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Mysterious Illness - Diabetes?, Vertigo?, Low Bp?

My husband has been experiencing a variety of medical problems over the past year. Initially, he was displaying symptoms of reactive hypoglycemia. We controlled this with diet fairly well for about a month and his doctor advised him to take a liquid vitamin which also seemed to help for a little while. He then began to have high blood sugars (250 - 300). His endocrinologist put him on glycet which also seemed to help for a short time. His gp picked up on low blood pressure and advised him to increase his salt intake. This helped but again he returned to feeling bad. He currently complains of dizzy, lightheaded, drunken type feelings. The doctor is treating him for vertigo with a patch called transderm scop. The patch helps but some days my husband can barely function so he sleeps. We are trying to schedule an MRI but are fighting with the insurance company and we have an appointment to see a neurologist this week. Have you ever heard of anything like this?
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replied December 28th, 2017

Postural orthostatic tachycardia syndrome (POTS) is a form of dysautonomia that is a form of orthostatic intolerance that is associated with the presence of excessive tachycardia, Lowered blood pressure and many other symptoms upon standing.

Many POTS patients also experience fatigue, headaches, lightheadedness, heart palpitations, exercise intolerance, nausea, diminished concentration, tremulousness (shaking), syncope (fainting), coldness or pain in the extremities, chest pain and shortness of breath.

Some patients have fairly mild symptoms and can continue with normal work, school, social and recreational activities. For others, symptoms may be so severe that normal life activities, such as bathing, housework, eating, sitting upright, walking or standing can be significantly limited.

POTS is typically diagnosed through a variety of tests, the most common of which is called a tilt table test. With this test, patients are strapped to a table which is tilted to simulate the process of standing up by forcing blood from the upper body to the legs.

There is no complete cure to the condition, but treatment is directed to control symptoms and improve the quality of life. Primary modes of management include diet management, exercise, and medication. Diets that are high in sodium and low in gluten have proven to be effective in some patients.

Compression stockings (full length to the waist) that compress the legs and help prevent pooling of blood in the lower extremities and hence reduce the symptoms. The degree of compression that is most effective will be at least 30mmHg.

Increased fluid and salt intake, low carbohydrate and small sized meals is necessary.

Alcohol, Caffiene and energy drinks should be avoided, as they can worsen orthostasis and have been associated with triggering POTS episodes. Those with GI symptoms should consider gluten and dairy intolerance and follow a gluten and dairy free diet.

Medications to improve the symptoms including betablockers, vasoconstrictors , SSRIs, Benzodiazepines, and desmopressin fludrocortisone can be prescribed as per patients requirements.

Hence consult your treating doctor or cardiologist who can help you manage the condition and improve your symptoms.

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