A 'Pill in the Pocket' for POTS patients
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- Опубликовано: 10 июл 2024
- One of the subjects I have become very interested in POTS. For those who don’t know POTS, it stands for postural orthostatic tachycardia syndrome and is characterised by an excessive increase in heart rate when the patient is upright and this can be extremely unsettling. The heart races, the patients feels tremulous and can feel very dizzy. In addition, patients with POTS have many other symptoms which are not postural. These include always feeling tired, never waking up feeling refreshed, very unpredictable and prolonged brain fog, gut issues such as swallowing difficulties, bloating, and constipation or diarrhoea and temperature issues such as feeling excessively cold at time and excessively hot at other times. Such patients often also have joint hypermobility, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome and migraines. Treatment is difficult but usually involves increasing blood volume by increasing fluid intake and salt intake. One of the biggest problems for POTS patients is that the symptoms can be unpredictable and this means that patients struggle to look forward to anything because they don’t know how they will feel on a specific day and this can sometimes lead them to avoid important events and this can lead to worsening social isolation which then makes everything worse.
Today I wanted to discuss an interesting medication that can be used as a ‘pill in the pocket’ in those situations where the patient may be worried that their symptoms may flare up.
The medication is called Desmopressin or sometimes also called DDAVP. It is used as tablet although you can also use it as a nasal spray (Desmospray). DDAVP is a synthetic version of arginine vasopression which is a natural anti-diuretic which means that it helps retain more water in the body by reducing the amount of water that is passed out in the urine.
In an interesting study published in Heart rhythm journal in 2012, Samuel Coffin et al found that when they gave 30 patients a 0.2 mg tablet of DDAVP and compared to placebo, there was a significant reduction in the heart rate on standing within 1 hour of taking the medication and this effect persisted for 4 hours. In addition, patiens felt better, complained of less symptoms of racing heart beat and less visual disturbance and tremulousness.
Subsequently there was a retrospective study which also showed that about half of the patients who were able to tolerate this medication noted improvement in their standing heart rates and symptoms at one year
There are a few things woth knowing about this medication. Because it retains fluid and because patients with POTS are told to drink a lot anyway, the extra water can cause a drop in sodium levels in the body and this can be dangerous. Secondly the fluid retention can cause oedema or sometimes headaches. Because of this risk of the sodium levels falling low, doctors who treat POTS generally recommend a close watch on blood levels and also recommend that rather than this medication be taken daily, it should be used as a pill in the pocket.
I think as a pill in the pocket, it may offer a lot of hope to patients with POTS as this may allow them to get some quality of life back.
What an amazing explanation of POTS but told with such empathy, compassion and understanding for the people who have it.
Your patients are so very blessed to have you as their Dr. If only we can figure out a way to clone you so you can be in the US as well. God Bless you Dr. Gupta. Thank you for all that you do & how much you care.
What a blessing to have a doctor not only understand POTS, but share expertise and guidance to the world out of kindness. Many blessings!
Man..I wished I had known about this the instant I got diagnosed with POTS three years ago. Since my diagnosis, I missed my sister's college graduation, countless family weddings, funerals, holiday dinners, birthday parties...I've often said that the single worst thing about POTS is that it has robbed me of time. Time with family that I can never get back. Thank you so much for sharing this. I plan to broach the topic at my next cardiologist visit.
Doc holy sh*t I am one of those patients who was diagnosed with CFS/ME and it was found that I have POTS. Thank you so much for this video, I am literally in tears listening to you explain the symptoms and I'm like YES YES YES YES YES!!!!!!!!!!!!!
I'm terribly cynical that any pharmaceutical intervention will offer more positives than negatives, but I'll look into it and greatly appreciate the tip. Regardless, it is so refreshing and validating to hear a physician that doesn't suffer from POTS accurately describe it.
