What lab work is used to detect excess norepinephrine in POTS?

[Peyt]

Hi,
Does anyone know which lab test is used to detect excess norepinephrine in POTS?
The reason I ask is when one goes to a normal lab they usually take your blood while sitting on a chair, but
in POTS patient's heart rate goes much higher when standing, so is there a test that can detect excess norepinephrine correctly for POTS patients? or is it the same test for all?
Thanks so much,

 

[Peyt]

Would this test be sufficient for the purpose of measuring the Catecholamines including Norepinephrine?
https://www.labcorp.com/test-menu/22751/clonidine-suppression-test-four-hour

 

[echobravo]

detect excess norepinephrine in POTS?

@Peyt, I am experiencing more and more issues with circulation lately (dizzy standing up, fatigued after eating, POTS, low blood pressure, high pulse 3 a.m. etc), could you elaborate a bit on how norepinephrine would be linked to POTS?

 

[Peyt]

@Peyt, I am experiencing more and more issues with circulation lately (dizzy standing up, fatigued after eating, POTS, low blood pressure, high pulse 3 a.m. etc), could you elaborate a bit on how norepinephrine would be linked to POTS?

I am taking this paragraph out from this article to show you how some forms of POTS(the hyperadrenergic type) are managed by blocking the release of norepinephrine:
http://www.bjmp.org/content/postural-orthostatic-tachycardia-syndrome-pots-evaluation-and-management

Agents that block the release or effect of norepinephrine (noradrenaline) are very effective for hyperadrenergic type POTS patients. We use clonidine starting at 0.1 mg orally twice daily and titrating up as needed. The patch form may be preferable to some patients and has the added benefit of providing a steady state drug release for one week. Labetalol, an alpha and beta receptor blocker, is also useful in this group of patients. Dosages of 100-400 mg orally twice daily are used. Methyldopa may have a role in highly selected patients with POTS. Symptom control may be improved with both the SSRI and SNRI classes of medications.

For a basic definition of norepinephrine please see:
https://en.wikipedia.org/wiki/Norepinephrine

 

[cyclamen]

I had this test - first you need to get a needle in and secured in a way it can be uses do draw blood without needing to hurt you a second time. Than You have to lay down for half an hour before blood is drawn for the first time. After that you get up and stand for 10 minutes before having your blood drawn a second time. The blood has to be cooled all the time before norepinephrine analysis.

 

[Peyt]

I had this test - first you need to get a needle in and secured in a way it can be uses do draw blood without needing to hurt you a second time. Than You have to lay down for half an hour before blood is drawn for the first time. After that you get up and stand for 10 minutes before having your blood drawn a second time. The blood has to be cooled all the time before norepinephrine analysis.

Do you know what the test is called?
Its not the usual Catecholamines test, it's one that's especially tailored for POTS patients . (as
you described)
That's what I need, so I can tell my doctor who is not especially trained in POTS to order it.

 

[cyclamen]

Do you know what the test is called?
Its not the usual Catecholamines test, it's one that's especially tailored for POTS patients . (as
you described)
That's what I need, so I can tell my doctor who is not especially trained in POTS to order it.

The way I understand it is that with POTS you need to have blood drawn two times, first in rest, laying down for 30 minutes and the second one after 10 minutes of standing. The analyzing for norepinephrine in the lab is done just like the normal catecholamines test. This way the difference of blood norepinephrine levels during rest and while standing will show up. I do not know a special name for this type of test.