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Clinical Trial: IV Albumin for Severe POTS

Ema

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A Double Blind Randomized Controlled Crossover Study to Systematically Assess the Efficacy and Safety of Intravenous Albumin Infusions in Severe Postural Orthostatic Tachycardia Syndrome

POTS is characterized by an excessive increase in heart rate and light-headedness on assuming an upright posture, standing or sitting that at times culminates in syncope. Most symptoms of POTS result from marked cardiovascular deconditioning and activation of sympathetic responses due to cerebral hypoperfusion.

Plasma volume expanding therapies are one of the mainstays of treatment. Saline infusions in patients with severe orthostatic intolerance lead to rapid but transient symptomatic improvement lasting several hours. Human albumin infusions are used for plasma volume replacement/expansion and have been shown to significantly improve cerebral blood flow.

A small subset of patients suffering from severe POTS have shown robust response to weekly albumin therapy, supporting the investigator's hypothesis that periodic albumininfusions will provide significant and sustained symptomatic relief to patients with severe POTS. This would increase their orthostatic tolerance and improve functional capacity without the limitations and side effects associated with other therapies.
http://ichgcp.net/clinical-trials-registry/NCT03365414
 
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Ema

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I spoke with a doctor who suggested this treatment. And also it’s apparently just a transitory improvement, lasts a few days. There are some side effects too, despite what the above says.
What side effects did they mention?
 

bombsh3ll

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Thanks so much for sharing this Ema, I will definitely be following this trial! I would love to try albumin but am sure I would need to provide evidence for its use in order to obtain it.
 

Hip

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A small subset of patients suffering from severe POTS have shown robust response to weekly albumin therapy, supporting the investigator's hypothesis that periodic albumininfusions will provide significant and sustained symptomatic relief to patients with severe POTS.
I wonder if that small subset who respond to albumin have echovirus as the cause of their POTS symptoms: albumin has antiviral effects against echovirus.
 

Hip

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Any idea what type of doctor one needs to go see to be checked for echovirus?
Echovirus is an ME/CFS-associated virus, so some of the ME/CFS doctors will test for it. Dr Chia is the expert in such enterovirus-linked ME/CFS.
 

Peyt

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Echovirus is an ME/CFS-associated virus, so some of the ME/CFS doctors will test for it. Dr Chia is the expert in such enterovirus-linked ME/CFS.
Thanks for this info.
I did a quick search on Dr. Chia and apparently before taking on any new patients he wants the patient to be diagnosed with CFS with another Doctor and get some blood tests done that shows if there are any viruses that he looks for.

So my question is: Any idea which viruses he would most likely want the patient to be tested for so I can ask my doctor to run those blood test to see if I even have those viruses ?
Thanks again.
 

Peyt

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From what I read, Albumin is responsible to maintain the oncotic pressure in the blood vessels. This is the pressure that assures that blood will flow in the body in equal amount everywhere in the body. I could see how this would help some POTS patients.
 

Ema

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I let this potential treatment go for lack of information back in 2018, but am considering it again, as some recent reports have indicated that it is helpful for a wider variety of immune conditions. I wonder if anyone else has tried IV albumin in the meanwhile? From what I can tell, it is fairly inexpensive and I can do it in the IV room at my doctor's office.