POTS and Lyme Disease: Understanding the Link

In previous posts, I discussed POTS syndrome (postural orthostatic tachycardia syndrome), what it is, how it’s diagnosed, and some POTS treatment approaches. In this article, I’ll discuss some research that made a link in between POTS and lyme disease.

What’s Lyme Disease Got To Do With POTS?

Lyme disease is an illness that can develop after a particular form of a tick bite. It is a disease that affects many organ systems including the nerves, heart, and muscles. It begins as a rash known as erythema migrans that develop after the tick bite. Usually, lyme disease responds to antibiotics; however, there is a group of patients that develop what is known as the post-Lyme disease syndrome. This is a syndrome of fatigue, pain, and mental clouding known as “brain fog” that can severely affect someone’s quality of life. A piece of research by a group of US investigators from Ohio demonstrated a link between POTS and lyme disease by investigating patients with Lyme disease and the post-Lyme disease syndrome who also suffered from POTS syndrome.

A Study on Correlation between POTS Syndrome & Lyme Disease

The study included 5 patients who develop fatigue, orthostatic intolerance, and cognitive dysfunction years after having Lyme disease. Symptoms included dizziness and passing out in some, fatigue, poor exercise tolerance, headache, mental clouding, and palpitations. All of the patients were so limited they were essentially housebound. Testing including clinical exam and tilt table testing were used to diagnose POTS syndrome.

The group who were well experienced in the care of POTS syndrome patients treated patients with standard protocols. Physical training and increased sodium and water intake were used. If the symptoms of P.O.T.S persisted then medications were used, with a different combination of medicines used as felt necessary on an individualized patient basis. Treatments were considered successful if there was symptomatic improvement.

All of the patients responded to treatment of the POTS syndrome. All patients had improvement in the orthostatic symptoms, particularly fatigue. Three of the patients had complete disappearance of passing out episodes and the other two had a much-decreased frequency. Four of the five patients were able to resume usual daily activities.

Demonstrated Importance Of Treating POTS Syndrome

This study showed that in patients that have had Lyme disease. POTS syndrome was a clear component of the post-Lyme disease syndrome, a syndrome that can appear. Recognition of POTS syndrome was important in this group because once identified, the appropriate treatment of POTS syndrome resulted in improvement in disabling symptoms and quality of life. Physicians should therefore have a high index of suspicion for POTS syndrome in those with post-Lyme disease syndrome. It’s not possible to tell from this study just how many patients with post-Lyme disease syndrome may be affected, it may only be a few percent of patients. Importantly though, it was clearly demonstrated that a targeted and systematic treatment approach can significantly improve the quality of life for those with POTS syndrome.