POTS or “postural orthostatic tachycardia syndrome” is a poorly recognized condition we’ve been hearing more about recently.
Before COVID, this debilitating condition was not widely talked about. But during the pandemic, we’ve been learning about the strong similarities with long COVID.
In fact, our recent research shows more than three-quarters of people with long COVID we studied had POTS.
What triggers it?
Multiple studies, including our own, have shown viral infection is the most common trigger for POTS.
Then came the pandemic, with almost 800 million people infected so far with SARS-CoV-2, the virus that causes COVID. The World Health Organization says 10%–20% of people infected with COVID are likely to develop long COVID—when unexplained symptoms persist three months or more after the infection.
Now, more research is showing how long COVID resembles POTS. Many people with long COVID show similar symptoms.
What we and others have found
Our recent study found nearly 80% of people with long COVID had POTS. In people who had both and were of similar age, symptoms were indistinguishable from those who got POTS from other causes.
The people in our study either attended a specialist cardiology clinic for people with POTS or long COVID, or came via a long COVID support group on social media. So we cannot generalize our results to people managing their long COVID at home or with their GP.
Earlier this year, a review said about 30% of people with people with “highly symptomatic” long COVID also had POTS. Most (73%) met criteria for POTS and other types of dysfunction of the autonomic nervous system.
Taken together, we can conclude that many, but not all, cases of long COVID can be explained by POTS—a condition we’ve known about for years and know how to manage.
What happens if you have POTS?
We suspect some cases of POTS result from a hyper-vigilant immune response to an invading pathogen, such as a virus. This, or another trigger, affects the autonomic nervous system.
This part of the nervous system balances a vast array of functions including maintaining blood flow to vital organs, digestion, temperature control, sweating and even sexual function.
Even if the autonomic nervous system is marginally disturbed, it leads to the physiological equivalent of anarchy.
The simplest of daily tasks—such as washing your hair in the shower—can result in profound symptoms of dizziness, a racing heart, breathlessness, brain fog and general exhaustion.
In other research published earlier this year, we found people with POTS have a poor quality of life—poorer than people with chronic illnesses such as HIV, cancer, or cardiovascular and kidney disease.
A long path to diagnosis
Many patients are also forced to negotiate a diagnostic odyssey littered with tales of disbelief and dismissal by medical professionals, friends and family. Diagnosis can take years.
In our submission to the parliamentary inquiry into long COVID, we shared the experiences of people with POTS symptoms and their frustration at the lack of recognition by the medical profession. One health worker said, “I am a nurse myself and specifically brought up that I believed I had POTS after COVID infection. I was treated like a hypochondriac and told I had anxiety, which was absolutely ludicrous as I had physical symptoms […] I had many presentations to [the emergency department] with no help or diagnosis whatsoever.”
We can do better
Prompt diagnosis is vital in the face of what we suspect are rising numbers of newly diagnosed cases associated with long COVID.
Although many people with POTS report they were referred to multiple specialists before they were diagnosed, this is not always necessary.
GPs can ask you to do a ten-minute standing test to help diagnose it. They can also exclude other common causes of POTS symptoms, such as lung and heart conditions.
There is no known cure for POTS. However, once diagnosed, there are multiple things that can improve and manage the condition. A questionnaire your GP can give you can help prioritize which symptoms to manage. You then work with your trusted GP to manage these.
Increasing fluid and salt intake (under the supervision of your GP), and using full-length compression tights is recommended. These help control heart rate and blood pressure, and reduce dizziness.
Avoiding triggers is important. These include avoiding standing still for extended periods, hot showers, large meals high in carbohydrates, and hot environments.
Many people also benefit from medicines to help control their blood pressure and heart rate.
How about referral?
If referral to specialist services are required, this can be complex and expensive. There are no specialized clinics for POTS in public hospitals. Instead, POTS is mainly managed in the private sector.
Referral options can be overwhelming. People may benefit from referral to a range of health professionals to manage their symptoms, including a physiotherapist, psychologist, occupational therapist or exercise physiologist—ideally ones familiar with POTS.
All these barriers means access to diagnosis and treatment largely depends on someone having sufficient money, or being confident enough to navigate the health system.