I don't have POTS but have been diagnosed with Dysautonomia. I have MVP, and have suffered with the symptoms most of my life. It caused heart palpation, shortness of breath, digestive problems, along with anxiety. I finally found that it was brought on by a sensitivity to free glutamate in foods. Once I cut all foods containing free glutamate out of my diet the symptoms went a way. Problem is that almost every processed food today has some form of free glutamate in it. Also most all foods prepared in restaurants also contain free glutamate. Makes travel, and socialized eating very difficult, or impossible. I have to stick to a whole foods plant based vegan diet. If I do ingest free glutamate, and am having symptoms I have found drinking lots of water, and taking electrolytes helps elevate the symptoms sooner. I have always wondered if those who suffer from POTS are actually just sensitive to free glutamate in foods as I am. Free glutamate is considered an excitotoxin that can effect the autonomic nervous system, as I understand it. Have there been any research studies done in this area?
Thank you so much for sharing!!! I've been in this same track just recently then I read this...I think you're right. Thank you again. God bless you.
Thank you
How do you cut glutamine out of your diet?
@@GeorgeKush24 I cut foods out of my diet high in glutamate. Over time and study I have learned that low GABA levels are a result of deficient magnesium. Raising my magnesium has allowed me to tolerate glutamate again as magnesium assists and is required for glutamate to be converted to GABA. I suggest you study or find a medical professional to look further into this subject.
@@GeorgeKush24glutamate or MSG, vetsin. Not glutamine
You are the first video I watched ,while searching for information on pots. You need to teach classes for physicians world wide, to help them learn about,and treat people with this horrible debilitating disorder. I have been living with pots for many years until diagnosed in 2022 when I had to leave my job due to my symptoms. You are very compassionate and kind, and for that I thank you.
I have a patient in my clinic that has been dealing with POTS most of her adult life. She is in her late 20s. I inherited her as a patient when I started intern year earlier this last summer. I will definitely be sharing this information with her at our next appointment. Thank you!
Thank you for advocating for us. Blessings
Just FYI. My son who has POTS hasn't tried this medicine but he is on Daily IV Saline which helps him more than any of the meds he has tried. (like Midodrine and fludrocortisone)
I want to thank you so much as my son has suffered for years. A very debilitating and awful condition.It is not known very much like you have said Dr. Sanjay. It has been very daunting to watch for so long my son being so tired.He at one time had a heart monitor put in . Then taken out and at one time drank so much water he had to have to go to hospital.I cannot tell you how awful he has endured this . Recently has improved but always tired, a severe tiredness.He is six foot tall and has had problems sitting up. Doctors do not always understand . My respect for you is ten fold.You are helping so much as you explain in a easy way. Thank you so very much. Wishing you the very best.
Thank you for everything you do for all of us around the world. May God always bless you and your family. I wish there were more doctors like you here in America.
Love Dr G. He is incredibly bright.
DDAVP/ ADH is a posterior pituitary hormone wjich acts at 2 main sites, the kidney and the splanchnic bed, which gives a clue to the pathophysiology of POTS
Omg can you please be my PoTS doctor?!? You hit it all! Never had a doctor who understood as well as you do!
Your Patients are lucky to have you as their physician, who understands in the true sense
My 18 yo daughter has recently been diagnosed with POTS. It’s a horribly debilitating disorder and breaks my heart seeing her suffer with this every day. I will ask her doctor about this medication at her next visit. It could help when she has a special occasion to go to. Thank you for all of your videos and information about PoTS, it helps me understand the condition so much! ❤️
Ask your dr for metoprolol
Simply amazing man. A massive thank you for your expertise
Yes! I have been isolated for three and a half years and still have not gotten diagnosed but this perfectly describes what I’ve been through. It would be so great to have something that could help so I didn’t feel like I can’t participate in life anymore
Watching your videos is great. I was diagnosed with POTS early this year. I am still trying to understand my condition and triggers. Your videos are very helpful. I live in Switzerland and would like to get a cardiologist who actually undertsands pots( not the kitchen ones with pans 😅) Thank you for your videos that make me undertsand my condition and also help my family and friends understand me better. 🙏🏽
My neck has bent. My shoulder hurt so bad.You are right on the water. And weight loss. I'm doing much better. Thanks Doctor. Mama Long
Thank you Dr I've so far listened to only 2 of your videos and have learnt more from you on my condition and how to help it than any medical proffessional since my diagnosis 5 yrs ago so Thank you for being here and sharing your expertise on RUclips in the past I've waited over 10 months for a ten min appointment that's told me nothing other than the lack of understanding of thus condition so I am very grateful to have come across this on you tube 🙏❤️
IV saline worked well for me but wore off too fast. Due to dysphagia, I just got a feeding tube. The continuous influx of formula--which has nutrition, minerals, and fluid--has made my POTS the best it's been in years! I went from mostly bed bound to barely even noticing it now. This is such an awesome side effect of tube feeding that only took a few days. I think the improvement has everything to do with increased fluid/fluid retention. So this pill, if the side effects are tolerable, seems like it makes sense for an episodic boost.
