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Adrenal gland response to adrenocorticotropic hormone is intact in patients with POTS, 2023, Jill K H Laurin et al

Discussion in ''Conditions related to ME/CFS' news and research' started by Mij, Jun 30, 2023.

  1. Mij

    Mij Senior Member (Voting Rights)

    Many patients with postural orthostatic tachycardia syndrome (POTS) are hypovolemic with plasma volume deficits of 10–30 %. Some also have low levels of aldosterone and diminished aldosterone-renin ratios despite elevations in angiotensin II, pointing to potential adrenal dysfunction. To assess adrenal gland responsiveness in POTS, we measured circulating levels of aldosterone and cortisol following adrenocorticotropin hormone (ACTH) stimulation.

    While on a low Na+ diet (∼10 mEq/day), 8 female patients with POTS and 5 female healthy controls (HC) received a low dose (1 μg) ACTH bolus following a baseline blood sample. After 60 min, a high dose (249 μg) infusion of ACTH was administered to ensure maximal adrenal response. Venous aldosterone and cortisol levels were sampled every 30 min for 2 h.

    Aldosterone increased in both groups in response to ACTH but was not different between POTS vs. HC at 60 min (53.5 ng/dL [37.8–61.8 ng/dL] vs. 46.1 ng/dL [36.7–84.9 ng/dL]; P = 1.000) or maximally (56.4 ng/dL [49.2–67.1 ng/dL] vs. 49.5 ng/dL [39.1–82.8 ng/dL]; P = 0.524). Cortisol increased in both groups in response to ACTH but was not different in patients with POTS vs. HC at 60 min (39.9 μg/dL [36.1–47.7 μg/dL] vs. 39.3 μg/dL [35.4–46.6 μg/dL]; P = 0.724) or maximally (39.9 μg/dL [33.9–45.4 μg/dL] vs. 42.0 μg/dL [37.6–49.7 μg/dL]; P = 0.354).

    ACTH appropriately increased the aldosterone and cortisol levels in patients with POTS. These findings suggest that the response of the adrenal cortex to hormonal stimulation is intact in patients with POTS.

    Milo, Sid, Trish and 5 others like this.
  2. Hutan

    Hutan Moderator Staff Member

    Aotearoa New Zealand
    Thanks for posting. It's a small study, but it's certainly not confirming the 'HPA axis' idea that so many people who think these sorts of conditions are a result of emotional stress favour.
    Milo, RedFox, Mij and 3 others like this.

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