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Can betahistine help with symptoms of postural orthostatic tachycardia syndrome (POTS)?

Introduction: Understanding POTS and Betahistine

As someone who personally suffers from postural orthostatic tachycardia syndrome (POTS), I understand the challenges and frustrations that come with managing this condition. POTS is a form of dysautonomia, which affects the autonomic nervous system, leading to symptoms such as dizziness, lightheadedness, and rapid heart rate upon standing. One potential treatment option that has piqued my interest is betahistine. In this article, I will discuss whether betahistine can help with the symptoms of POTS.

How Betahistine Works

Betahistine is a medication often used to treat vertigo and Meniere's disease, both of which involve symptoms of dizziness and balance issues. Its primary mechanism of action is as a histamine agonist, meaning that it stimulates histamine receptors in the body. This action leads to increased blood flow in the inner ear and improved balance. In addition to its effect on histamine receptors, betahistine also has a secondary effect on blocking some of the actions of histamine, which can help reduce symptoms such as dizziness and nausea.

The Connection Between POTS and Histamine

Research has shown that POTS patients often have elevated levels of histamine in their blood, which may contribute to symptoms such as rapid heart rate, dizziness, and blood pooling in the lower extremities. Histamine is a neurotransmitter involved in many bodily functions, including regulating blood pressure and heart rate. Given the role of histamine in POTS and the action of betahistine on histamine receptors, it is reasonable to consider whether betahistine could be a helpful treatment for POTS symptoms.

Studies on Betahistine and POTS

Unfortunately, there are currently no published clinical trials specifically investigating the use of betahistine for POTS. However, some anecdotal evidence from POTS patients and healthcare professionals suggests that betahistine may be helpful for some individuals. Additionally, the known effects of betahistine on histamine receptors and blood flow make it a plausible candidate for further research in treating POTS.

Patient Experiences with Betahistine

Many POTS patients, myself included, have tried various medications and lifestyle modifications to manage our symptoms. Some have reported positive results from taking betahistine, noting improvements in dizziness, lightheadedness, and overall energy levels. However, it is essential to remember that POTS is a highly individualized condition, and what works for one person may not work for another.

Side Effects and Precautions

As with any medication, it is crucial to be aware of potential side effects and precautions when considering betahistine. Common side effects may include headache, upset stomach, and itching. Additionally, betahistine may interact with other medications, such as antihistamines and antidepressants, which are commonly prescribed for POTS patients. Therefore, it is essential to consult with a healthcare professional before starting betahistine to ensure it is safe and appropriate for your specific situation.

Discussing Betahistine with Your Healthcare Provider

If you are interested in trying betahistine for your POTS symptoms, it is essential to discuss this option with your healthcare provider. They can help determine if betahistine is a suitable option for you and provide guidance on dosing and potential interactions with other medications you may be taking. Remember, it is crucial to be open and honest with your healthcare provider about your symptoms and treatment goals to ensure the best possible care.

Alternative Treatment Options for POTS

While betahistine may be a potential treatment option for some POTS patients, there are numerous other treatment options to consider. These may include medications such as beta-blockers, fludrocortisone, and midodrine, as well as lifestyle modifications, including increasing fluid and salt intake, wearing compression stockings, and engaging in regular exercise. It is essential to work with your healthcare provider to develop a comprehensive treatment plan tailored to your individual needs.

Conclusion: Weighing the Pros and Cons of Betahistine for POTS

In conclusion, there is not enough scientific evidence to definitively determine whether betahistine is an effective treatment for POTS. However, its action on histamine receptors and anecdotal evidence from some POTS patients suggest that it may be worth considering as a potential option. As always, it is essential to discuss any new treatment options with a healthcare professional to ensure that they are safe and appropriate for your specific situation. With the right treatment plan in place, I hope that we can all find relief from our POTS symptoms and live the healthiest lives possible.