Your the best!!!! Keep helping millions of people ❤
Thank you. I've had POTS for 8+years. Have known about DDAVP for decades but this is the first time I've heard of it for treating POTS.
Thank you for this video. I was diagnosed with POTS 6 months ago....midodrine has helped significantly. Anyway you are such a blessing to me, I turn to your videos always to help myself through some tough things. So thank you so so much!
I am recently diagnosed with POTS, Listening to your POTS update made me hopeful, Keep updating. Thank you
I noticed when I stopped eating gluten and grains my symptoms got so much better. As soon as I eat gluten I will stand up and feel those symptoms again. Hope this helps someone.
How long before you seen a difference?
Yes, I noticed the exact same. I eliminated gluten and coffee. Reduced the carbs and ate smaller portion. vagus nerve stimulation a life saver as well.
@@egyptiankitchen2655 when it was out of my system I started feeling better
Same. It didn’t make my symptoms go away entirely but I would have periods of being almost bed bound for days to weeks before I stopped eating gluten. I do have celiac disease, confirmed by multiple doctors and tests so that is why. The autoimmune response would overwhelm my body and by proxy cause my pots to flare up badly. If you don’t have any underlying gluten intolerance or sensitivity I’m not sure how beneficial cutting out gluten would be for you. But sugar and refined carbohydrates in general are shown to cause pots symptom flares for whatever reason
Thank you, Dr. Gupta!
Thank you Doctor. You just made my day. I am going to see my cardiologist next month and I will definitely talk to him about this medication. You gave me hope with this information. Thank you so very much.
I so wish you could be my doctor, compassionate, caring, empathetic and gentle.
I have Lyme induced POTS and it’s incredibly difficult to find a practitioner that knows what they’re doing.
Thank you for your videos, I’ve learned more from them (for free I might add) than all my specialists combined.
How do you treat your condition ?
Professor Jack Lambert Dublin
Thank you for the video. It has been added to the list of informational videos I save in order to educate those around me about my condition.
You are an amazing cardiologist. Thank you for this because you understand the condition perfectly
I add this comment under many POTS videos' as I found few things that worked for me and reversed(not cured yet) the progress of my POTS , so I hope they can do it for you too..
I am a guy with POTS, a rare bird I know and it took a while to get diagnosed, but once I was the most help I was given was a handful of medication. Before my diagnose I was, as most of you, mistaken for having anxiety. A busy doctor prescribed me Xanax and let me go. That thing works, but it comes at a HUGE price so I took it twice and did not anymore. Since the other pills did help some, but not enough, I went on and did a internet research on substances like Xanax, benzos in general, and why the positive effect on POTS. It turns out the answer is simple - neurotransmitters. We lack some, our immune system is causing problems with some attacking specific receptors like ACH2 one. Knowing this then I went and did a research on what non addictive, no side effect substance can do similar thing as the benzos as they were not an option and for my surprise found one. Found a German study on special Lavender extract, did try it and it did miracles for me! In US it is sold as CalmAid lavender. I take one in the morning and sometimes one before bed. Recently I am not taking it on regular basis anymore as I don't need it much. No side effects, no withdrawal symptoms, only lavender burps. Usually taking it on empty stomach, Gave me my life back and allowed me to start exercising. On exercising - very important for POTS, and almost impossible for us! But there is a work around for that too - start swimming! When in water you don't get the orthostatic effects from gravity. Actually standing in upright in water will increase the blood volume your hearth can work with and will make exercising easy. Exercising will on its turn increase you blood volume and hearth strength, that will make standing easy. It does not happen overnight, but in few weeks you will feel the benefits.
