ABSTRACT
Chapter 12 introduces the diagnosis of Postural Orthostatic Tachycardia Syndrome (POTS), in which patients upon rising from a seated position may develop a fast heart rate, palpitations, dizziness, syncope (passing out), shortness of breath, sweating, brain fog, anxiety, headaches, diarrhea, and even rage. POTS is believed to be a form of dysautonomia, in which the sympathetic nervous system is overactive. There are three overlapping types of POTS: hyperadrenergic, neuropathic, and hypovolemic, and their treatments are slightly different. Mast cell activation (MCA), also called mast cell dysfunction (MCD), refers to a dysfunction of a population of white blood cells that contain histamine granules. When these degranulate inappropriately, patients may develop hives, apparent food intolerances, abdominal, sinus, or joint pain, flushing sensations, anaphylaxis, and POTS. Treatment of MCA can help ameliorate POTS symptoms. Ehlers Danlos Syndrome (EDS) is a genetic connective tissue disease that can be associated with MCA and POTS. Chronic fatigue can be a disabling symptom that accompanies POTS. Individuals with a current or past history of eating disorders and high mind-body connection appear to be at risk for POTS and MCA/MCD.
