Midodrine for POTS

A full transcript is available at drsanjayguptacardiologist.com...
POTS is characterised by orthostatic intolerance. This means that patients feel significantly worse when they adopt an upright posture compared to when they are lying down. To try and find effective treatments, it is vital that we try and understand the physiology of what happens in the body when normal healthy people stand up.
When we stand up, blood in our vessels tends to get sucked down into our legs because of the effect of gravity. This means that there is less blood getting to our brain and ordinarily we would all pass out and fall because of a shortage of blood to the brain. This does not happen because two reflex mechanisms come into action which serve to maintain the blood flow to our brains. The first is regulated by stretch receptors in our blood vessels in the legs which try and constrict the best they can to prevent blood from pooling in the legs. Secondly the heart rate increases to try and maintain adequate blood flow to the brain. In some patients, the leg vessels don’t constrict as well and therefore they are not able to contribute to increasing the blood flow to the brain and therefore the body has to compensate for this by increasing the heart rate even further. As the heart rate goes up excessively the heart doesn’t have as much time to fill with blood and therefore pumps out less blood than it should which exacerbates the situation.
If we can in some way reduce the stretching of blood vessels especially in the lower limbs when we adopt an upright posture, it means that there is relatively more blood going round and less blood pooling which can improve symptoms.
Midodrine works by increasing the tone of our peripheral blood vessels and therefore reduces the likelihood of pooling of blood. It doesn’t really directly affect the heart as such but if there is more blood getting to the heart then that means that every heart beat is more effective and that can have the effect of improving orthostatic tolerance. Interestingly though this can also have an unwanted effect on the bladder. Because of the effect of the agent on tone, the bladder does not stretch as much and therefore bladder emptying is delayed.

Пікірлер: 90

  • @msnpassjan2004
    @msnpassjan20044 жыл бұрын

    Thank you from Ohio, USA. I don't have POTS but I still appreciate you taking the time to create this valuable content.

  • @Mellowmichelle
    @Mellowmichelle4 жыл бұрын

    You have literally saved my life, I just wanted to say thank you thank you! I was having bigeminy and horrible headaches andwas going to be put on beta blockers, luckily I stumbled on your vidoes about magnesium and within days my PVCs are almost gone! Headaches gone! You are amazing doctor I wish I could send you a huge gift basket!

  • @prathamrballal1229

    @prathamrballal1229

    3 жыл бұрын

    How is ur pvc and headache

  • @L.B.5.4.
    @L.B.5.4.4 жыл бұрын

    Thank you so much for taking the time to do this. I have been diagnosed with POTS and my doctor put me on this medication. She didn't explain much so I'm kind of hesitant take it so thank you for giving me more insight into it.

  • @MurrayPaws
    @MurrayPaws Жыл бұрын

    I have been following your videos since diagnosed with POTS. Thank you very much for this video and all the time you spend educating everyone. Just thank you. God bless you.

  • @IJustWantToUseMyName
    @IJustWantToUseMyName3 жыл бұрын

    Thank you for sharing your knowledge. I was recently put on Midodrine for POTS and it is nice to really understand what the doctor is trying to accomplish with it. Thank you for taking your time to make this video.

  • @ElizabethMillerTX
    @ElizabethMillerTX4 жыл бұрын

    Midodrine is the only thing that I have not tried for my POTS. But I've gone from being too weak to feed and dress myself, too weak to hold a bath towel, to being able to bench press half my bodyweight. My heart rate was about 60 lying and would double just by sitting up. Standing would immidiately triple it. I didn't need the 10 minutes. Now, I might not even meet the technical diagnostic criteria on a good day. But I still have POTS. I have the fatigue. And the many many other symptoms. I'm still sick. But I'm much improved. Hard to imagine taking on more RX when I have tried so hard to rid myself of them. Don't give up, y'all. Thanks for caring, Doc. My cardiologist could not possibly care less to help me deal with this. Had my annual visit. He had no idea to whom he was talking, or my diagnosis. Sigh.

  • @suzihazlove4979

    @suzihazlove4979

    4 жыл бұрын

    What did you do??????

  • @kausikroychowdhury1859
    @kausikroychowdhury18594 жыл бұрын

    Thank you for sharing your knowledge! There is so much to learn from you ...