News
A Surprising Brain Signal Could Explain Why Eating Less Protein Extends Lifespan
A new paper suggests that limiting protein intake triggers a coordinated response throughout the body that may help explain how protein restriction affects healthy aging. Animals respond to protein restriction, or reduced protein in [...]
Back and shoulder surgery is often worse than useless
Millions of operations should be scrapped SIX IN TEN Britons have surgery at some point. So do lots of Americans, at a cost of perhaps $500bn a year, a third of all spending on [...]
Cocaine plays with mind, hijacks brain circuit, drives increasingly rigid and repetitive behavior
Researchers have found that cocaine hijacks brain circuit, which to drive increasingly rigid and repetitive behavior. The brain circuit that normally participates in selecting natural mouth and face movements, but which becomes disproportionately engaged [...]
Injectable nanodevices could provide effective treatment for drug-resistant glioblastoma
The brain cancer glioblastoma is one of the most aggressive and treatment-resistant cancers known to medicine, carrying a median survival of just 12-15 months, even with the best available care. Now, researchers at the [...]
New Treatment Cuts “Bad” Cholesterol in Half for a Full Year
A single infusion of an experimental CRISPR-Cas9 therapy was reported to safely lower LDL cholesterol by 52.5% and triglycerides by 47.8%, as measured 12 months after treatment. What if one infusion could keep cholesterol [...]
Too Much RNA Can Drain a Cell’s Energy, Scientists Discover
A virus may cripple a cell’s power supply simply by producing too much of a molecule the cell needs to survive. New research from the Texas A&M College of Veterinary Medicine and Biomedical Sciences [...]
West African scientists warn of weakening health systems and urge stronger outbreak detection
LOME, Togo (AP) — West African laboratory scientists called on governments Friday to strengthen capacity to detect disease outbreaks to avoid another major outbreak, saying health systems across the region are becoming weaker. Participants [...]
A Little-Known Protein Could Point to a New Way To Treat Alzheimer’s
A study suggests that increasing SORLA protein levels could help treat Alzheimer’s disease and other disorders involving tau protein. Increasing SORLA, a protein with a protective role in the brain, helped mice withstand damage [...]
Cancer’s Hidden Antioxidant Shield Helps It Escape the Immune System
Blocking an antioxidant protein that tumors use to suppress immune attacks improved cancer immunotherapy responses in mice. Cancer cells can release antioxidants that interfere with the immune cells trying to kill them. Researchers have [...]
Scientists Find a Berry Compound That Helps Muscle Cells Burn Fat
Pterostilbene, a compound found naturally in some foods, affects how skeletal muscles process fats by stabilizing a protein called PPARδ and increasing its signaling activity. Pterostilbene, a natural compound found in blueberries, grapes, and [...]
Two Hidden Forces Help Build the Human Brain Before Birth
Scientists have uncovered two surprising forces that help guide how the human brain forms before birth. Before birth, the human brain is shaped in large part by an unusual class of stem cells known [...]
Researchers Uncover a Hidden Trigger Behind Chronic Inflammation
The findings offer new insights that could help guide the development of future therapies. A protein called human resistin may help flip on one of the immune system’s most powerful inflammatory switches. Researchers at [...]
Scientists Have Uncovered Previously Hidden Microbial Activity on Human Skin
The most abundant microbes on your skin may not be the ones doing most of the work. Human skin supports vast communities of bacteria, fungi, and viruses that can influence its protective barrier, immune [...]
Brazilian Tree Compounds Fight COVID-19 on Multiple Fronts
Scientists found compounds in a Brazilian tree that hit SARS-CoV-2 on multiple fronts, revealing a promising new lead in the search for COVID-19 treatments. Researchers have found that galloylquinic acids extracted from the leaves [...]
Cutting Two Amino Acids Slowed Prostate Cancer in Mice
A newly identified link between amino acid metabolism and cholesterol production may help prostate tumors adapt to hormone therapy. Prostate cancer can find ways around treatments designed to deprive tumors of the hormones they [...]
Largest-Ever Physics Survey Raises New Doubts About Our Model of the Universe
Physicists around the world remain deeply divided on key mysteries of the universe, from dark matter to quantum gravity. The standard cosmological model failed to gain majority support, and no leading theory dominated the [...]
