I have Hyoer POTS. I am one of the rarer subset types with higher blood pressures. POTS is not based on your blood pressure but on your heart rate with upright posture. I do have the drops in my blood pressure but it starts from a higher baseline. So when it drops it may appear into a normal range - but it's too much of a drop too fast and can still cause extreme dizziness, naseau, near fainting and tachycardia to try to pull the Bp back up. The blood in the lower body,below heart level, can pool and not circulate properly and that's why probably there is an extreme release of NE to cause the heart to pump harder to get the much needed blood to the heart and head. If you have this Protozoa and biofilm issue, and narrowed veins due to it, with the autonomic nervous system is in overdrive because it needs to be as a compensation - that causes an extreme anxious feeling with the surge of too many catacholomines. Plus you may have pooling of you blood - mine because I have EDS (Ehlers Danlos) and this seems to be common in this subset type of POTS with MCAS. That's a cliff note version - it is much more complex. But you get the picture. For me, an abdominal binder works better than compression hose. The compression hose actually seem to cause more nerve damage to the small nerves and more issues with neuropathy. But I do wear them with long trip travel and if I pool too bad and have edema going on. Because of the higher BP I don't salt load like most POTS people do. And also having kidney issues - that's not a good thing. I'm not low salt - but I don't over salt either. I have research on this and the affect it can do to the veins and affects on kidneys. Corrosive. Also upsets kidney function of renin and aldosterone. Some POTS people are low in these two things - I am.