  • @dianesinosky7227
    @dianesinosky72274 жыл бұрын

    I’m in the process of stepping up Midodrine as an experiment to deal with my orthostatic intolerance from CFS. I’m at 10mgx3times per day and have absolutely seen benefit in blunting my heart rate upon standing, with no increase in blood pressure (even when laying down). I have also observed a slight drop in RHR from 62 to 57, with an overall improvement in HRV.

  • @shirleyfretty487
    @shirleyfretty4874 жыл бұрын

    Thank you so much Dr. Gupta!!!!!

  • @ritamartin311
    @ritamartin3114 жыл бұрын

    This has helped me soo much I’m soo thankful for it ! Thanks Doctor for ur videos

  • @sarahturnbull7610
    @sarahturnbull76106 ай бұрын

    Excellent talk. Thank you, Dr Gupta.

  • @tammyfernandez7915
    @tammyfernandez79154 жыл бұрын

    Thank you for your video from New Jersey USA

  • @katbrit
    @katbrit4 жыл бұрын

    I have pots and midodrine has given me my life back. The side effects are well worth it

  • @suzihazlove4979

    @suzihazlove4979

    4 жыл бұрын

    What side effects? I felt migraines.....

  • @jasperp.5357

    @jasperp.5357

    3 жыл бұрын

    im hikinh my dosage to 10mg, cos the initial 2.5mg a day didnt do shit to me. so im still yet to find out midodrine's adverse effects, im willing to risk the side effects than to deal with daily POTS. wish me luck :)

  • @kalkidangobezie4078

    @kalkidangobezie4078

    2 жыл бұрын

    Where you buy midodrine

  • @cherylmollett3222
    @cherylmollett3222 Жыл бұрын

    Thanks for all the information on this topic

  • @patriciabennett1819
    @patriciabennett18194 жыл бұрын

    Hi Dr. Sanjay,this is valuable information.I cannot express enough how much that I am so grateful. You are so clever.A lot of people do not know this syndrome.Also some doctors are not aware.Tiredness is a huge problem.It is a daunting illness. I do prefer a method where less medication is used although maybe it will work. You are indeed a very experienced doctor I value all you say. I appreciate. Thank you so very much.

  • @SawmillerSmith
    @SawmillerSmith4 жыл бұрын

    Im 71 and your explanation of the blood vessels in the legs . What i do is i do a lot of leg exercises at the gym to exercise by blood vessels. It seems to help strengthen knees and improve balance..

  • @nerychristian

    @nerychristian

    4 жыл бұрын

    There is a supplement called Pine Bark Extract that is good for leg veins.

  • @Grey03
    @Grey038 ай бұрын

    Wow - someone that makes it make sense!

  • @vivojefe26
    @vivojefe264 жыл бұрын

    Please do a video on (1) potassium and heart heart health/palpitations and thyroid and heart palpitations.

  • @mariaroqueta3135
    @mariaroqueta31354 жыл бұрын

    I enjoy learning about all the issues of the heart Dr Gupta bc of ur clear and easy deliverance! I have CHF. Sending u much love from Florida 🌴♥️🌴

  • @YorkCardiology

    @YorkCardiology

    4 жыл бұрын

    Hi Maria. Thank you for your kind comments, I'm so pleased the videos have been helping you. Many thanks, Carrie, Dr. Gupta's Assistant

  • @heptoxidem3829
    @heptoxidem38292 жыл бұрын

    Doctor, would you please make another video about other meds for pots like Corlanor, Digoxin, Beta blockers. A lot of people now suffer from covid pots. Thank you dr. You are the best cardiologist on KZread

  • @daniellehammerschmidt5712
    @daniellehammerschmidt57124 жыл бұрын

    Thank you, very informative comme toujours ! The beard is nice! An old lady can make such a compliment!! 😂Grand bonjour de l’Allemagne!

  • @Naijamomlifeqmoves
    @Naijamomlifeqmoves2 жыл бұрын

    Very informative. The contraindications are very important. .

