Thread by @Lymenews

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Peter Rowe, MD: Lessons from ME/CFS that can inform Lyme disease as well as Long COVID
Professor of Pediatrics @HopkinsMedicine
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Peter Rowe, MD
Postural Orthostatic Intolerance #POTS is very common in ME/CFS.
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Peter Rowe, MD
Common forms of orthostatic intolerance. Frequently the heart rate will be above 120 BPM. #POTS #NMH
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Peter Rowe, MD
summary of the physiology of orthostatic intolerance. When patients stand they get a dramatic drop in blood flow to the brain.
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Peter Rowe, MD
Neurally mediated hypotension was first noted in the 1990's in children with chronic fatigue syndrome. #ME #CFS #POTS
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Peter Rowe, MD
POTS is treatable with medication
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Peter Rowe, MD
Heart rate is not always the best indicator. Measuring blood flow is a better indicator of orthostatic intolerance.
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Peter Rowe, MD
Many patients with POTS also have hyper mobility. This and reduction of cerebral blood flow is being researched in Long COVID as well #EDS #ME #CFS #LongLyme
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Peter Rowe, MD
Treatment for #POTS
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Peter Rowe, MD
Certain co-morbid factors make some people more prone including mast cell activation syndrome. We do a Physical Therapist type full-exam looking at limbs and spine. #CCI #TOS #MCAS

Peter Rowe, MD
Need to fully examine for co-morbid conditions in addition to infection.
Case 1: ME/CFS improved once the cervical spine was repaired.
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Peter Rowe, MD
Case2: Slight improvement with medications. More improvement after adding medications for MCAS & low dose naltrexone.
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Peter Rowe, MD
Other cases more complex form of florid POTS. MCAS appears to be a component in all of these cases. ME/CFS, dysautonomia, #LongCOVID & thinks we need to do research on patients with #LongLyme.
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Peter Rowe, MD
Webinars and support groups for ME/CFS, EDS, Long COVID.
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