Chapter 14: Discussion and Summary

[Rebecca]

Chapter 14: Lyme and Autonomic Nervous System Dysfunction/POTS

Discussion Questions:

1. This was a very medically dense chapter, do you have any questions?

2. Have you performed a tilt-table test?

3. Do you suspect you have a ANS or POTS issue?

Summary:

• Lyme disease and co-infections, hormonal disorders, environmental toxins, detoxification problems, mitochondrial dysfunction, food allergies, hypoglycemia, sleep disorders, and psychological problems can cause the same symptoms; each one individually or in combination with the others can be responsible for the same set of symptoms.

• POTS (postural orthostatic tachycardia syndrome, a form of ANS (autonomic nervous system dysfunction), is a common disease often missed for MSIDS patients.
1. POTS refers to symptoms resulting from the impaired functioning of the autonomic nervous system, when we are unable to maintain our vascular tone.
2. Vascular tone is crucial, we need it to be able to remain upright and maintain normal blood pressure.

• ANS dysfunction describes any disease or malfunction of the nerves in the body controlling the blood pressure, heart rate, sweat glands, and bladder and bowel function.
1. Can be caused by Lyme, diabetes or Shy-Drager syndrome.

• Symptoms depend on what part of the autonomic system has been affected; the brain/hypothalamus (causing temperature dysregulation) or peripheral sensory nerves (causing burning, tingling, numbness, and problems with sweating), and whether the parasympathetic or orthosympathetic system has been affected, both of which control heart rate and blood pressure, as well as bladder and bowel function.

• ANS involves the central nervous system, peripheral nervous system, and the enteric nervous system. ANS operated through two main branches; orthosympathetic (OS) and parasympathetic (PS) nervous systems. PS regulates automatic functions such as breathing, heart rate, and digestion. OS secretes the neurotransmitters norepinephrine (helps control heart rate and blood pressure through blood dilation) and epinephrine (adrenaline- controls raising the heart rate and blood pressure by causing blood vessels to constrict).

• 5 reasons why the autonomic nervous system may not work well:
1. Abnormal production of hormones and neurotransmitters
2. Inability of receptors on blood vessels to properly respond to these hormones
3. Low intravascular fluid volume
4. Autonomic neuropathy
5. Autoimmune neuropathy

• POTS patients may also suffer from autonomic neuropathy affecting several different nerves in the body. Symptoms range from temperature sensitivity, sweating problems, burning, tingling, numbness, pooling of fluids in lower extremities, lowering blood pressure, bowel and bladder problems, and blood pressure swings.

• A tilt-table test is typical for diagnosing POTS, showing a patient’s heart rate increase when moved from a sitting or lying down to being upright and their blood pressure dropping.

• Treatment Options for relieving the symptoms of AND and Pots; increasing salt and fluids, Florinef with beta-blockers to control palpitations (Toprol XL Dr.H’s fav beta blocker, followed by Florinef and ProAmatine), selective serotonin reuptake inhibitors (SSRIs), Catapres, Diamox, Mestinon, and IV Procit therapy.