  • @annefraser6908
    @annefraser69084 жыл бұрын

    Thankyou Scotland

  • @Leigh_Leigh
    @Leigh_Leigh4 жыл бұрын

    Great information! I thought I had POTS for years. Recently I found out I had Paroxysmal Parasympathetic Syndrome which to me is similar to POTS. I was put on Bethanechol 3x a day and Midodren when needed. I can tell it’s helping. Dr have you ever treated anyone for Paroxysmal Parasympathetic Syndrome? Your thoughts on Bethanechol? Thank you 🙂👍🏼

  • @calidyme69
    @calidyme694 жыл бұрын

    Thank You. I wish my doctors weren't as inept as they are. I just asked my cardiologist about midodrine for my POTS, and dysautonomia, and he refused saying it could make things worse. I'm going to die dealing with U.S doctors, and just living in the U.S, at these times, in general.

  • @mariaroqueta3135

    @mariaroqueta3135

    4 жыл бұрын

    I’m in Florida, I have CHF, and the doctors here in the states r extremely disengaging & uninterested in our health as clients... of course not all but 95%

  • @comradebork

    @comradebork

    4 жыл бұрын

    Most physicians don't go to medical school because they want to practice medicine, they go to medical school because they want to _be doctors_ which is a completely different attitude. So their contempt for their clients is no surprise. There's no alternative than to keep searching, and remember it's not your fault if most **seem** to be jerks; most **are**.

  • @tonyproctor7143
    @tonyproctor71434 жыл бұрын

    Thanks Dr. I've been having what feels like pressure in my veins on my right calf muscle especially in the morning upon waking this only started when I went on testosterone replacement therapy because it was very low, would the testosterone be a cause for pots? When I stand up i nearly pass out I'm 44 fit train 5day's a week 13% body fat it's horrible feeling like this?

  • @KeepinItClassySoFU
    @KeepinItClassySoFU3 жыл бұрын

    Omg this is what I have!! I’ve been trying to explain to my doctors the feelings I have when my heart rate goes up and I feel it in my legs. My heart rate spikes just going up the stairs.

  • @elieibrahim4125
    @elieibrahim41254 жыл бұрын

    Amazing video Doctor, but I have a question. I have familial Mediterranean Fever , I take Colchicine and I have a lot of heart palpitations. I did all my tests but the doctor said everything is fine. So I want to ask if colchicine cause heart palpitations or not.

  • @mogahidtag3134
    @mogahidtag31342 жыл бұрын

    Thank you doctor, is there a side effect of developing hypertension when getting old ?

  • @sitaghimire9850
    @sitaghimire98504 жыл бұрын

    Sir I wanna beg you to make a video for a myocardities patient , how can it be completely healed?😣🙏🙏

  • @starrfishhill
    @starrfishhill4 жыл бұрын

    Your an amazing human being Doctor.. so willing to help millions of people... you’ll be 1st in-line at the Pearly Gates!!!!

  • @peggymicsky8607

    @peggymicsky8607

    2 жыл бұрын

    What a joke coming from you!

  • @Sterayb
    @SteraybАй бұрын

    I've been on it for a while but don't notice much on it but I've had chronic DVT in both legs so have to have compression socks on as well

  • @mariaroqueta3135
    @mariaroqueta31354 жыл бұрын

    Dr Gupta can u talk more about thyroid medications and how it can negatively effect the heart. I have been on armour thyroid for at least half of my life and I am 51 years old. Thank u! This would be very helpful to women & of course some men.⭐️🌴⭐️

  • @suzihazlove4979
    @suzihazlove49794 жыл бұрын

    How do you determine what kind of pots you have my neurologist never really told me....

  • @joybrooks564
    @joybrooks5644 жыл бұрын

    I don't have POTS either, but i wonder if midodrine slows down metabolism?

  • @leona5508
    @leona55084 жыл бұрын

    Hi doc I’m sixteen is there a way I could get in touch about something? I have a bounding pulse which I can see in my neck my stomach and palpitations.

