Topics
26 topics, grouped by pillar in a suggested reading order. Each one shows its sources, the level of evidence behind each statement and who reviewed it.
POTS
- What is POTS?What POTS is, what the published criteria say, who it affects and what is still debated, with the level of evidence behind each statement.
- What are the symptoms of POTS and how do they affect daily life?POTS combines difficulty tolerating an upright position with symptoms that can affect several body systems and limit daily activities.
- How is POTS evaluated: active stand test, tilt-table test and other tests?How POTS is evaluated: clinical history, heart rate and blood pressure measured lying and standing, an ECG and targeted tests to look for other causes.
- Managing POTS: what do the guidelines say?An overview of the approaches described in guidelines, with no individual advice or doses: choices are made together with a health professional.
- POTS in adolescents: criteria, specific features and outcomesIn adolescents, POTS heart-rate criteria differ from those used in adults, and pediatric data on diagnosis and outcomes remain incomplete.
Dysautonomia
- What is the autonomic nervous system, and what is dysautonomia?What the autonomic nervous system controls, what the term dysautonomia covers, and why it does not refer to a single disease.
- What is orthostatic intolerance, and what are its main forms?What orthostatic intolerance covers, and how POTS, orthostatic hypotension and reflex syncope differ according to the published criteria.
- Which tests can be used to assess the autonomic nervous system?The main autonomic tests (tilt test, active stand, Valsalva, deep breathing, sweat tests): what each one measures and the limits of interpretation.
- What is small fiber neuropathy, and what links with POTS have been studied?Understanding small nerve fibers, the tests used to assess them and the limits of the studies carried out in people with POTS.
- Can a viral infection be followed by dysautonomia?What studies show about autonomic disorders after viral infections, including COVID-19, and why they do not prove that the infection is the cause.
Hypermobility
- What is the difference between joint hypermobility, HSD and hypermobile EDS?Hypermobility can be an isolated trait or part of a hypermobility spectrum disorder (HSD) or hypermobile EDS. Here is what sets them apart.
- What do the 2017 diagnostic criteria for hypermobile EDS require, and what are their limits?The 2017 criteria combine generalized hypermobility, clinical features and the exclusion of other diagnoses. They are not a self-test.
- What symptoms are described in hypermobile EDS: pain, fatigue and associated features?Pain, instability and fatigue are often described; the features present and their severity vary widely from one person to another.
- How is joint hypermobility assessed in children and adolescents?In children, joint mobility changes with growth: a specific pediatric framework avoids applying adult criteria too early.
MCAS
- What is a mast cell, and what is mast cell activation syndrome (MCAS)?Mast cells are immune cells that live in tissues. MCAS refers to systemic episodes of mast cell activation that meet specific criteria.
- What are the consensus criteria for MCAS, and where does the controversy lie?The ECNM-AIM framework requires three criteria to be met together. Broader definitions exist, but their status and validation differ.
- What is the difference between MCAS, mastocytosis and allergies?These conditions can involve mast cells, but their mechanisms and diagnostic criteria differ, and they can coexist.
- What do tryptase and hereditary alpha-tryptasemia mean?Acute tryptase, baseline tryptase and hereditary alpha-tryptasemia answer different questions and do not replace a clinical diagnosis.
Associated conditions
- POTS and long COVID: what do studies show?Studies describe autonomic problems after COVID-19, but how often they occur varies widely between cohorts and criteria.
- What are myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and post-exertional malaise?Understanding ME/CFS, post-exertional malaise, the published criteria (IOM/NAM, NICE) and what sets post-exertional malaise apart from ordinary fatigue.
- What is fibromyalgia, and what links with POTS, hypermobility and ME/CFS are being studied?Definition of fibromyalgia, published diagnostic criteria and the limits of studies on its coexistence with hypermobility, dysautonomia and ME/CFS.
- Which digestive problems are described in POTS, hypermobility and hypermobile Ehlers-Danlos syndrome?Telling apart digestive symptoms, disorders of gut-brain interaction (DGBI) and documented dysmotility in people with POTS or hEDS/HSD.
- What is known about brain fog and cognitive difficulties in POTS, ME/CFS, fibromyalgia and long COVID?Attention, memory and processing-speed difficulties: what studies show, without reducing brain fog to a single diagnosis.
Cross-cutting
- What do studies show about the association between hypermobility and POTS?POTS and hypermobility disorders coexist in some cohorts, but the figures vary and do not demonstrate causation.
- Has the POTS, hEDS and MCAS "triad" been proven?Clinical overlap between POTS, hEDS and MCAS has been described, but no common cause and no validated diagnostic triad has been demonstrated.
- Bilingual English–French glossary: 40 key termsForty key terms in English and French (ME/CFS, post-exertional malaise, fibromyalgia, digestive disorders, cognition) with short definitions and sources.