POTS
Postural orthostatic tachycardia syndrome (POTS) is a condition characterized by an abnormally large increase in heart rate upon sitting up or standing.This increased heart rate should occur in the absence of orthostatic hypotension (>20 mm Hg drop in systolic blood pressure).
I'm skeptical that everyone diagnosed with POTS has had orthostatic hypotension confidently ruled out.
If you smoke marijuana, it can cause orthostatic hypotension. If you are diagnosed with POTS and are a toker, let me suggest you start a health journal and discontinue marijuana use or at least track the relationship between toking and severity of symptoms.
Wikipedia lists hyperadrenergic POTS which probably means overactive adrenals and Copilot says in part:
Hyperadrenergic POTS is a subtype of POTS in which the sympathetic nervous system is overactive, causing excess norepinephrine and a rise in blood pressure when standing, rather than the drop seen in other forms. It produces a distinct symptom pattern and requires different treatment considerations.---Hyperadrenergic POTS is defined by excess sympathetic (adrenergic) activity, leading to elevated norepinephrine levels and orthostatic hypertension. It represents about 10% of POTS cases according to Dysautonomia Information Network , though some newer estimates suggest a higher prevalence.Diagnostic hallmarks- Standing norepinephrine ≥ 600 pg/mL- Systolic BP rise ≥ 10 mmHg on standing (instead of dropping)- Tachycardia ≥ 30 bpm within 10 minutes upright (standard POTS criterion)- Symptoms present ≥ 6 months and orthostatic hypotension ruled out.
That directly contradicts the claim that POTS should occur in the absence of orthostatic hypotension. So now I'm really skeptical.
All the stuff I'm seeing suggests electrolytes and fluid intake etc. can impact this and those are all factors that influence blood pressure.
Magnesium deficiency is known to be involved with heart arrhythmias of various sorts, including long QT syndrome which can be fatal and causes fast, erratic heart beats.
Your GP (general practitioner -- plain old doctor, not a specialist) is probably not secretly Dr. Gregory House, super diagnostician. If you are diagnosed with POTS, please start a health journal and read up on magnesium deficiency and what medications can cause long QT syndrome and what medications promote magnesium deficiency.
In my experience, light and noise sensitivity are indicators of magnesium deficiency. Dark chocolate -- a source of magnesium -- helps mitigate it. I often get such symptoms following fever or vomiting.
Hyperadrenergic POTS makes POTS a potential issue for the trans community as it means hormonal stuff can be a factor. Adrenals are one of the hormone-producing organs and they play a significant role in my three step process.
Keep in mind that this blog being about "trans medical issues" is a kind of koan or thought experiment for helping me hit a high bar for my hormone sandbox health site. Also also keep in mind that my use of the word trans is shorthand for "any of a variety of currently under diagnosed, misunderstood hormonal syndromes which have yet to be meaningfully catalogued."
If you are seriously magnesium deficient, you very likely also need calcium, vitamin K and vitamin D. Please do not grab a generic multivitamin as they frequently have ingredients with poor bioavailability and ingredients which interfere with each other and should not be taken together.
The most common chemical form of calcium supplements is calcium carbonate. This is what sea shells are made of and we don't absorb it well. I took calcium citrate because I could find it. I don't recall the other bioavailable form.
Calcium and iron interfere with each other and should not be taken at the same time.
If you have any other conditions on top of POTS involving minerals, such as iron deficient anemia, you should read up on the interactions of these various minerals in the body and wonder how your two conditions are interacting.
Last but not least, I am aware that marijuana causes orthostatic hypotension because I did a research paper at age seventeen on functional hypoglycemia to try to understand why I was passing out and in my forties finally figured out a primary factor in that resolving was me moving out of my parental home where my brother secretly smoked marijuana behind closed doors unbeknownst to me. So I didn't simply do a fantastic job of eating better, I also stopped having orthostatic hypotension due to second hand marijuana exposure.
That story is told in more detail elsewhere.
If you have a serious medical situation, let me encourage you to be a bit of a paranoid fruitcake and consider the possibility that you may have factors impacting you that are currently making no one's radar and which it would be rude and meanie face of you to speculate about.
If your condition is seriously impairing and potentially life threatening, figure out how to be DIPLOMATICALLY rude and meanie face. Or, you know, politely die for the convenience of assholes around you. Whatevs.