  • @SeyiL-zk6lu
    @SeyiL-zk6lu3 жыл бұрын

    So I'm not sure if I have disautonamia. My heart rate skyrockets with any exertion but my heart rate actually skyrocket when I sleep. I also have pins and needles, feeling of cold water droplets on some parts of my body, and pins and needles when I eat carbs..not diabetic. I believe I had covid olin march but I recovered and dealing with these symptoms

  • @sumit5800
    @sumit58004 жыл бұрын

    Plz make a video on calcium channel blockers and which are better calcium channel blockers or beta blockers for ectopics

  • @jamesphillips9272
    @jamesphillips92724 жыл бұрын

    I'm a 43 year old 6'3" Male, was diagnosed with pots 10 years ago. Heart dr put me on .5 mg of clonidine 2x daily and 1mg of clonazepam 3x daily. Diagnosed me on a tilt table test and the nurse doing the test told me that my heart rate jumped from 77 to 113 in 3 seconds. Never had any of the postural issues that supposedly comes with pots. I work residential construction so I'm pretty active plus walk 1 mile every morning except sundays. Starting to believe I just have a mineral and vitamin deficiency. Time will tell

  • @emilysquires6464
    @emilysquires64642 жыл бұрын

    Can midodrine and ivabradine be used together?

  • @StartFromScratch1
    @StartFromScratch14 жыл бұрын

    Midodrine did nothing for me which was very suropising,to my.doctors and myself.Do you know why that could be?

  • @siobhancunningham2923
    @siobhancunningham29232 жыл бұрын

    I'm taking this twice a day 5mg but it lowers my heart rate to 50 is this normal??

  • @denverwilliams22
    @denverwilliams224 жыл бұрын

    Hey Doc, I have been to countless doctors and gastro specialists but no one can figure out what’s going on with me. I’m 21 and have pretty severe acid reflux, It was caused by me being very overweight as a teen. But ever since I can remember I have been able to feel my heartbeat in my stomach/ esophagus. Even when I’m not doing much, it’s always there. It does get more pronounced after a fatty or greasy meal. But I don’t believe it ever goes away. A few doctors have tried to put me on anxiety medication to see if it would help, but it did not. Do you have any idea why I am able to feel my heart? What would you recommend me to do?

  • @princessmari5063

    @princessmari5063

    2 жыл бұрын

    How are you doing now? Pray that you are better now. Blessings.

  • @FindMyAdventure
    @FindMyAdventure4 жыл бұрын

    Does POTS get better by itself? self recovery?

  • @Swansue
    @Swansue2 жыл бұрын

    Can those with clotting factors take this?

  • @sarahgordon2597
    @sarahgordon25975 ай бұрын

    i have very low hearr rate and low bp. i was diagonosed with pots but not the kind where heart rate increases, my blood pools in legs and i am dizzy and pass out. i am trying to understand the cause, maybe its low sodium or low thyroid or jsut the dysautomina itself. i am scared to take medicines that hurt me. i keep gong to er passing out. i am not needed my heart rate to go lower, it was 40 in er

  • @suzihazlove4979
    @suzihazlove49794 жыл бұрын

    Is it common to have Sensations in the body like you're being bitten by a bug and various body parts with neuropathic pots

  • @Malsawm_kima
    @Malsawm_kima4 жыл бұрын

    sir i had a OHS one year ago ASD closure,i am always underweight in my whole life and they say it is because of my hole in the heart,but it was closed,but i dont gain any weight and i am still underweight i eat alot,i count my calorie intake,,1700-2000calorie everyday,,but cant gain weight can you help me sir thanks for your reply🙏

  • @rebeccagilbert1749
    @rebeccagilbert17492 жыл бұрын

    This drug has helped me tremendously, and I am sooooo sensitive to meds that I didn't have much hope. (I can't tolerate beta blockers and calcium channel blockers, even in tiny doses. After hearing your talk here though, I'm wondering if I could tolerate beta blockers better, combined with the Midodrine...) I only take a microscopic dose that most people wouldn't even feel, (a quarter of a 2.5, twice a day!) but it makes a HUGE difference for my constant fatigue and dizziness. Thank you so much for all your wonderful work to aid POTS patients and help us to not feel like we're hypochondriacs, or crazy. !!!

  • @princessmari5063

    @princessmari5063

    Жыл бұрын

    I am about to try the Midodrine and super nervous about it 😭. I too am sensitive to any medication so will start very low too. Do you take beta blockers in addition to the midodrine? If so, do you take them at the same time or only as needed?

