Like many people with a chronic illness, I had to wait many years to start treatment. I naively thought that medication would solve all my problems as that is what my doctors led me to believe. The medication that I took initially did not solve all my problems as they were designed to treat my symptoms and not the underlying cause of my illness. Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia and is a complex illness that involves many bodily systems. There isn’t a magic pill that will rid you of your tachycardia, low blood pressure, brain fog and nausea etc. This means that you can end up taking a variety of pills to treat each one and also extra ones to treat any side effects.
Below, I have outlined the treatments that I have tried and how successful they were for me.
Some medications may not be available in your country. Discuss suitability with your doctor before starting a new treatment programme e.g graded exercise.
Treatment 1- Fludrocortisone + Ivabradine
This is the standard treatment for POTS in the UK. I had trouble with Fludrocortisone from the outset as it caused severe nausea. My nausea was so severe that I wasn’t able to eat. I was prescribed some anti-nausea medication to treat this which suppressed my appetite. Ivabradine works well for me, lowering my heart rate by around 50 bpm which means that my heart rate is around 100 bpm when standing, instead of 150 bpm. In the end, I had to come off the Fludrocortisone as it caused me breathing problems.
Treatment 2- Midodrine + Ivabradine
I didn’t last long on Midodrine as I had a severe allergic reaction to it almost straight away.
Treatment 3- IV Saline + Ivabradine + Graded Excercise
IV saline is the only treatment that I’ve tried that has restored my quality of life. It eliminates almost all of my symptoms (lightheadedness, brain fog etc.) and it has allowed me to start on a graded exercise programme to help treat my chronic fatigue. I have not yet experienced any side effects from this treatment and I am currently asymptomatic with regards to my POTS.
Last Updated 30/06/18