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Fludrocortisone and POTS/Dysautonomia

In this blog post, we'll be taking a look at fludrocortisone. We will learn how it works and how it's used to help people with POTS.


What is POTS?

First, let’s define POTS. Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that falls under the umbrella of dysautonomia—a group of disorders related to dysfunction of the autonomic nervous system. The term “autonomic” refers to the self-governing nature of this system, which controls involuntary functions that we do not consciously regulate. These include breathing, digestion, heart rate, blood pressure, body temperature, sweating, and more.


What is Fludrocortisone?

Fludrocortisone is a corticosteroid, a mild steroid, used to expand your plasma volume. It does this by increasing salt retention via the kidneys.


It is typically prescribed in doses of 50 to 300 micrograms and is usually taken once a day.


How Does Fludrocortisone Help People With POTS?

By increasing sodium retention, fludrocortisone also increases overall blood volume, which can help reduce episodes of low blood pressure.


With greater hydration, your body will be better equipped to manage blood pressure shifts when you stand or take part in strenuous activities.


Important Considerations While Taking Fludrocortisone:

  • Drink 2-3 liters of water daily.

  • Increase salt intake, as your body will need more to replenish sodium levels.

  • Increase potassium intake, since low potassium is a common side effect.


For more information about side effects or fluid management, click here.


Conclusion

Fludrocortisone can be an effective treatment option for managing symptoms of POTS by helping to increase blood volume and stabilize blood pressure. However, it's often a second-line drug used when midodrine is not well tolerated.



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