  • @StartFromScratch1
    @StartFromScratch14 жыл бұрын

    Mididrine didn‘t work for me at all- I have severe OI . is there an explanation why?

  • @robjones899
    @robjones8994 жыл бұрын

    I have a question? I was watching a interview with Warren buffet. He says he has drunk 5 cans of coke daily, eats junk food every day and many other no nos all his life. Why has this not caused him clogging of the heart, not that I want anything to happen to him, just find this interesting, thanks.

  • @djlongshlong
    @djlongshlong3 жыл бұрын

    Hi Doctor Sanjay. Could you please do a video on PoTS and ectopic beats? I used to never have ectopic beats in my life until I have developed PoTS symptoms. What I find really weird is that my mum has DVT and maybe this could be a correlation as to why I have PoTS. Whenever I stand up I get ectopic beats. I don’t leave my bed anymore 🤷🏼‍♀️

  • @prathamrballal1229

    @prathamrballal1229

    3 жыл бұрын

    Wht u did for eptopic beats

  • @nerychristian
    @nerychristian4 жыл бұрын

    Pine Bark Extract and Melatonin helped to improve my blood circulation.

  • @suzihazlove4979

    @suzihazlove4979

    4 жыл бұрын

    Are YOU SERIOUS? HOW did you find this combo?

  • @westitis2580
    @westitis25804 жыл бұрын

    Can you do a video on anomalous coronary artery from birth thank you

  • @grizzlegrowlsem
    @grizzlegrowlsem4 жыл бұрын

    I take it 3X a day! Love Midodrine

  • @simpletechvlogs
    @simpletechvlogs4 жыл бұрын

    I'm 21 I got w.p.w syndrome the weird thing is during stress test the delta wave disappeared and and when I'm relaxed it's starts to show again doc said wait for month and come back

  • @ericrosario5369

    @ericrosario5369

    3 жыл бұрын

    Well, what happened?

  • @jameskantor0459
    @jameskantor04594 жыл бұрын

    So in general do people with POTS have low blood pressure?

  • @69birdboy

    @69birdboy

    4 жыл бұрын

    There is a subset. Hyperadrenic pots

  • @darkbluematter1753

    @darkbluematter1753

    4 жыл бұрын

    Most people with POTS have lower blood pressure, I do, but there is a group of people with a type of POTS called hyperandrenergic POTS where people are more sensitive to adrenaline and get both high heart rate and high blood pressure. These people often have success with Beta blockers.

  • @babybrittyoung4889

    @babybrittyoung4889

    2 жыл бұрын

    @@darkbluematter1753 thank you

  • @michellestrickland2810
    @michellestrickland28102 жыл бұрын

    Does medicine cause anxiety

  • @rahamadadi955
    @rahamadadi955 Жыл бұрын

    You are a great dr, thank you for explaining, it's super helpful. By the way u got more handsome on 2023 with all the beard and everything 😂😂😂😂😂😂😂😂😂

  • @ripsaw2322
    @ripsaw23224 жыл бұрын

    I just wish I knew why I get PVC's 30 mins to an hour after I eat that last for hours and hours. Lately it seems to happen more often. What is wierd if I lean forward they stop immediatly. If I lean back in my chair they start back up again. In the ER I could actually see this work on the machine. Lean forward they stop, lean back they start. But these have been bugging me nearly a year every day. Cardiologist put my on a 24 hour monitor and said I was fine and that was that.

  • @hollyfisher8811

    @hollyfisher8811

    4 жыл бұрын

    Me too~Exactly what I get after eating a meal or even sometimes a snack...totally understand what you feel and can be exhausting😓:( I do have Atenenol for rapid heart rate so almost always end-up needing to take one of those, which then leaves me feeling even more tired yet need that calming or my heart bothers me for hours~Please do not give-up and find another Cardio Doc that cares and truly wants to help you feel better❤!!

  • @ripsaw2322

    @ripsaw2322

    4 жыл бұрын

    @@hollyfisher8811 I hate it! I just started a new magnesium tho and for the past few days Ive been pretty good! To good to be tru tho ya know!