I hope all of you find this helpful.
Thanks for this
Oh god, this is great info--thank you so much for sharing it!
Thank you so much! Where do you get the Lavender from?
Can you share where you purchase and your story link if available? Thank you😊
Yay someone is listening! Love it. Please comment next of you can on mTBI, similar hormone related (?) crushing fatigue, brain fog and heart palpitations out of the blue. Love that there are Drs looking at less understood conditions. Remain curious. Thank you for your work.
I am still trying to find a doctor that understands this condition or even believes it exists and can treat it.
Look online for a support group. They can recommend drs, but I also am having a problem getting a dr who is not already overwhelmed with patients.
Very. Helpful. Thank you. You are an angel. 😇
Selfless service of Dr.gupta even your face is enough for relaxation of a patient....
This man is a genius!
New to you...love that your educating us. Thank you
I've recently been diagnosed with Sinus Tachycardia Syndrome, my doctor prescribed me Inderal...exactly as a pill in the pocket...because we all need to have some quality of living. Thanks for the amazing information.
The problem with inderal is that it lowers blood pressure. This med does the opposite.
@@andreawisner7358 I'm confused, please forgive me...inderal does or doesn't lower blood pressure or is there another medication you were thinking of? Thanks for answering my comment.
I was diagnosed with pots After an ablation. I'm 66 years old. I went off of gluten, sugar. My symptoms were severe but Doxocicline and Colchicine really helps me a ton with horrible symptoms. I was scared to go anywhere. I'm fine if I stay on these two drugs.
My Cardiologist said wouldn't that be a Miracle if we found a cure for Pots. Something to check out with your Dr. It sure can't hurt. Lord bless
😂😂😂😂 one is antibiotics and other is gout medicine , no logic behind ur pots curr
Thank you so much with your heartfelt explanation. 🙏🏻
Always clear, concise & informative 👍🏼🙏🏼 You are ã Godsend sir . Blessings to you .
i am on clonazepam and experiencing POTS symptoms
Thank you Dr.
I love watching your videos
You are so knowledgeable
Thank you! 14 yr old son just diagnosed with POTS
Your videos are so helpful.
Your just so awesome! Wish you were my cardiologist.
Thank you Dr. Gupta very helpful.
I'm so excited to ask about DDVAP, Dr. Gupta! I have my daughter's baby shower coming up and I'm so stressed out, worrying how I will handle the heat and a 2 hour drive. This would be amazing if it works for me! ♥️ Your understanding of POTS is just so rare and your patients are very, very lucky.
Thank you thank you doctor
Wow THANK YOU for this really important information. My daughter suffers from POTS and this info is so important. I will be talking to her doctor about this treatment. Thanks
Thank you Doctor 💞
You're great!
Dr. G,
I first want to start by thanking you for sharing your wealth of knowledge to all of us struggling with a heart condition, and those with loved ones with a condition. I am 22 years old and 4 days ago went into SVT on and off for 4 hours. I ended up in the ER, and after thinking I wasn’t going to make it, I was discharged with 12.5 mg of metoprolol. I am having a lot of dizziness and overall anxiety about this new journey in my life. Since I am so young, I don’t want to live the rest of my life on BB, so I am opting for an ablation. Could you please make a video about your knowledge of SVT, it’s prognosis for young people, and the success rates after an ablation. Thank you in advance.
Thanks Doctor God bless u I have pots with Brady cardio episodes I try to eat chocolate when it happens sometimes it help sometimes it doesn’t I’ve been on midodrine sense 2012 thanks for all ur videos and help may God give u a special blessing
I wish I had a doctor like you.
So interesting to listen to you (again as always). I have POTS & connective tissue probs. I have found the only way to live is to pace myself & eat a mainly raw vegan diet, not my choice but as soon as I have a lot of cooked processed food my systems worsen. My GP is no help at all. Thanks so very much for your time.
