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Do I Have Postural Orthostatic Hypotension Syndrome(POTS)?

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What is Postural Orthostatic Hypotension Syndrome(POTS)?

Postural orthostatic hypotension syndrome, also known as POTs, is a disorder where the heart rate increases significantly in patients when they assume the upright position within a ten minute period of time and can cause a constellation of symptoms. The symptoms are part of a spectrum of orthostatic intolerance (OI).

Symptoms of POTS

Before understanding exactly what POTs is, one needs to understand the symptoms of orthostatic intolerance. Orthostatic intolerance is the development of symptoms which occurs when an individual stands upright from a lying or sitting position. These symptoms are relieved when the patient reclines. When orthostatic intolerance can occur in an acute setting when patients are dehydrated or have taken medications that can lower blood pressures when they stand up, these are termed secondary orthostatic intolerance. Primary orthostatic intolerance occurs in the absence of dehydration or medications causing the abrupt symptoms that occur when an individual assumes the upright position.

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What is Joint Hypermobility Spectrum Disorder?

Joint Hypermobility Syndrome or Joint Hypermobility Spectrum Disorder

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The joint hypermobility syndrome, also abbreviated JHS and the hypermobility spectrum disorder, also known as HSD are new terminology often used to describe the most common hereditary disorder of connective tissue diseases.  Connective tissue diseases include joint hypermobility syndrome, or the hypermobility spectrum disorder, Ehlers-Danlos syndrome, Marfan syndrome, osteogenesis imperfecta, Stickler syndrome.  Connective tissue disease disorders do not generally include lupus, rheumatoid arthritis, Sjogren’s disease, scleroderma, mixed connective tissue disease, vasculitis and other related rheumatologic diseases, although these diseases can give pain throughout the body and joints and muscles. They are usually not associated with connective tissue disorders unless there are two separate disease entities existing.

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What is Hypermobile Ehlers-Danlos Syndrome?

Ehlers-Danlos Syndrome Hypermobility Type III

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Do I have Ehlers-Danlos Syndrome or EDS, or am I just simply hypermobile and have diffuse pain all over? I hurt all over.  These are questions that I am often asked from patients that present to our office practice.

There are several types of Ehlers-Danlos Syndrome.  We will discuss the various types subsequently.  However, the most common type that we see in clinical practice is the type known as Type III.  This is also known as the hypermobile type of Ehlers-Danlos Syndrome (hEDS).  It has also been referred as benign joint hypermobility, or joint hypermobility syndrome (JHS).

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Myalgic Encephalomyelitis (ME) / Chronic Fatigue Syndrome (CFS)

Chronic fatigue syndrome (CFS) is also called myalgic encephalomyelitis (ME).  It is a challenge to physicians both to diagnosis and treat.  It is believed the prevalence is approximately 1% in the general population.

The cause of ME/CFS is unknown.  Its mechanism of causing disease is also unknown.  It is actually an independent unique disease.  No two patients have the same type of symptoms and the associated circumstances vary among individuals.  In addition, there was no consistent diagnostic criteria.  Over the last 30 years, diagnostic criteria have continuously changed.  This is because, as mentioned, there are no unique features of the disease that make for a set pattern.

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The Six-Prong Lifestyle

We have recently developed a six-prong lifestyle and supplement approach for treatment of autonomic dysfunction. This includes patients with chronic fatigue, chronic muscle aches, sweating disorders, significant dizziness on standing up, brain fog, and many orthostatic intolerance symptoms. The six-prong approach incorporates principals of biochemistries and theories of biological feasibility. It is partly based on valuable information through medical literature, including many significant studies. The program basically promotes wellness and is not used to diagnose or treat specific diseases. We do not use a combination of commonly used pharmacologic agents such as statins and cholesterol-lowering agents, or antihypertensive prescription agents in this program, but that is left to the discretion of the treating physicians. Various nutraceuticals including vitamins, minerals and potent antioxidants are used. The antioxidants that we use are alpha lipoic acid, coenzyme Q10 and L-carnitine. We also use a nitric oxide-boosting supplemental approach with beet root extract, which operates through nitric oxide and amino acid precursors L-arginine and L-citrulline, which we also use. The concentrations that we have used we have found empirically to cause less side-effects and still give feelings of well-being and efficacy to our patients. Again, we emphasize that we do not use these supplements to diagnose or treat disease.

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