  • @prathamrballal1229

    @prathamrballal1229

    3 жыл бұрын

    How is ur pvcs

  • @rmarvin211
    @rmarvin2113 жыл бұрын

    I’m a 44 year old man from South Texas. I was recently diagnosed from this syndrome. It has literally destroyed my life. To make matters worse I live in the Rio Grande Valley Texas therefore no healthcare Is available to me due to the virus overwhelming out hospitals. We are at max capacity at every hospital. My cardiologist does not do telemedicine and going to office visits is an extreme risk. So I’m going untreated because of this pandemic. I’m just drinking as much water as I can. Please if you can help me in any way that would mean a lot.

  • @jasperp.5357

    @jasperp.5357

    3 жыл бұрын

    This is where i got my Midodrine goldpharma.cn/search/gutron%20aca%20tbl.%20100%20st.%20n3/lang/ENGLISH/ I am experiencing the same as per healthcare, I live in Philippines, been to alot of doctors here and none of them know shit about POTS and Midodrine, they just kept telling me im anxious and some doctors even wanted to sent me to a Psychiatrist. They all refused to test me for POTS even though im experiencing all the symptoms of POTS. Since then, i just said fk them, im self medicating and managing this POTS myself.

  • @rmarvin211

    @rmarvin211

    3 жыл бұрын

    Jenny C. I was treated by a psychiatrist for a few months for anxiety disorder ! My cardiologist here in South Texas said I was crazy!!! But I knew something about as wrong! I did my own homework and found out about POTs! When I mentioned it to him he started launching and said that was for females and that I had psychiatric issues! Finally I went to see an electro cardio physiologist and he did a tilt table test! Low and behold there it was! It was POTs! But now this doctor doesn’t know how to treat it! He knows I have it but doesn’t know much about the syndrome! Which upsets me because it’s not like this is a new syndrome! It’s been around long enough for someone to know something!!!! Meanwhile I feel paralyzed and can’t do anything with my children!

  • @jasperp.5357

    @jasperp.5357

    3 жыл бұрын

    @@rmarvin211 Same here. All the doctors that suppose to treat Dysautonomias and POTs like Cardiologists and Neurologists said I was crazy, I was crying in their offices begging them to test me for Dysautonomias and POTS but they all refused and told me to go to Psychiatrists. Until the day come that I cannot even leave the house cos I cant even remain standing for an hour. Thats when I realized, I need to treat this myself cos these mfking inept doctors dont know shit, wont do shit and dont give a shit about their patients, apparently the 'Dr' title on their names are just words, they dont have the skills and compassion for it. So I fired them all, digged the internet for a year researching, searching for treatments and medications, and then I stumbled upon a European Online Pharmacy that sells Midodrine without prescription(online pharmacies like these are godsend, they make poor people like me afford medicines without going through alot of bullshit with alot of doctors). Im just starting on Midodrine yesterday, the lowest 2.5mg dose doesnt affect me, so now im hiking up my dosage to the adult recommended dosage which is 10mg, I hope this works or I have to hike up the dosage for another milligram(gosh). Anyway, I hope we all get through this, or atleast manage it to the point that we are almost normal, I have hope from things Ive read on the internet like online forums for POTS and the inputs of people with POTS like us are positive and theyre leading an almost normal life after also being told crazy by alot of doctors for years.

  • @locoemutwo4872
    @locoemutwo48724 жыл бұрын

    volume

  • @whitney8931
    @whitney89314 жыл бұрын

    Thank you so much for this video! I am so happy to find more KZread channels that have resources for POTS sufferers. I am newly diagnosed. My doc recently prescribed fludrocortisone and midodrine. I've yet to start the midodrine. Thank you so much for the info. I'd love if you'd check out my new channel all about my POTS and Dysautonomia. Subscribing now!! :)

  • @dvornikovalexei
    @dvornikovalexei2 ай бұрын

    No doctor has given me midodrine yet and it's a prescription drug😢

  • @ChiDraconis
    @ChiDraconis4 жыл бұрын

    Blackstrap Molasses as covid-19 prophylaxis: Blackstrap Molasses is rich in iron; Pt with blood-oxygen levels at 60-65% just talking normally like nothing wrong was noted by first team to Wuhan ~ the whole and entirety of the Angiotensin issue is something in the area of oxygen & heme