I would think raw vegetables would be much worse for your stomach as POTS and hEDS or HSD can cause Gastroparesis and other digestive difficulty. Cooking usually breaks down the fiber a little to make it easier to digest. My own specialists have me on a high sodium low fiber diet myself. And I should think raw would literally murder me. Are you sure it’s cooking the food that makes you feel unwell? Perhaps it’s a certain type of oil? Or seasoning? Food intolerances can really set off and exacerbate POTS symptoms. I would really consider finding a dietician if your GP is no help. Bc clearly something in your previous diet was indeed causing POTS flares, but working with a dietician could help you find what exactly was doing it so that you can eat more food again.
Im sorry but although youtubers often tout raw vegan diets as the cure all and the best diet ever, it is rarely medically advised, ESPECIALLY for people with digestive issues. I am vegan as well and even with cooking all my food, I was still told my my cardiologist and dietician that I was consuming too much fiber for someone with pots and heds. With connective tissue disorders especially raw vegan could actually be quite dangerous for you I really would not be doing that especially when no professional with medical or nutritional knowledge has advised you to do so. Seek out a professional who is not your GP, please, before you end up with blockages or on a feeding tube
Verrrrry helpful .. thank you dr u always helping me with ur explanation and ur advices .. I hope to meet u one day
Thank you ❤
We discovered in the year 2114 that POTS is just a vitamin B1 (thiamine) deficiency. You can't patent a vitamin though ;)
Maybe for some people. Definitely try taking it if you are low.
I got pots due to Covid, living with this disease is just miserable. You sometimes suffer from a different symptom and sometimes you suffer from other different symptoms. I usually joint pain in elbow (left hand), i feel out of breath all time like i am not getting enough air in the lungs, sometimes i feel jaw pain that comes for 1sec and goes away (that worries me worse) , i sometime feel pain in armpits etc. I know that these symptoms are caused by POTS but i usually think that i am going to get a heart attack or something. I once thought that I had chronic Kidney failure just because i was anxious about things. My parents usually ignore me because they know it's nothing (they are also doctors) but i know that's something is weird happening in my body. Everyday i am fighting like i am in a war. Hope we all will recover from this.
I just want you to know that I hear you & empathize with you...I was also diagnosed with POTS this year and already have other heart issues that add to my condition and it's absolutely scary & exhausting & miserable & I sometimes wonder how I'm able to make it another day. Keep your head up, take care of the aspects of your health that you CAN control, and find ways to stay positive. I have bad days too...and I keep pushing. If there's a will, there's a way! I choose to overcome this, and I will. We all will. Hang in there!
I was eyed with suspicion by my GP's for nearly 50 years before I finally got a referral to a cardiologist who diagnosed me with POTS. Very few GP's know much about it. Even your parents by the sound of it.
Great video!
Metoprolol has been awesome for the tachycardia parts of pots
Beta blockers cleared mine up I was going from 76 to 176 upon standing and it would stay there until I passed out or later down. Now I go from 76 to 96 then back down to 85 or so. Only occasionally I’ll have an episode that is short lived and it usually happens at the end of a 12 hour pill cycle.
What beta blocker do you take and dose? Also does it affect it your blood pressure at all?
@@hayd9785 Saw your comment & thought I would quick share. I was diagnosed with POTS this year, along with SVT...and I already have an Arrhythmia Tachycardia that I have been living with for over 10 years...I am now on a Beta Blocker to help with my POTS. It works to lower my heart rate & the fluctuation of my blood pressure (ultimately keeps it from getting high). It's called Metoprolol. I hope this helps you!
You are amazing on how well you explain all of this thank you 🙏 so much ❤my 21 year old son has pots after having covid three months ago 😢today is his 21 birthday 🎂 I had a party for him over The Weeknd but he couldn’t even dance or enjoy his party 😢😢😢
Thanks so much for the info! I’m stuck at home with POTS and DDD. I’m going to talk to my rheumy about this med to see if I can try it. It would be wonderful to get out of the house for more than just doc appts. 👏🏻💯👍🏻
Me too
What's DDD?
May god bless for the yeoman service
ddavp helped me retain fluids for many years, which really helped. Once I started corlanor, I no longer needed ddavp, and the corlanor also lowered my heart rate without dropping my blood pressure. Add carbidopa to that and things are vastly improved for me. No more nausea and less dizziness and sweating.