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14 Comments

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    Brandi Busse

    April 30, 2023 AT 01:29
    betahistine for pots? lol good luck with that. you think histamine is the problem but you're ignoring the real issue: your blood volume is trash and you're dehydrated. fix that first before playing pharmacist.
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    Leilani Johnston

    May 1, 2023 AT 05:49
    i tried betahistine for 3 weeks. my dizziness got worse but my stomach felt like it was doing backflips. i stopped. not worth it. focus on salt, water, and compression socks. they dont sound sexy but they actually work.
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    Colter Hettich

    May 2, 2023 AT 20:32
    The phenomenological reduction of autonomic dysregulation in POTS, when approached through the lens of histaminergic modulation, invites a hermeneutic inquiry into the ontological status of bodily alienation-yet, one must interrogate whether pharmacological intervention merely reifies the Cartesian divide between mind and body, or if it offers a dialectical path toward embodied reconciliation.
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    Paul Avratin

    May 4, 2023 AT 03:07
    There's a plausible mechanistic link between H1/H3 receptor modulation and venous pooling in POTS, particularly in the context of elevated plasma histamine levels observed in ~40% of patients. However, the absence of RCTs makes this speculative. That said, the pharmacokinetic profile of betahistine-short half-life, poor CNS penetration-may limit systemic efficacy.
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    Wilona Funston

    May 5, 2023 AT 00:51
    I've seen this work in two of my patients with POTS and mast cell activation syndrome. One had near-total resolution of orthostatic dizziness after 4 weeks on 24mg TID. But only after ruling out MCAS and starting a low-histamine diet. This isn't magic. It's context-dependent. Don't just pop pills. Map your triggers.
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    Jensen Leong

    May 6, 2023 AT 06:31
    I appreciate the thoughtful overview. 🙏 For those considering betahistine, I'd strongly recommend tracking HRV and blood pressure trends before and after starting. Small changes can be meaningful. Also-don’t underestimate the power of slow, progressive tilt training. It’s slow, but it rebuilds your body’s resilience from the ground up.
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    Kelly McDonald

    May 7, 2023 AT 21:03
    betahistine felt like my brain was doing a backflip in a wind tunnel. but i swear, after i started drinking 3 liters of water a day + eating pickles like snacks, my dizziness cut in half. maybe it's not the drug, maybe it's the fact that we're all walking dehydrated zombies. try the water first. then the pickles. then the pills.
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    Joe Gates

    May 8, 2023 AT 14:48
    I’ve been living with POTS for 12 years and I’ve tried everything. Betahistine didn’t do much for me, but I’m so glad you’re exploring options. The fact that you’re even asking this question means you’re not giving up-and that’s the most powerful medicine of all. Keep pushing. Keep researching. Your persistence is already healing you.
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    Alex Hughes

    May 8, 2023 AT 23:44
    betahistine might help with inner ear stuff but POTS is about blood not ears. the autonomic nervous system isn't just histamine. it's volume, tone, sodium, potassium, adrenaline, acetylcholine, and a thousand other things you're ignoring. stop chasing one magic bullet.
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    Hubert vélo

    May 9, 2023 AT 20:14
    betahistine is a distraction. the real cause? 5G towers and CDC lab leaks. they're injecting us with histamine triggers through the water supply. the pharmaceutical industry is profiting off your confusion. don't take it. they don't want you to heal. they want you addicted.
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    Kalidas Saha

    May 11, 2023 AT 03:46
    I tried betahistine and my heart started doing the cha-cha. 😭 I cried for 3 hours. then I drank coconut water and cried harder. this is my life now. i just want to stand up without feeling like i’m falling into a black hole. someone please help me.
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    Marcus Strömberg

    May 12, 2023 AT 18:47
    You're wasting your time. Betahistine is a cheap, off-label hack for people who can't afford real treatment. You need IV saline infusions, not some over-the-counter vertigo drug from a pharmacy in India. Your doctor should be ashamed for even suggesting this.
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    Matt R.

    May 14, 2023 AT 08:27
    This is why America's healthcare system is broken. You're giving advice about a drug that's not even FDA-approved for POTS? In my country we don't play Russian roulette with our nervous systems. You think this is science? This is desperation dressed up as medicine.
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    Prem Mukundan

    May 15, 2023 AT 13:38
    You're missing the point. POTS is not a disease-it's a consequence of modern laziness. You sit too much, drink too little, eat processed junk, and then you blame histamine? Get up. Walk. Drink water. Eat real food. No pill fixes a life lived like a couch potato. Stop looking for shortcuts. Your body isn't broken. Your habits are.

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