Recently diagnosed with POTS

[idogis1]

I was recently diagnosed with POTS and have started on Atenolol, which is great. For the first time in 4 years I've been able to go for a walk without incredible pain.

However, few months ago I donated blood and the next day I was incredibly dizzy, had trouble concentrating, and was unable to follow a chain of thought for more than a short while. I thought it was low blood sugar or anemia and it would go away in a few weeks. It hasn't; I was told by my doctor that this was a symptom and it would go away after I started medication, but so far it has only gotten worse. Something similar happened during the summer, but it went away after a week or so.

I've done some research and have found that these symptoms are also side-effects of Atenolol. So I have no way of knowing whether the condition or the medication is causing this.

I've been taking 12 mg of Atenolol in the morning for a little over a week now and next week I'll start taking 12 in the morning and 12 at night. Two weeks from that I'll take a full 25 mg tablet in the morning and 12 mg at night and after another 2 weeks 2 full tablets in a day. After that it is uncertain whether I'll have to increase or decrease the dosage.

I seem fine at night when I'm lieing down but when I stand or sit up I feal just as bad as ever; during the day I feal like **** no matter what position I'm in, so I'm confident that Its the medication is the cause. What I want to know is if these side effects will ever stop.

[AireScottie]

Well, I wouldn't recommend giving blood again :)
It's normal with POTS to feel better lying down than sitting or standing, but I can relate to the beta-blocker problem.  I'm not able to tolerate them at all, because they can actually lower BP and make the symptoms worse.  I definitely lost my mental ability on them and had no memory.  Not surprising, as doctors are now using them psychologically to "selectively erase" traumatic memories.  Can't see how it doesn't affect your memory when you take it for POTS but does affect it when you've had a traumatic experience.  Do you have low BP with your POTS?  If so, are you taking midodrine?

[Heiferly]

As a POTS patient, you probably shouldn't ever donate blood.  You need to focus on maintaining normal or even slightly higher than normal blood volume to help compensate for the POTS--that's the crux of the idea behind increasing fluid and salt intake.  Were you instructed to increase your fluid and/or salt intake?  The reason you had those symptoms after giving blood is because your total blood volume was slightly decreased so less blood was available to pump up to your brain; if you have blood pooling in your legs or abdominal bed (and thus, thoracic hypovolemia) which contributes to lightheadedness as is generally the case in POTS, having less than normal total blood volume (hypovolemia) exacerbates the problem.  Likewise, in summer, this is where heat intolerance can also come into play.  The body controls its temperature relative to excessive environmental heat by dilating peripheral blood vessels, which can increase blood pooling (ergo, worsening thoracic hypovolemia); also, in high temperatures fluid and electrolyte loss through sweat can contribute to worsening of POTS symptoms.  

You may benefit from reading more about the mechanisms of POTS, Orthostatic Intolerance, and Dysautonomia in some of the articles in our further reading health page:

http://www.medhelp.org/health_pages/Neurological-Disorders/Further-Reading-on-Dysautonomia/show/696?cid=196

Is the beta blocker the only medication you are taking?  On average, what are your heart rate and blood pressure when you are lying down?  Sitting upright with feet on the floor (legs not crossed)?  Standing (taken 2-3 minutes after rising)?  (Standing values at 10 or 15 minutes may also be useful if these are appreciably different from the 2-3 minute value, as they are for some.)  

Some POTS patients do not tolerate beta blockers, or may be able to tolerate a certain beta blocker but not a different one.  Important information to have is what your lying/sitting/standing BPs and HRs were before you even started taking the BB, what they are at night when you feel better, and what they are during the day when you feel the BB is affecting you negatively.  This can give objective information to your doctor about WHY the beta blocker is making you subjectively feel a certain way, and help guide his/her decision about what the best course of action is.  Some problems can be dealt with with a dosage adjustment or a switch to a different beta blocker; in other cases, a beta blocker may not be the most appropriate treatment for you.