I have the hEDS, POTS, MCAS trio. Probably NET POTS or hyper POTS.
Hi....I am also facing these issues....can u please help me to know more about corlanor
How is this medication different from Fludrocortisone?
Thank you Mr Gupta 👏🏻👏🏻👏🏻
I have POTS from hypermobile type Ehlers Danlos syndrome, and take Catapres (Clonidine) to increase blood volume and to prevent the sympathetic nervous system issues that are common in EDS patients. It's been a miracle for me.
I thought Clonidine lowered your blood pressure? I have the same condition. Any suggestions! Thanks
@@elainemcadams5645 Higher doses of Clonidine will lower blood pressure. Doctors use lower doses of Clonidine to treat POTS, dysautonomia, and other conditions without affecting blood pressure.
Hello Dr. York!
I really enjoyed this video and this looks like a very promising treatment.
I wanted to ask if you could do a video about constant vertigo/head pressure in POTS patients.
My POTS symptoms are actually not the worse symptoms, the worse one are from the constant feeling of vertigo and the head pressure, pins and needles on the head. I was wondering if you know anything about it, I've found no medication for that yet & it's desperating.
I wish you could come to Texas and educate these ignorant fools that call themselves doctors here. I'm seeing a GI who knows zilch about EDS, but swears it has no GI manifestations🤦♀️. Now he's wanting to test me for angioedema and treat me with an antibiotic for a bacteria he doesn't think I have. I'm not doing either. My cardiologist agrees that I need IV therapy multiple times a week, but has no clue as to who to refer me to. I lost my rheumatologist when he decided to take on another fellowship somewhere else. And my poor gp is learning along the way.
I see there's a dysautonomia center of excellence at University of Texas ( search UT dysautonomia)and also you can check dysautonomia international website for physicians in your area. It's very hard and I am in a decent size city known for it's medical centers and our care has been horrible. Finally found someone on the website and it was like a miracle. He knew what tests to perform and what medicines to offer...Best wishes. He is a Neurologist by the way, trained in POTS protocol from Mayo clinic. Because it is an autonomic disorder....but not every neurologist is trained. We had many cardiologisits blow us off, like drink water, bye. Ugh
Hi Dr. Gupta, can you make a video about adrenaline? And adrenal surges?
Adrenals. Yes please.
They. Get. Swallowing. Difficulties. :O Your videos about POTS (recent realization that's what I have, and working through all the changes with my doc) has explained so many odd little things that have annoyed me over the years.Some I have recently discovered were associated with POTS, but I had the second half of my thyroid removed last year because my swallowing difficulties weren't completely resolved when the first half (which definitely needed removal) was removed a few years ago, and we hadn't found another cause. The 2nd half would have needed removal anyway due to a large nodule, but probably could have gotten a few more years out of it. Sigh.
I thought pots was treated either with hydration, midodrine or beta blockers???
Wow interesting. I have pan hypopituitarism so on ddavp for that plus I take flecanide for PVC’s. The pots symptoms you described sound very much like me.
I have pots, and my cardiologist prescribed desmopressin. It made my palpitations so much worse, as it is a vasoconstrictor and in my particular case, my pots causes me to have a second degree heart block (wenckebach) from the adrenaline crash. It may work for some people, but unfortunately it did not in my case :(
Thank u doctor.plz make video on orthostatic intolerance.
But what about people with heart problems that need the water off? Thank u for your knowledge and explaining it so we understand.
You look so nice, Sanjay! The blue suit, another pretty shirt with the lapel pen! How dapper you look! You are so handsome, clothes were made for you! Some designer would probably pay you big bucks to model their clothes. Can't touch being a Doctor though and we need you. You're not just "eye candy" there either.
This medicine is also helpful in vasovagal syncope?
I was diagnosed by a cardiologist 5 years ago she did a stand to lying down test. Australian doctors are hopeless most of them know nothing about it.
