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Dr Sanjay Gupta- York Cardiology Aug 7, 2022- Can this simple treatment transform patients with POTS and Long COVID? - YouTube

CSMLSM

Senior Member
Messages
973
Can this simple treatment transform patients with POTS and Long COVID? - YouTube
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Dr Sanjay Gupta
York Cardiology Aug 7, 2022. 23.13min

This video will be of interest to POTS, Dysautonomia, Long Covid, ME/CFS, HPA axis dysfunction/adrenal issues patients.

Start- What is POTS, how POTS is not really a diagnosis, talks of what he hears from his patients, goes over symptoms and how all symptoms of POTS is not covered by a POTS diagnosis and how he believes that dysautonomia better describes POTS patients symptoms. That a disequilibrium between the flight and fight systems (HPA axis) and the rest and digest (cannabinoids) systems is going on. How patients spend most of the time in flight or fight and very little in rest and digest, so always wired and tired.

2.32min- How do patients develope POTS. Genetic vulnerabilities/susceptibilities exist then usually an infection uncovers the vulnerability and then symptoms start to develope.

3.18min- Suggests that long covid is similar to POTS and puts forward the argument that they are the same condition.

3.42min- Why he says they are essentially the same condition.

5.56min- Usual optimal management for POTS patients.

7min- Talks about an intervention that can be transformative for some patients. Regular intravenous saline infusions.

7.21min- Begins to explain symptoms and how certain things can make the symptoms worse. Why patients have symptoms and how these are normally addressed and how saline infusions can help more. Blood pressure, thirst, electrolytes/lack of salts, this is how saline infusions come into the picture.

11.12min- Limitations of and how saline infusions improve POTS/Post Viral Dysautonomia symptoms.

11.35min- Is there any evidence for repeated saline infusions in POTS, talks about some research by Blair Grub from Toledo- 2017 Effects of intravenous saline infusion in patients with medication refractory POTS. Only 4 out of 57 did not feel they had benefited from saline infusions, the rest reported benefit across all domains of quality of life assessments. Most reported immediate improvement that lasted up to 3 days after the infusion. Many gained enough improvement to do things like physio that then further improved symptoms. In fact many could eventually discontinue the saline infusions and importantly there was no major adverse events from the intravenous saline.

Effects of intermittent intravenous saline infusions in patients with medication-refractory postural tachycardia syndrome - PubMed (nih.gov)

13.28min- Talks of no further research by others and that this is likely due to no money in giving saline infusions for patients symptom management. In his words 'its as cheap as chips'.

13.52min- Talks of benefits of this for patients and how he was keen to try this with his patients. How he found it difficult to persuade the NHS to fund this treatment. Talks of the reasons such as outdated wrong attitudes towards POTS patients and how current advice is just not good enough from doctors currently. How only when a patient of his wrote to his MP about the intervention, was he able to give this to patients following a letter to him by said MP saying that on humanitarian grounds it should be given to this person as she struggles so much and is missing out on life. This then allowed more patients to be prescribed it.


16.53min- Talks about approx 30 of his worse POTS patients he is treating with the saline infusions and the results of this. How the vast majority have found this simple intervention transformative.

17.39min- Feedback from patients in their own words.


I really like this guy!

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wabi-sabi

Senior Member
Messages
1,458
Location
small town midwest
Umm... no.

It's quite correct that we don't know quite what causes POTS. Probably lots of stuff. IV or oral saline has been a known treatment for years. This is not a new miracle. Will it help you temporarily? Yes, just until you pee out the extra fluid that went in by IV.

Oral rehydration is safer and more effective than IV hydration, unless of course yo are in an emergency situation. Cort has done a lot of articles on this over the years.

https://www.healthrising.org/blog/2...al-rehydration-pots-chronic-fatigue-syndrome/

https://www.healthrising.org/blog/2...al-rehydration-pots-chronic-fatigue-syndrome/

Dysautonomia International also has good info on how to increase your salt and fluid intake.

http://www.dysautonomiainternational.org/pdf/RoweOIsummary.pdf
 

CSMLSM

Senior Member
Messages
973
They have said the effects only last a couple of days and they expect to suffer PEM.
Thats what it does for patients yes. It is a quick fix to a system that has broken down because of the constant state of flight or fight response (HPA axis) and hardly ever being in rest and digest, repair (cannabinoid system).
I believe this causes vasopressin V1a receptor desensitisation and thus POTS/Dysautonomia type symptoms.

