Abnormal Tilt Table

[SadieSunflower]

I am a 25 year old female. A year and a half ago I developed numbness in my toes which has continued to progress. Never Conduction Studies are normal. I also have developed chronic dizziness and weakness. MRI was normal. I had a tilt table test done last year, and I was told it was normal, but I ordered the test recently it says abnormal. Do I need to be concerned about this? Could this be contributing to my dizziness and weakness and spacey feelings I’ve had for the last year and a half? Can you guess why the doctor would tell that “everything looks good.” The doctor who left me a phone message was a different doctor than the one who wrote this report. Can I do anything to alleviate my symptoms? I had one and only episode of near-syncope two weeks ago, which is why I decided to order this report.

Discussion:
Sudomotor (sweat production) test is normal. There is a slight decrease in average heart rate variability to deep breathing. Blood pressure response to Valsalva maneuver is abnormal because there was a 40 mmHg reduction in mean arterial pressure during early phase II with no return to the baseline value suggestive of adrenergic system dysfunction. There was a significant and transiently symptomatic decline of 25-30 mmHg in systolic blood pressure during the tilt-up with and appropriate increase in heart rate indicative of peripheral adrenergic system abnormality and/or hypovlemia.

Clinical Impression:
Abnormal autonomic function test; peripheral sympatric adrenergic system dysfunction.

[Flo2000]

I have been diagnosed with POTS (Postural Orthostatic Tachycardia Syndrome) 6 months ago, following an abnormal Tilt Table test. Indeed, every time I stood, my heart rate reached 160 (max 180), drop in BP (Min 40/?), my symptoms got worse over 2 months, my GI system shut down, adrenal glands produced high level of Cortisol & Adrenaline, urinary output was 6 Liters/day + severe diarrhea, resulting in chronic dehydration. Got many other symptoms & many torturous pains that I'll spare you... bottom line: autonomic dysfunction was my ordeal, they said. Some others said it's your Vagus Nerve... brain, nerve, heart, stomach... go figure what's wrong! All of the above, maybe.
I tried all the medicine they threw at me (Beta-Blocker Metropolol, Florinef, Vaso-constrictor Midrodrine, Anti-depressants, Anti-anxiolitics, SSRIs, Effexor, Anti-spasmodic Ativan, anti-nausea,...) They ALL made me worse.
Here's what worked for me after 4 hospitalizations, 25+ doctors, countless visits to the ER:
Vitamin supplements & herbal medicine!! Yes I was desperate, I accepted to try anything, even if not convinced. But to my surprised, it is working! I started 2 months ago, & it is quite amazing that I have improved that much in that little amount of time (keep in mind that 2 months, when you're sick, feels like forever).
My tips for you would be:
1. Salt pills I have read helped people with orthostatic drop in BP (source Mayo Clinic). I tried. I recommend REAL sea salt over food rather than salt pills. Salt pills would make me retain water in my intestines (where I did not need it) & promoted diarrhea.
2. Another help is Hawthorn: the German Commission E has approved it for people with orthostatic intolerance. I have read some medical reviews from over there, showing an improvement in orthostatic intolerance thanks to Hawthorn.
3. Drink 1-2L of water. I actually recommend Mineral Water, it gets little pricey but I did find it made a big difference for me. Otherwise add salt to your water or chose an electrolyte drink that is not sweet (in other word avoid Gatorade).
4. I would pursue more tests. Being Orthostatic Intolerant can be the results of many malfunctions. Pursue all the cardiac & neurological tests you can.
Good Luck! I hope you'll feel better
:)

[Cleveland Clinic]

Based on the report you have autonomic dysfunction.  I am assuming that you do not have DM.  I think you should have another test to confirm these findings given that this test was done  a year ago or so and your symptoms are still persisting.  Sometimes certain medications can help.  Salt and prevention of dehydration by drinking is also helpful.  you should also consider wearing compression stalkings on your calves.