I have had all the classic symptoms since puberty including fainting when standing from a seated position on the floor, fatigue and only feeling comfortable when lying down and not one GP had even mentioned POTS in almost 50 years of looking for a diagnosis. I've had so many tests for diabetes it's ridiculous. I finally found a young GP straight out of university who decided to refer me for every relevant test and specialist until I got a diagnosis and proper treatment. That was in 2019. Most GP's seem to be so afraid of overstepping the line of Medicare referral guidelines they're perfectly happy to shrug their shoulders and suggest a healthy diet and exercise thereby implying the patient is the problem. I thank God for that young GP and his devil-may-care attitude every day. Being able to hold up a piece of paper signed by a Cardiologist that shows impirically that I have a very real physical condition and I'm not lazy has shut down the bullies. The ones it hasn't shut down I no longer take anything they say to heart because I know society judges their disablism and ableism and not me for having a disability.
Sounds like a great idea! However, I take Florinef (fludrocortisone). Would it be safe to take this on special occasions while also on florinef?
My mom have spondylisis according to you what should be the treatment procedure
Emergency meds :
Desmopressin ( synthetic anti-diuretic hormone to excrete more water whichretains more fluid within the body. Its duration of action is 4 hours) , - 0.2 mg always with you in your pocket, as prophylaxisbefore any activity which requires prolonged standing .
Not to be taken daily, only for special occasions only.
Otherwise , the other treatment is saline infusion 3 liters for 4 hours) , once a week.
Why to excrete more water
Thank you for this video Dr. Gupta. Can you please talk about experiencing palpitations / irregular heartbeat when waking up from REM or a dream. I had this experience last night and once in a blue moon I have this. I would love for you to let us know when to get evaluated if we already have not and whether magnesium can help with this too. What can we watch out for? At what point is there any concern? Should we keep a sleep diary? thanks
Menopausal hormone related? Thyroid?
@@hannavandijk-alac7500 I have endometriosis but not menopausal yet yaaay! I also have have hashimotos' thyroiditis
i have had spells of black and stars that last minutes at a time, it started very specifically, and I get soooo dizzy...my doctors refuse to acknowledge.
You are so kind. POTS has decimated my life. I was healthy and living life / never sick and them boom. I faint all the time. I have injured my head, leg and arm and even nearly feel down the stairs. I live in a state of ore syncope and fear. I used to run and now? Ha! Lucky if I can walk. I get vertigo and dizziness is all the time. I feel nausea and gut issues. The fatigue is so extreme. I have out on weight despite eating little and healthy as I just give up some days and avoid walking / falling. Worst of all, I have given up on my dream of a second child. I stand up from a chair and boom. It's like a balloon in my head.
I can't plan. Pots plans for me. I lost my job as a reached as I kept fainting in class and on it goes. I have tried so many meds and was always proactive but as of late I feel like I just want to give up.
Don't give up..everything happens for a greater reason..
Drink 3 litres of water a day with pinch of pink himalayan salt
No gluten no dairy atall no more than 60 carbs a day no sugar alcohol or processed junk walk bit by bit each day build up very slow eat Lean meats nut butters half banana a day take magnesium and coq10 flax seed powder small amount daily to build up fibre tolerance...Notice that if your gut is swollen inflamed or having spasms heart rate goes up so concentrate on healing gut first and keep moving every chance you get.
I've been seeing lots of videos lately about vitamin B1 as a treatment for POTS.
James is right on the mark. Except I need two teaspoons of salt per day, and propranolol to keep my heart rate down and control the increased blood pressure from all the salt. Liters and liters of water! This has made a huge difference for me, otherwise I would be bed bound. And I got PoTS after Covid....getting better but not gone. I have to FORCE myself to be marginally active to keep my legs conditioned, very important with PoTS.
I have struggled with my POTS diagnosis this year...it is one of the hardest things to deal with and the strength to get up and function...it's hard for those who don't have it to even fathom. I want you to know that I understand and I will pray for you! Stay strong! Beta Blocker & Physical Therapy have helped me so much more than if I were fighting this all by myself. Take care!
@@deidra7326 thanks so much. Its so lovely to have such support. I would be delighted and grateful if you could pray for me as I believe in the power of prayer. Yes, I am back at cardiologist soon and I am rethinking meds and might give beta blockers another try. It's so hard ❤️
thank you. i am so so isolated right now with this every day i feel faint and hve to cancel plans, nobody understand, i hope my drs can help me
I don't know if I have pots or not. It is just so confusing. I fainted few days back very badly and since then I have symptoms like heart palpation well it has nothing to do with my position. And i don't wake up feeling good ever , tired most of the time. I hear my heart beating very loud and fast sometimes. I went to the doctor he said I was okay he even checked my bp and my pulse rate everything was normal. Now I don't know what to do , anyone here with any good suggestions?
