The blood draw that showed the low pyruvate showed very elevated lactate but still barely within the normal range. I do know my lactate always seems high whenever it is tested.
The Neuro I was seeing canceled my muscle biopsy and said, "you just have POTS, I can't help you".
As far as the workup, I have had to fire my local doctor and start with a new one. I'm also no longer working with NOVA, nice people but no results/treatment.
Right now I'm planning on doing some of these Mayo tests for autoantibodies and maybe going back to seeing one of the 'big' POTS specialists since I have not seen one for about 3.5-4 years now and I know research has revealed a lot of stuff over that time.
I think we have everything nailed down to pretty much my smooth muscle is the issue. (Gi tract and circulation). I think my kidneys are doing poorly because of the increased blood pressure I'm having from POTS. I'll confirm that with nephrology in early October.