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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Do You Suggest For POTS Syndrome When On Florinef With High Heart Rate?

Hi, I was diagnosed with POTS syndrome along with all the things that are part of that syndrome ten years ago. The past couple years certain things have gotten worse, can't tolerate heat, had to go on medication florinef to raise bp, and a couple of months ago, high heart rate. I was put on inderol 10 mg 2x a day. I ended up going to the ER a few times and many times to get IV fluids. I just got done wearing a halter monitor for 72 hours and got a call from the cardiologist today saying they did see the increases but nothing pathithetically (sp) wrong with my heart. I am seeing a special cardiologist (but not until April) that deals in electrical physiology. I noticed recently the worst attacks of this is after I eat (about 7 pm) only large meal I usually eat. It happened again tonight after a big meal, I take my beta blocker and it gets better in about an hour. I haven't been able to work for the past year (fighting with social security over disability- also fell off top of my house and damaged vertrabrae in neck and back. Besides that, I suffer from extreme insomnia. It first started ten years ago with anxiety attacks, then feeling like I was going to black out whenever I stood up, depression, body aches, extreme fatigue... I don't know how much you know about POTS syndrome but this has been life altering. I was a teacher and coach of three sports for ten years, now I can't do much of anything physical because of fatigue and getting out of breath. I am not overweight and was an avid runner and athlete before this. I noticed when I was coaching standing for any length of time left me feeling awful and breathless. My EKG's have been normal and halter monitor results say my heart is fine in itself. Is there something that could be affecting my autonomic nervous system, hence giving false signals to my body (HR, BP, anxiety)? I know this is long and hopefully it makes sense. Frustrated and discouraged.<br>Dan
Tue, 18 Feb 2014
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Addiction Medicine Specialist 's  Response
Hi,

Your symptoms appear to be consistent with Postural Orthostatic Tachycardia Syndrome (POTS). The exact cause is not yet known. But large meals can induce the symptoms by causing the diversion of a larger amount of blood to the gastrointestinal tract. Eating frequent, small meals is known to help. Beta blockers also help, as they have in your case. In my opinion, please also consider adding a SSRI like Zoloft, Prozac etc to your medication regimen as these not only control anxiety but also regulate autonomic function and benefit in POTS.

Best wishes.
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What Do You Suggest For POTS Syndrome When On Florinef With High Heart Rate?

Hi, Your symptoms appear to be consistent with Postural Orthostatic Tachycardia Syndrome (POTS). The exact cause is not yet known. But large meals can induce the symptoms by causing the diversion of a larger amount of blood to the gastrointestinal tract. Eating frequent, small meals is known to help. Beta blockers also help, as they have in your case. In my opinion, please also consider adding a SSRI like Zoloft, Prozac etc to your medication regimen as these not only control anxiety but also regulate autonomic function and benefit in POTS. Best wishes.