While not completely new, I find this hypothesis and the way Cort explains it really interesting. For me, the first warning signs I started to get at the gym (a few weeks before my decline into ME) were breathlessness, tachycardia and lightheadedness...It was like my heart & lungs were playing serious catch up, even after exercises I could easily tolerate normally.
I know that has been research into dysregulation of aceytlcholine and adrenergic signalling in the past with
some evidence of autoantibodies.
I'm not going to speculate about that research, but for anyone interested, i've tried the following treatments with guidance from my POTS consultant:
Treatment one: Midodrine 2.5mg x 3 per day (Alpha Agonist, vasopressor).
My Anecdotal Experience: Seemed to help with OI in the beginning. Made headaches worse. Had bad reaction at 5mg. Overall, found very little benefit and stopped taking it.
Treatment two: Ivabradine (Lowers heart rate through different mechanism than beta blockers).
My Anecdotal Experience: Definitely lowered heart rate and made it feel very stable but made me feel very tired/lethargic so I stopped taking it.
Treatment three: Propranolol 10-20mg (beta blocker). I read
here that low doses can help POTS. Alan Light also suggested that it may help in low doses.
My Anecdotal Experience: I definitely noticed that I felt less out of breath when walking/doing mild exercise on propranolol in the beginning, but it didn't seem to help me significantly enough to justify continuing it. The impact really was minimal.
*I've also tried Ivabradine/Midodrine in combination as well as Propranolol/Midodrine and neither helped me much.
So the puzzle for me still goes on, I have to say that Cort's article made a lot of sense to me, I hope we find some answers soon. Fluge & Mella's mention of Arginine a while back and the anecdotal reports about the benefits of NO2 Black/Isordil on here do make me think that for some of us, there is a problem with vasodilation/constriction.