Garland, Emily M, Celedonio, Jorge E, Raj, Satish R · Current neurology and neuroscience reports · 2015 · DOI
This review explains postural tachycardia syndrome (POTS), a condition where your heart rate increases excessively when you stand up, often causing dizziness, fatigue, and other symptoms that improve when lying down. POTS can result from several different underlying problems—such as low blood volume, overactive stress nerves, or problems with small nerves in the legs—and may overlap with other conditions like ME/CFS. Treatment typically involves a combination of lifestyle changes, structured exercise, and sometimes medications.
Many ME/CFS patients experience POTS-like symptoms or concurrent POTS diagnosis, making understanding of POTS pathophysiology directly relevant to ME/CFS research and clinical management. This review highlights that conditions like ME/CFS and POTS may share common mechanisms (autonomic dysfunction, deconditioning, mast cell activation), potentially informing treatment strategies. Recognizing POTS as a heterogeneous condition with multiple causes could help clinicians better tailor interventions for overlapping patient populations.
This review does not establish the prevalence of POTS in ME/CFS populations or prove that POTS and ME/CFS share a common underlying cause, only that they may coexist and share some pathophysiological features. The review does not provide direct evidence comparing efficacy of different treatments or determining which pathophysiological mechanism predominates in individual patients. It also does not evaluate how exercise tolerance differs between POTS and ME/CFS, an important distinction given post-exertional malaise in the latter.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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