For people suffering from Orthostatic Intolerance, Postural Orthostatic Tachycardia, Mast Cell Activtation or EDS. Follow me as I document my struggle towards better health.

The Grinch Syndrome

Dr. Levine's Exercise Study for POTS now published in the JACC.

The paper entitled "Cardiac Origins of the Postural Orthostatic Tachycardia Syndrome" coins a new descriptive term for POTS; The Grinch Syndrome.

(Dr. Levine has sent me a copy of the publication for this blog. Email me if you would like a copy.)

Dr. Levine's paper talks about how patients diagnosed with POTS or OI can have hearts that are too small.
"Results from our laboratory have shown that there is a sex-specific difference in cardiac size and mass even in healthy humans and that women have a smaller (and therefore, less distensible) heart compared with men (2,54). It is possible that such a sex difference is exaggerated in POTS patients. This notion is supported by a recent study of Miwa and Fujita (8) showing that a considerable number of chronic fatigue syndrome patients had a small heart, as assessed by roentgenography and echocardiography. POTS is a frequent finding in patients with chronic fatigue syndrome (55). It is highly likely that the small heart contributes to the development of POTS and probably should be included in the genesis of this syndrome."
So what does that mean to the average POTS or OI sufferer?  Exercise designed to improve the performance of the heart muscle could be THE MOST IMPORTANT FACTOR contributing to a patient's recovery.

Start Exercising in a Recumbent Position
In this study, patients started with recumbent exercises such as rowing and the recumbent bike.  They then gradually moved to performing exercises in an upright posture.  They also combined their cardio training with weight lifting in order to progress the patient's conditioning levels.

Significant Findings from the Study

"1) cardiac size and mass and blood volume were much smaller in POTS patients compared with healthy sedentary controls; 2) HR was greater, whereas stroke volume was smaller, in patients than in controls during upright posture; 3) the function of the autonomic nervous system was intact in POTS patients; and 4) exercise training increased cardiac size and mass, expanded blood volume, and thus improved or even cured POTS syndrome. These results suggest that POTS per se is indeed a consequence of deconditioning (i.e., cardiac atrophy and hypovolemia) and that carefully prescribed exercise training can be used as a nondrug treatment for patients with POTS."
If you have POTS then start NOW!
Ten out of the nineteen patients in the study no longer met the criteria for POTS after finishing the three month program.  They were effectively cured.  If you had any doubts or worries about starting to exercise while sick with POTS then dismiss them, talk to your doctor and get on the rowing machine.

Thank you for helping me feel better
Contributors to the study report are: Qi Fu, MD, PhD, Tiffany B. VanGundy, MS, M. Melyn Galbreath, PhD, Shigeki Shibata, MD, PhD, Manish Jain, MD*,,Jeffrey L. Hastings, MD, Paul S. Bhella, MD, and Benjamin D. Levine, MD