a condition in which a person experiences symptoms that worsen when they get out of a seated or lying down position. Lightheadedness, fainting, and an uneasy, rapid rise in heartbeat are the main signs of an orthostatic intolerance.

Irrespective of the position the body is in, the heart rate and blood pressure work together to maintain a healthy rate of blood flow. The delicate balancing act between heart rate response and blood vessel squeeze is impossible for people with POTS. Therefore, it is impossible to maintain a constant and stable blood pressure.

Every POTS case is unique. Over the course of years, symptoms for people with POTS may come and go. In most situations, a person with POTS will experience an improvement in quality of life with changes to diet, medications, and physical activity. Additionally, if an underlying reason is identified and treated, POTS symptoms may improve.

POTS can take different forms:

  • Neuropathic POTS: Loss of peripheral nerve supply causes weak blood vessel muscles, particularly in the legs and core of the body.
  • POTS with hyperadrenergic symptoms: excessive sympathetic nervous system activation.
  • POTS caused by low blood volume: POTS can result from low blood volume. Similar symptoms that may coexist with neuropathic and hyperadrenergic POTS can be brought on by low blood volume.


What Does POTS Have To Do With Lyme Disease?

A tick bite can result in the illness Lyme disease. It is a disease that affects a variety of organ systems, such as the heart, muscles, and nerves. Erythema migrans, a rash that appears after a tick bite, is where it starts. Antibiotics typically work to treat lyme disease, but some people have what is known as the post-Lyme disease syndrome. "Brain fog" is a syndrome of exhaustion, discomfort, and mental haziness that has a negative impact on a person's quality of life. By examining patients with POTS who also had Lyme disease and the post-Lyme disease syndrome, a team of US researchers from Ohio was able to show a connection between the two conditions.


Studies on POTS & Lyme disease

A study on the relationship between Lyme disease and POTS syndrome :

Five individuals with Lyme disease who had developed fatigue, orthostatic intolerance, and cognitive dysfunction were included in the study. Some people experienced dizziness and fainting as well as other symptoms like palpitations, poor exercise tolerance, headaches, and mental fogginess. All of the patients were so weak that they were confined to their homes. To make a diagnosis of POTS syndrome, tests like tilt table testing and a clinical examination were employed.

Patients were treated according to established guidelines by the team with extensive experience in caring for people with POTS disease. The usage of exercise as well as increased sodium and water consumption was made. If P.O.T.S symptoms persisted, medication was administered, with each patient receiving a distinct mix of drugs based on what was deemed required. If there was an improvement in symptoms, treatments were deemed successful.

The POTS syndrome was successfully treated in all of the patients. Orthostatic symptoms, particularly weariness, improved in all patients. The passing out episodes completely vanished in three of the patients, whereas they appeared substantially less frequently in the other two. Four out of the five patients were able to get back to their regular daily routines.


The Importance Of Treating POTS Syndrome Has Been Proven

That was demonstrated in this study's Lyme disease participants. The post-Lyme disease syndrome, a syndrome that can manifest, has POTS syndrome as a clear component. It was crucial for this group to recognize POTS syndrome since, once treated properly, it led to a reduction in debilitating symptoms and an improvement in quality of life. Therefore, when treating patients with post-Lyme disease syndrome, doctors should have a high degree of suspicion for POTS syndrome. How many people with post-Lyme disease syndrome may be affected is unknown from this study; it may only be a small percentage of patients. However, it was crucially shown that a focused and organized approach to treatment can greatly raise the quality of life for those with POTS condition.


How does POTS present?

POTS can start gradually or unexpectedly in some people.

Occasionally, you may have symptoms right away or a few minutes after standing or sitting up. Some of the symptoms could be lessened by lying down.

The following are typical POTS symptoms:

  • feeling unsteady or lightheaded
  • heart palpitations fainting problems with thinking, memory, and concentration — this combination of symptoms is frequently referred to as "brain fog"
  • trembling and perspiring weakness and exhaustion (tiredness)
  • headaches
  • difficulty sleeping
  • chest discomfort
  •  nausea
  •  breathlessness
  • Some people discover that getting heated, eating, engaging in vigorous exercise, or going through their period can exacerbate their symptoms.


When to consult a doctor

Consult a doctor if you suspect POTS.

It's a good idea to get a precise diagnosis because the symptoms could have a variety of causes, including medication or low blood pressure. It may occasionally be incorrectly diagnosed as anxiety or panic episodes.


Diagnosis of POTS

When your heart rate rises by at least 30 beats per minute (bpm) and typically within 10 minutes of standing (40 bpm in children and adolescents aged 12 to 19), PoTS is suspected. With this increase come other POTS symptoms that last longer than 30 seconds.

To confirm a diagnosis and rule out other diseases, you might undergo a variety of tests, such as:

  • The tilt table test: which involves lying on a specially made bed that can be tilted upright while your blood pressure and heart rate are monitored. More measurements are taken when the bed is gradually tilted toward a more upright position.
  • active When you stand up from lying down, your heart rate and blood pressure are recorded. They are then recorded after 2, 5, and 10 minutes.
  • An echocardiogram, which is an ultrasound scan of your heart, and an electrocardiogram (ECG), which measures the electrical activity of your heart
  • Holter monitoring: Small, belt-mounted gadgets that continuously measure your pulse rate and blood pressure while you go about your daily business.
  • Blood tests are used to check the health of your kidneys, liver, and thyroid as well as your blood count, calcium levels, and glucose levels.


Treatment of POTS

Self-care practices can occasionally assist in easing POTS symptoms. You might need to take medication if these do not work.

Treating an occurrence

You can try to stop the decline in blood flow if you suddenly feel lightheaded or faint by:

laying down while elevating your legs if possible

If you are unable to lie down, try swaying back and forth on your toes, crossing your legs in front of each other while standing, tightening your buttocks and stomach muscles, and/or clenching your fists.


There isn't a single medication used to treat POTS, although your doctor might recommend trying:

  • a beta blocker or the heart-rate-lowering drug ivabradine
  • Blood arteries are narrowed by midodrine.
  • Fludrocortisone reduces the quantity of sodium lost during urination.
  • SSRIs, a kind of antidepressants that alter how your nervous system functions, are selective serotonin reuptake inhibitors.