Dysautonomia is a term describing several medical conditions impacting the function of the sympathetic and parasympathetic sections of the autonomic nervous system.

As depicted, the autonomic nervous system controls all of the bodily functions that occur “automatically.” In other words, it controls the processes that one typically has no conscious awareness of like breathing, digestion, temperature regulation, etc. People living with various forms of Dysautonomia have trouble regulating these systems. They often go from one extreme to the other, as the condition is comparable to constantly flipping an on/off switch in the body.

  • Lightheadedness
  • Fainting
  • Hypotension or Hypertension
  • Tachycardia or Bradycardia
  • Excessive or Reduced Sweating
  • Dilated Pupils
  • Blurred Vision
  • Insomnia
  • Delayed or Fast Gastric Emptying
  • Hyperventilation or Involuntary Breath Holding
  • Fatigue
  • Frequent Urination or Decrease in Urination

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A common form of Dysautonomia is called Postural Orthostatic Tachycardia Syndrome (POTS). POTS mainly encompasses the cardiovascular symptoms of Dysautonomia, but symptoms primarily occur during postural changes when the blood volume is not dispersed appropriately. Typically, the blood pressure drops upon standing and the pulse increases to compensate. However, there are POTS patients who experience any combination of the following symptoms triggered by standing:

  • Tachycardia
  • Bradycardia
  • Hypotension
  • Hypertension
  • Syncope (Fainting)
  • Presyncope (Blackout episodes)
  • Dizziness
  • Lightheadedness
  • Fatigue
  • Chest Pain
  • Palpitations
  • And more

Upon standing, the overly lax blood vessels in EDS patients fail to pump blood back to the brain during orthostatic changes. The weak, unstable vessels contribute to the drastic change of vitals that is the POTS phenomena. 

When triggered, mast cells release over 200+ chemical mediators such as histamine, prostaglandins, and leukotrienes. The mediators released by degranulating mast cells are vasodilators, while others are vasoconstrictors. Those mechanisms result in the associated condition, POTS.

Hyperadrenergic POTS, characterized by an increase rather than a decrease in blood pressure upon standing, is most commonly diagnosed in patients with Mast Cell Disease. It is increasingly important to discern the difference between an orthostatic POTS response from a full-blown mast cell reaction. Tachycardia and blood pressure abnormalities occurring simply laying there without postural changes are less likely to be considered “just POTS.”