It wasn't a big study but it could be an important study. The authors supposed that having POTS would predispose young patients to having other common comorbid disorders such as ME/CFS, fibromyalgia, gut problems, migraines, etc. So they took young POTS patients and young patients with these other "functional disorders" and saw who had what.
They found that POTS patients didn't tend to have more of the other functional disorders than the other patients; i.e. POTS itself was not causing POTS patients to also have FM, ME/CFS and other other disorders. They were all kind of the same package; everyone had a mix of problems and some of those patients happened to have POTS. That suggested (to me) that something underneath all of those disorders is driving them.....some general dysfunction that shows up in various ways...
J Pediatr. 2015 Apr 24. pii: S0022-3476(15)00340-6. doi: 10.1016/j.jpeds.2015.03.039. [Epub ahead of print]
They found that POTS patients didn't tend to have more of the other functional disorders than the other patients; i.e. POTS itself was not causing POTS patients to also have FM, ME/CFS and other other disorders. They were all kind of the same package; everyone had a mix of problems and some of those patients happened to have POTS. That suggested (to me) that something underneath all of those disorders is driving them.....some general dysfunction that shows up in various ways...
J Pediatr. 2015 Apr 24. pii: S0022-3476(15)00340-6. doi: 10.1016/j.jpeds.2015.03.039. [Epub ahead of print]
Comorbid Conditions Do Not Differ in Children and Young Adults with Functional Disorders with or without Postural Tachycardia Syndrome.Chelimsky G1, Kovacic K1, Nugent M2, Mueller A1, Simpson P2, Chelimsky TC3.Author information
OBJECTIVE:
To determine if several multisystem comorbid conditions occur more frequently in subjects with tilt-table defined postural tachycardia syndrome (POTS) compared with those without.
STUDY DESIGN:
Retrospective chart review of 67 subjects aged 6-24 years, referred to a tertiary care neurogastroenterology and autonomic disorders clinic for a constellation of functional gastrointestinal, chronic pain, and autonomic complaints. All patients underwent formal autonomic testing, Beighton scores assessment for joint hypermobility (0-9), and fibromyalgia tender points (0-18) (43 subjects).
RESULTS:
Twenty-five subjects (37%) met tilt table criteria for POTS. The median age of 16 years (range, 12-24 years) in the POTS group differed from 15 years (range, 6-21 years) in the no-POTS group (P = .03). Comorbidities including chronic fatigue, sleep disturbances, dizziness, syncope, migraines, functional gastrointestinal disorders, chronic nausea, fibromyalgia, and joint hypermobility did not differ between groups. All subjects with fibromyalgia by tender point-examination had a Beighton score ≥4 (P = .002).
CONCLUSIONS:
Comorbid conditions are equally prevalent in children and young adults with and without tilt-table defined POTS, suggesting that POTS itself is not a cause of the other comorbidities. Instead, POTS likely reflects another comorbid condition in children with functional disorders. Dizziness and syncope, classically associated with POTS, are not predictive of a diagnosis of POTS by tilt table, a test that is still required for formal diagnosis.
These results suggest a paradigm shift in the concept of POTS as the physiological basis of many functional symptoms.