I have recently linked vasopressin V1a receptor to thirst issues and POTS type symptoms from overactive stress response (HPA axis) I believe-
1- theory of excessive thirst from vasopressin issues due to either low vasopressin or more likely desensitisation of V1a receptors- Members Only - A place to ask Questions about Caryophyllene + related stuff! | Page 6 | Phoenix Rising ME/CFS Forums

2- How vasopressin 1a receptor desensitisation is more likely- Members Only - A place to ask Questions about Caryophyllene + related stuff! | Page 6 | Phoenix Rising ME/CFS Forums

3- How cannabinoid system relates to the HPA axis regulation- Members Only - A place to ask Questions about Caryophyllene + related stuff! | Page 6 | Phoenix Rising ME/CFS Forums

4- How this vasopressin ligand/receptor dysregulation relates to the PVN of the hypothalamus, blood pressure and HPA axis Vasopressin, Central Autonomic Control and Blood Pressure Regulation - PubMed (nih.gov)
Abstract
Purpose of review: We present recent advances in understanding of the role of vasopressin as a neurotransmitter in autonomic nervous system control of the circulation, emphasizing hypothalamic mechanisms in the paraventricular nucleus (PVN) involved in controlling sympathetic outflow toward the cardiovascular system.
Recent findings: Suggest that somato-dendritically released vasopressin modulates the activity of magnocellular neurons in the PVN and SON, their discharge pattern and systemic release. Advances have been made in uncovering autocrine and paracrine mechanisms controlling presympathetic neuron activity, involving intranuclear receptors, co-released neuroactive substances and glia. It is now obvious that intranuclear release of vasopressin and the co-release of neuroactive substances in the PVN, as well as the level of expression of vasopressin receptors, modulate sympathetic outflow to the cardiovascular system and determine vulnerability to stress. Further research involving patho-physiological models is needed to validate these targets and foster the development of more efficient treatment.

Mechanism of desensitization of the cloned vasopressin V1a receptor expressed in Xenopus oocytes - PubMed (nih.gov)
Abstract
The vasopressin V1a receptor exerts its effects by G protein-mediated increases in cytosolic Ca2+ (Cai2+) and activation of protein kinase C. The V1a receptor also undergoes autologous desensitization. To clarify the mechanism of this desensitization, we expressed the cloned receptor in Xenopus oocytes, and vasopressin-induced Cai2+ waves were examined as an index of V1a activation using confocal microscopy. Pretreatment of oocytes with a minimal concentration of vasopressin inhibited further generation of Cai2+ waves upon maximal stimulation. Such pretreatment did not abolish Cai2+ waves induced by subsequent microinjection of inositol trisphosphate, suggesting that this phenomenon represents receptor desensitization rather than depletion of inositol trisphosphate-sensitive Cai2+ stores. Pretreatment with phorbol dibutyrate, ionomycin, or 8-bromoadenosine 3',5'-cyclic monophosphate had no effect on vasopressin-induced Cai2+ waves. Oocytes recovered from desensitization within 1 h, but the microtubule inhibitor methyl-5-[2-thienylcarbonyl]-1H-benzimiidazol-2-yl)-carbamate (nocodazole) inhibited this recovery. Receptor binding sites were reduced by over 50% within 10 min of exposure to vasopressin, with no associated change in the Kd for the V1a receptor. These findings indicate that 1) expression of the cloned V1a receptor in Xenopus oocytes, coupled with subcellular Cai2+ imaging, provides a useful system to examine mechanisms of V1a desensitization, 2) the V1a receptor undergoes autologous desensitization in this experimental system, and 3) protein kinase C, Cai2+, and adenosine 3',5'-cyclic monophosphate do not appear responsible for this desensitization, but 4) microtubule-dependent recycling of the receptor is preserved in this system and may be important for receptor desensitization.
 

CSMLSM

Senior Member
Messages
973
Umm... no.

It's quite correct that we don't know quite what causes POTS. Probably lots of stuff. IV or oral saline has been a known treatment for years. This is not a new miracle. Will it help you temporarily? Yes, just until you pee out the extra fluid that went in by IV.

Oral rehydration is safer and more effective than IV hydration, unless of course yo are in an emergency situation. Cort has done a lot of articles on this over the years.

https://www.healthrising.org/blog/2...al-rehydration-pots-chronic-fatigue-syndrome/

https://www.healthrising.org/blog/2...al-rehydration-pots-chronic-fatigue-syndrome/

Dysautonomia International also has good info on how to increase your salt and fluid intake.

http://www.dysautonomiainternational.org/pdf/RoweOIsummary.pdf
You miss the point completely. What he is saying about the cause is the relevance and I am not saying this is a miraculous cure. I am using this to make a point. See my posts to Treeman.
 

CSMLSM

Senior Member
Messages
973
Is it helpful temporarily? Yes, but it's nothing new or groundbreaking. It won't cure you. Fluid and salt are the basic treatments for POTS that have been known for decades.
I know, not the point. The symptoms of POTS are and the constant flight or fight response and not being in rest and digest.
Again see my posts to Treeman!
 

Treeman

Senior Member
Messages
774
Location
York, England
I'm in York and know a me/CFS patient who is going to have this treatment with him soon. I'll report back on its effects.

Hi. My friend tried the treatment twice. Unfortunately the traveling to the hospital, the bright lights and noise left them over whelmed and they suffered a substantial crash after.

Their not undergoing further treatment.