HyperPOTS

HyperPOTS is a type of POTS characterized by high adrenaline. This is the type of POTS that I have so I’m speaking from my experience.

Some adrenaline symptoms:

  • Tremors

  • Pupil dilation issues

  • Muscle rigidity (I assumed that it was muscle stiffness, but it is more than that. My muscles don’t give how they’re supposed to)

  • Inability to tolerate medication (because adrenaline interferes with medication)

  • Lack of hunger or thirst sensations

  • Food and water make me nauseous

  • Constantly being anxious

  • Racing thoughts

  • Not being able to sleep

 

Diagnosis

  • Tilt Test

    • I had adrenaline symptoms during the test. Being tilted gave me tremors

  • Catecholamine bloodwork

    • Not 100% accurate

  • Holter monitor

    • My heart rate spiked to 170 while waking up a single flight of stairs. With that I also had heart arrhythmias. That high of a spike + arrhythmias is indicative of adrenaline

Treatment

  • Beta blockers are usually the first medication to try for this

  • Calcium channel blockers

  • Atarax is a good option if you can’t handle beta blockers. However, it may make heart arrhythmia’s worse. If this is something you/your doctor is considering, you should wear a holtor monitor and verify that it is safe for you.

HyperPOTS Study

Clinical presentation and management of patients with hyperadrenergic postural orthostatic tachycardia syndrome

My experience

Many neurologists don’t know that this exists or that it requires to be treated differently than the other types of POTS.

HyperPOTS can’t be treated only with normal POTS treatments. If you don’t control the adrenaline, your POTS won’t improve. I was treated only for POTS for over a year while I continued to get worse.