Managing fatigue in postural tachycardia syndrome (PoTS): The Newcastle approach

Fatigue is a significant symptom that is frequently reported by those with postural tachycardia syndrome (PoTS). There are a variety of reasons why those with PoTS might experience fatigue and as a consequence an individualised approach to management is most appropriate. In this chapter we will examine the prevalence of fatigue in those with PoTS, its overlap with conditions such as chronic fatigue syndrome and describe a clinical approach to the management of fatigue in those with PoTS.

[1]  A. Komaroff,et al.  Does the chronic fatigue syndrome involve the autonomic nervous system? , 1997, The American journal of medicine.

[2]  J. Newton,et al.  Postural orthostatic tachycardia syndrome is an under-recognized condition in chronic fatigue syndrome. , 2008, QJM : monthly journal of the Association of Physicians.

[3]  J. Newton,et al.  Fatigue in non-alcoholic fatty liver disease (NAFLD) is significant and associates with inactivity and excessive daytime sleepiness but not with liver disease severity or insulin resistance , 2008, Gut.

[4]  G. Antonutto,et al.  Cardiovascular deconditioning in microgravity: some possible countermeasures , 2003, European Journal of Applied Physiology.

[5]  T. Marrie,et al.  Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. , 1994, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[6]  G. Bury,et al.  Prevalence of fatigue in general practice , 2002, Irish journal of medical science.

[7]  J. Newton,et al.  The evolution of the Newcastle CRESTA Fatigue Clinic: a unique NHS multidisciplinary approach to fatigue , 2015 .

[8]  I. Nazareth,et al.  Health care resource use by patients before and after a diagnosis of chronic fatigue syndrome (CFS/ME): a clinical practice research datalink study , 2017, BMC Family Practice.

[9]  J. Newton,et al.  A concept mapping study evaluating the UK's first NHS generic fatigue clinic , 2015, Health expectations : an international journal of public participation in health care and health policy.

[10]  M. Molokhia,et al.  RESEARCH ARTICLE Open Access Prevalence of myalgic encephalomyelitis/chronic , 2022 .

[11]  S. Wessely,et al.  Development of a fatigue scale. , 1993, Journal of psychosomatic research.

[12]  M. Meeus,et al.  Assessment of activity limitations and participation restrictions with persons with chronic fatigue syndrome: a systematic review , 2015, Disability and rehabilitation.

[13]  G. Bleijenberg,et al.  Kinesiophobia, catastrophizing and anticipated symptoms before stair climbing in chronic fatigue syndrome: an experimental study , 2012, Disability and rehabilitation.

[14]  J. Newton,et al.  Postural tachycardia syndrome is associated with significant symptoms and functional impairment predominantly affecting young women: a UK perspective , 2014, BMJ Open.

[15]  A. B. Kuhlman,et al.  The effect of age and unilateral leg immobilization for 2 weeks on substrate utilization during moderate‐intensity exercise in human skeletal muscle , 2016, The Journal of physiology.

[16]  A. Hakim,et al.  Chronic fatigue in Ehlers–Danlos syndrome—Hypermobile type , 2017, American journal of medical genetics. Part C, Seminars in medical genetics.

[17]  David C. Jones,et al.  Population prevalence and symptom associations of autonomic dysfunction in primary biliary cirrhosis , 2007, Hepatology.

[18]  T. Theoharides,et al.  Chronic fatigue syndrome, mast cells, and tricyclic antidepressants. , 2005, Journal of clinical psychopharmacology.

[19]  A. Mann,et al.  Tired, weak, or in need of rest: fatigue among general practice attenders. , 1990, BMJ.

[20]  D. P. Lewis,et al.  Comorbidity of postural orthostatic tachycardia syndrome and chronic fatigue syndrome in an Australian cohort , 2014, Journal of internal medicine.

[21]  B. Levine,et al.  The international POTS registry: Evaluating the efficacy of an exercise training intervention in a community setting. , 2016, Heart rhythm.

[22]  J. Newton,et al.  Fatigue in early renal disease , 2009 .

[23]  H. Meltzer,et al.  Clarifying the relationship between unexplained chronic fatigue and psychiatric morbidity: results from a community survey in Great Britain , 2003, The American journal of psychiatry.

[24]  W. Ng,et al.  Primary Sjogren's syndrome: too dry and too tired. , 2010, Rheumatology.

[25]  N. Larocca,et al.  The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. , 1989, Archives of neurology.

[26]  C. Cook,et al.  Measurement Properties of the Central Sensitization Inventory: A Systematic Review , 2018, Pain practice : the official journal of World Institute of Pain.

[27]  J. Newton,et al.  Making sense of fatigue. , 2010, Occupational medicine.

[28]  Lauren B. Krupp,et al.  Fatigue in multiple sclerosis. , 1988, Archives of neurology.

[29]  P Wallace,et al.  Population based study of fatigue and psychological distress , 1994, BMJ.

[30]  J. Stewart Chronic orthostatic intolerance and the postural tachycardia syndrome (POTS). , 2004, The Journal of pediatrics.

[31]  J. Nijs,et al.  Rehabilitation for patients with myalgic encephalomyelitis/chronic fatigue syndrome: time to extent the boundaries of this field , 2016, Journal of internal medicine.

[32]  K. Miwa Variability of postural orthostatic tachycardia in patients with myalgic encephalomyelitis and orthostatic intolerance , 2016, Heart and Vessels.

[33]  J. Weinberg,et al.  Ehlers–Danlos Syndrome and Postural Tachycardia Syndrome: A relationship study , 2014, Journal of the Neurological Sciences.

[34]  J. Ricci,et al.  Fatigue in the U.S. Workforce: Prevalence and Implications for Lost Productive Work Time , 2007, Journal of occupational and environmental medicine.

[35]  J. Newton,et al.  A profile of patients with postural tachycardia syndrome and their experience of healthcare in the UK , 2016 .

[36]  A. Agarwal,et al.  Postural orthostatic tachycardia syndrome , 2007, Postgraduate Medical Journal.