Activate Now
ProHealth health Vitamin and Natural Supplement Store and Health
Home  |  Log In  |  My Account  |  View Cart  View Your ProHealth Vitamin and Supplement Shopping Cart
800-366-6056  |  Contact Us  |  Help
Facebook Google Plus
Fibromyalgia  Chronic Fatigue Syndrome & M.E.  Lyme Disease  Natural Wellness  Supplement News  Forums  Our Story
Store     Brands   |   A-Z Index   |   Best Sellers   |   New Products   |   Deals & Specials   |   Under $10   |   SmartSavings Club

Trending News

'Healthy' Foods Differ by Individual

Surprising Benefits of Cinnamon

Specific vitamin D levels linked to heart problems

A Sleep Intervention For Children With Autism: A Pilot Study

Higher vitamin D levels may be protective against acute rhinosinusitis

Basic Vitamin A Primer

Curcumin: The All In One Solution

Coconut oil can control overgrowth of a fungal pathogen in GI tract, study in mice suggests

Pilot Study: Measuring Relaxation Response to the iLs Dreampad

Researchers are on their way to predicting what side effects you'll experience from a drug

Print Page
Email Article

CFS Patients with POTS: Clinically Distinct Subgroup

  [ 448 votes ]   [ Discuss This Article ] • December 6, 2012

Clinical characteristics of a novel subgroup of chronic fatigue syndrome patients with postural orthostatic tachycardia syndrome
– Source: Journal of Internal Medicine, Dec 4, 2012

By I Lewis, J Newton, et al.

[Note: POTS is one of five types of orthostatic intolerance that collectively affect nearly all chronic fatigue syndrome (ME/CFS) patients, according to Dr. David Bell - see “Orthostatic Intolerance and Chronic Fatigue Syndrome.”]

Objectives: A significant proportion of patients with chronic fatigue syndrome (CFS) also have postural orthostatic tachycardia syndrome (POTS). We aimed to characterize these patients and differentiate them from CFS patients without POTS in terms of clinical and autonomic features.

Methods: A total of 179 patients with CFS (1994 Centers for Disease Control and Prevention criteria) attending one of the largest Department of Health-funded CFS clinical services were included in the study.

Outcome measures were:

1. Symptom assessment tools including the fatigue impact scale, Chalder fatigue scale, Epworth sleepiness scale (ESS), orthostatic grading scale (OGS) and hospital anxiety and depression scale (HADS-A and -D, respectively),

2. Autonomic function analysis including heart rate variability and

3. Hemodynamic responses including left ventricular ejection time and systolic blood pressure drop upon standing.


CFS patients with POTS (13%, n=24) were:

• Younger (29 +/- 12 vs. 42 +/- 13 years, P<0.0001) [probability the difference resulted by chance less than 1 in 10,000],

• Less fatigued (Chalder fatigue scale, 8 +/- 4 vs. 10 +/- 2, P=0.002),

• Less depressed (HADS-D, 6 +/- 4 vs. 9 +/- 4, P=0.01),

• And had reduced daytime hypersomnolence [hypersomnolence is excessive sleeping/sleepiness] (ESS, 7 +/- 6 vs. 10 +/- 5, P=0.02)…

…Compared with patients without POTS.

In addition, they exhibited greater orthostatic intolerance (OGS, 11 +/- 5; P<0.0001) and autonomic dysfunction.

A combined clinical assessment tool of Epworth sleepiness scale 9 or less and orthostatic grading scale 9 or more identifies accurately CFS patients with POTS with 100% positive and negative predictive values.


The presence of POTS marks a distinct clinical group of CFS patents, with phenotypic features differentiating them from those without POTS.

A combination of validated clinical assessment tools can determine which CFS patients have POTS with a high degree of accuracy, and thus potentially identify those who require further investigation and consideration for therapy to control heart rate.

Source: Journal of Internal Medicine, Dec 4, 2012. PMID:23206180, by Lewis I, Pairman J, Spickett G, Newton JL. Institute for Ageing & Health, Newcastle University, Newcastle, UK. [Email:]

Post a Comment

Featured Products From the ProHealth Store
Mitochondria Ignite™ with NT Factor® Vitamin D3 Extreme™ Optimized Curcumin Longvida®

Looking for Vitamins, Herbs and Supplements?
Search the ProHealth Store for Hundreds of Natural Health Products

Article Comments

Be the first to comment on this article!

Post a Comment

Free Chronic Fatigue Syndrome and Fibromyalgia Newsletters
Subscribe to
Subscribe Now!
Receive up-to-date ME/CFS, Fibromyalgia & Lyme Disease treatment and research news
 Privacy Guaranteed  |  View Archives

Repair Damaged Mitochondria and Reduce Fatigue Up to 45%

Featured Products

Vitamin D3 Extreme™ Vitamin D3 Extreme™
50,000 IU Vitamin D3 - Prescription Strength
Energy NADH™ 12.5mg Energy NADH™ 12.5mg
Improve Energy & Cognitive Function
Ultra ATP+, Double Strength Ultra ATP+, Double Strength
Get energized with malic acid & magnesium
FibroSleep™ FibroSleep™
The All-in-One Natural Sleep Aid
Optimized Curcumin Longvida® Optimized Curcumin Longvida®
Supports Cognition, Memory & Overall Health

Natural Remedies

Olea25 Olive Hydroxytyrosol Hits Astonishing 68,000+ ORAC Antioxidant Value Olea25 Olive Hydroxytyrosol Hits Astonishing 68,000+ ORAC Antioxidant Value
Prepare Yourself for Cold & Flu Season Prepare Yourself for Cold & Flu Season
The Remarkable Benefits of Reishi Medicinal Mushrooms The Remarkable Benefits of Reishi Medicinal Mushrooms
The Fast-Acting Solution for Healthy Digestive Function The Fast-Acting Solution for Healthy Digestive Function
Front Line Defense Against Colds & Flu - Support for Healthy Immune System Balance Front Line Defense Against Colds & Flu - Support for Healthy Immune System Balance

What is Fibromyalgia?
Fibromyalgia Diagnosis
Fibromyalgia Symptoms
Fibromyalgia Causes
Fibromyalgia Treatments
Fibromyalgia Diet
Fibromyalgia Medications
M.E. & CFS
What is M.E./CFS?
M.E./CFS Diagnosis
M.E./CFS Symptoms
M.E./CFS Causes
M.E./CFS Treatments
M.E./CFS Diet
M.E./CFS Medications
What is Lyme Disease?
Lyme Disease Diagnosis
Lyme Disease Symptoms
Lyme Disease Causes
Lyme Disease Treatments
Lyme Disease Diet
Lyme Disease Medications
M.E. & CFS
Lyme Disease
General Health
ProHealth on Facebook  ProHealth on Twitter  ProHealth on Pinterest  ProHealth on Google Plus
Credit Card Processing