REview: Postural orthostatic tachycardia syndrome (POTS): a common but unfamiliar syndrome, 2019, van der Zalm

http://www.njmonline.nl/getpdf.php?id=2071

 

It's weird how something that explains so much past mystery is met with a shrug of indifference. People inexplicably fainting has long been a fascination and subject of much psychologisation and speculation. Well, there it is, a lot of it may be explained by this pathology or something close to it. It's a centuries-long mystery that could finally get a proper explanation and treatment. The very stuff of scientific breakthrough, overturning long-held myths.

And yet:


Relying on the interest of medical professionals as a guide, rather than the needs of patients, is a seriously broken system. Doesn't matter that millions of people would benefit from it, until enough medical professionals decide to make it an area of personal interest, nothing happens. No wonder it takes generational replacement to move forward. Just bizarre.

 

This would appear to be a form of BPS approach to POTS (including the biomedical bit). Although, it still seems as if the underlying cause was seen as largely psychological/deconditioning. A sibling and her father had this as well. We don't know if their POTS had resolved. Genetics were examined, and discounted, but do we know all there is to know about genetics for POTS? I'm doubtful.

Can hypovolemia be caused by deconditioning?

 

Yep.

 

Hypovolemia is also detected in ME/CFS patients, so this would imply that deconditioning is partly responsible for ME/CFS symptoms. I have seen no evidence that deconditioned people develop hypovolemia or POTS. Some people with ME/CFS who are bedbound don't have POTS, whereas others do.

 

That doesn't necessarily follow.

Hypovolemia doesn't ONLY come from deconditioning.

Also, that deconditioning does lead to hypovolemia is pretty well-established.