Re: propranolol success

[Guest guest]

pnl is often successful for adrenal dysfunction but doses usually need

to be much much lower than what is given for BP

nx

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> Just for the sake of mentioning it, Tom has not done well on

> Propranolol. It made him withdrawn and more autistic.

> It didn't work even though he is a stressed kid. I suppose the fact

that

> I would describe it as stress and wouldn't think to use the word

> 'anxiety' for Tom really might be the clue???

> I would still say it's worth a try due to the success other kids are

> having.

> Sara

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[Guest guest]

yes that dose is quite high if in the adult POTS 'category', def on the no-no side of 20mg note last bit below "Blood flow and blood pressure regulation are

also abnormal while supine or sitting, but these abnormalities may not be as

apparent and may require orthostatic stress to become evident "-----------------Postural Orthostatic Tachycardia is a syndrome. As such, there is a collection of symptoms that distinguish it. The symptoms are widespread because the autonomic nervous system plays an extensive role in regulating functions throughout the body. Many of these symptoms, such as low blood pressure,* may present only after prolonged standing. Symptoms will vary from person to person. The following is a list of symptoms reported by patients. When possible, we have included the percentage of patients that research reports have experienced a given symptom.

Symptoms presumed to be related to

cerebral

hypoperfusion:**

Lightheadedness 77.6 % (Grubb, 2000)Fainting or near fainting 60.5% of patients report near fainting

(Grubb, 2000)Generalized weakness 50% (Low

et al.)

Symptoms presumed to be related to autonomic overactivity include the following:**

Palpitations 75% (Grubb,

2000)Tremulousness 37.5% (Low,

Opffer-Gehrking, Textor, Benarroch, Shen, Schondorf, Suarez & Rummans, 1995)Shortness of breath 27.6 %

(Grubb, 2000)Chest discomfort and/or pain 24.3 %

(Grubb, 2000)

Sudomotor symptoms include the following:**

Loss of sweating 5.3 % (Low et al.) Excessive sweating 9.2 %

(on, 2000)

Loss of sweating and excessive sweating are more common in patients with elevated norepinephrine levels (Thieben, Sandroni, Sletten, Benrud-Larson, Fealey, Vernino, Lennon, Shen & Low, 2007).

Symptoms that may reflect dysautonomia:**

Delayed gastric emptying

23.7% of patients report gastrointestinal complaints, including bloating (Grubb

et al., 1997)Bloating after meals (Grubb

et al., 1997) Nausea 38.8% (on,

2000)Vomiting 8.6% (Thieben et al., 2007)Abdominal pain 15.1% (Thieben et al., 2007)Diarrhea 17.8% ( & Biaggioni, 1999) (sometimes with alternating constipation)Constipation 15.1% (Thieben et al., 2007)Bladder dysfunction 9.2% (Thieben et al., 2007) (this may include Polyuria ( & Biaggioni, 1999)

(excessive urination)Pupillary dysfunction 3.3% (Thieben et al., 2007) Pupillary dysfunction may or may not be responsible for some other reported symptoms, such as: Blurred Vision (Grubb,

2000) and Tunnel vision (Low et

al.).

Generalized Complaint symptoms:**

Fatigue 48% (Grubb,

2000) (which can be disabling) Sleep disorders 31.6% (Low et al.)

(can cause unrefreshing sleep and an increased

need for sleep)Headache/migraine 27.6%

(Grubb, 2000)Myofascial pain 15.8% (Thieben et al., 2007) (characterized by regional muscle pain accompanied by trigger points)Neuropathic pain 3% (Thieben et al., 2007)

Other symptoms reported in research that are not categorized above include:

Dizziness (Grubb, 2000)Tachycardia (Grubb,

2000)Exercise intolerance

(Grubb, 2000)Clamminess (Grubb, 2000)Anxiety (Grubb, 2000)Flushing (Grubb, 2000)Postprandial hypotension

(Grubb,

2000) (low blood pressure after meals) Blood pooling in limbs

(Grubb, 2000) (can make legs feel heavy and appear

mottled and purple in color) Intolerance to heat (Grubb & Karas, 1999)Feeling cold all over (Grubb & Karas, 1999)Low blood pressure upon standing (Grubb,

Kosinski, Boehm & Kip, 1997) (Some physicians feel orthostatic hypotension is a separate entity from POTS)Cognitive impairment (Grubb

et al., 1997) (may include difficulties with

concentration, brain fog,

memory and/or word recall)Narrowing of upright pulse pressure

( & Biaggioni, 1999)Cold hands (Low et al.) (and often feet & nose)Hypovolemia (Low et al.)

(low blood volume)Chills (Low et al.)High blood pressure (Low

et al.)Hyperventilation (Low et al.)Numbness or tingling sensations

(Low et al.)Reduced pulse pressure upon standing

(Low et al.)Low back pain (Mathias,

2000)Aching neck and shoulders

(Mathias, 2000)Noise sensitivity (,

2001)Light Sensitivity (,

2001)Disequalibrium (Sandroni,

Opfer-Gehrking, McPhee & Low, 1999)

The above are symptoms reported by POTS researchers. Other symptoms sometimes

reported by POTS patients include:

Arrhythmias (irregular heart beats)Chemical sensitivities (May have multiple chemical sensitivity and can be

very sensitive to medications - may only need small doses)Easily over-stimulated Feeling full quicklyFeeling "wired"Food allergies/sensitivities (some foods seem to make symptoms worse)HyperreflexiaIrregular menstrual cyclesLoss of appetiteLoss of sex driveMuscle aches and/or joint painsSwollen nodules/lymph nodesPolydipsia (excessive thirst)Weight loss or gainFeeling detached from surroundingsRestless leg syndrome

POTS symptoms can vary from day to day. They tend to multiply

and become exaggerated upon upright posture. Blood flow and blood pressure regulation are

also abnormal while supine or sitting, but these abnormalities may not be as

apparent and may require orthostatic stress to become evident ( &

kson, 2002). Some patients do report symptoms

occurring while sitting or lying down. Heat, exercise and eating can exacerbate symptoms. Women sometimes report an increase in

symptoms around menstruation. >> 80mg BD SR type, don;t know what POTS ortho intolerance is ???> > Mx> > > > > Hi Mandy, what was the dose? Do you suffer POTS / ortho intolerance?>

[Guest guest]

they use it as 'official' in the link below " ...In an attempt to elucidate the

ECG changes associated with the SCMS, we have applied the propranolol test in 35

of our patients suffering from this syndrome... "

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> > Just for the sake of mentioning it, Tom has not done well on

> > Propranolol. It made him withdrawn and more autistic.

> > It didn't work even though he is a stressed kid. I suppose the

> fact that

> > I would describe it as stress and wouldn't think to use the word

> > 'anxiety' for Tom really might be the clue???

> > I would still say it's worth a try due to the success other kids

> are

> > having.

> > Sara

> >

>