Was diagnosed two months ago. Debilitating symptoms for 8 months out of nowhere. Countless hospital and doctors visits. I can’t take it anymore and don’t know what to do.
What about throbbing pains in your muscles
I’m starting ivrabradine, worried it will lower my resting rate too much
Thanks for this info :) I wonder if this could be considered as a nightly treatment? I find I pee twice in the night and it effects my sleep and I wake up every morning feeling hungover. I am going to talk to my GP about asking my cardiologist if I could try it. I feel like I constantly pee, every half an hour I am peeing and it's frustrating. I also take dioralyte and high salt diet so don't understand why I am still peeing.
I have POTS and found that taking salt in fluid helps this, my cardiologist said you need around 10g of salt per day for POTS patients (he's on the POTS UK website as a doctor with a specialist interest in POTS) it's a lot, but it definitely helps x
Dr I spoke to you about my daughter. She has all the symptoms you just described but they diagnosed her with Intractable Migraine and Trigeminal Neuralgia and Fibromyalgia. She’s missed out on medical school because of this brain condition. She’s super smart but I think she has pots. They did the tilt test she barely passed. She’s dizzy when she tries to get out of bed she’s now always tired and barely eats because of constant nausea. She’s constantly having to go for a DHE infusion and she just spent 7 days in the hospital. It took 15 attempts to get an iv in and even her pic line failed. They ended up sedating her to put a hard line directly into her heart. She’s my only daughter and I don’t want to lose her. She’s in her late 20’s and has no friends and never really got to date. It’s too late for her to be a neurosurgeon but she would like to be a music therapist for people with brain trauma. She is an excellent classical pianist and also composes her own music since she was 8yrs old. Her thyroid has been checked for hyper and hypo but the came back normal. Do you think I should take her to a cardiologist to see if it’s a cardio problem because her heart beat resting is very high and she’s always very tired. She loves learning and everyone who sees her says she should go back to premed, with her nearly identic memory she memorized everything easily and including music. If I don’t get her help soon I’m terrified she might commit suicide. She’s needs her life back! I can only be her mom and she feels guilty that I have to help her so much and my 90yr old mother. She’s losing so much weight I can clearly see her collar bones and she’s only 5’2” can you tell me what kind of dr she should see next. If you saw her you wouldn’t believe it because she is very beautiful and has long hair and gorgeous smile. She is a strong person but lately she’s been very depressed Despite all this she hopes to go back to school.for now she is forced to spend most of her time alone in bed. She does not drink or drug my being a police officer helps but she has a lot of integrity and rarely can get out because she’s so dizzy and nauseous. What kind of dr should she see now? By the way she has a therapist and goes to group therapy too. Last but not lease she is very well provided for. Can you make any new suggestions? We’re really desperate, this time she ended leaving the hospital with a deep vein thrombosis that was a direct result of one of the 15 iv botches. So now she has to be on blood thinners too. I know you’re very busy but if you find time could you get back to me? I’m susan my daughter is Angel. Thank for so kindly helping so many people. Have a restful night and a brilliant day!! I can patiently wait for your response!
Look up the Carnivore Diet…all were healed from very serious ailments. I started it today and can’t wait for the results! (I also have pots and eds)
How about a minerelocort like the fludrocort? Thank you Dr.Gupta.
Is there a link between benzodiazepine use and POTS. I had many sxs of POTS when I was recovering for benzodiazepine use. It’s literally taken me a few yrs to get better from it.
i am on clonazepam..and recently started to feel pots symptoms..pls tell me how long it took you to feel better
God Bless You! If you are on Fludrocortisone could you take this? Also, I have had recent Hypokalemia with Hypertensive Crisis...plus, looking for Doctor that understands this syndrome in state of South Carolina..it is a constant battle.
..Thank you so much..