Review nature reviews cardiology: Cardiovascular autonomic dysfunction in post-COVID-19 syndrome: a major health care burden, Fedorowski et al, 2024

Somehow, though, we are still stuck at the "my clinical experience says so" stage, because there really is no reliable evidence that it helps with POTS, same as with ME, and that all improvements, subjective and indirect at best, are not simply down to time / natural recovery, may even happen despite the rehabilitation delaying it in some.

For years we had the mantra of "the RCTs say so, it's not just our opinion", and now we are right back to just them stating their opinion that they see it happening in private, even though no reliable research can actually back up those claims. And here Fedorovosky basically says that future RCTs will prove it right, which we've literally been hearing for decades, and the trials, not even proper RCTs, will be exactly the same old formula anyway.

This is fundamentally a problem of understanding what science is even about, what type of evidence is reliable, and the danger of relying on biased opinions about things happening behind closed doors that cannot ever be demonstrated in a rigorous process.

 

For those wanting to learn more about Fedorowski's views, here's a podcast episode from March 2023 where he talks about his research on POTS and more. Transcript available too.

E127: New Clues in Plasma Proteins in POTS Patients with Dr. Artur Fedorowski
https://the-potscast.castos.com/epi...ins-in-pots-patients-with-dr-artur-fedorowski