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  • Improvement of hyperadrenergic postural orthostatic tachycardia syndrome (POTS) with methylated B vitamins in the setting of a heterozygous COMT Val158Met polymorphism

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Case report
Improvement of hyperadrenergic postural orthostatic tachycardia syndrome (POTS) with methylated B vitamins in the setting of a heterozygous COMT Val158Met polymorphism
  1. Nikita Mittal1,
  2. Ariel Portera2 and
  3. Pam Taub1
  1. 1Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, La Jolla, California, USA
  2. 2Division of Family Medicine, Department of Medicine, University of California San Diego, La Jolla, California, USA
  1. Correspondence to Nikita Mittal; nmittal{at}health.ucsd.edu

Abstract

A middle-aged woman was diagnosed with postural orthostatic tachycardia syndrome based on her clinical symptoms, elevated norepinephrine levels and positive tilt-table test. The patient was refractory to conventional treatment and improved only after she was treated with methylated B vitamins for her heterozygous catechol-O-methyltransferase Val158Met polymorphism.

  • cardiovascular medicine
  • cardiovascular system

http://dx.doi.org/10.1136/bcr-2021-245012

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    Footnotes

    • Contributors NM, AP and PT contributed to the design and implementation of the research, to the analysis of the results and to the writing of the case report.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests PT: Amgen (consultant) Novo-Nordisk (consultant) Sanofi (consultant) Boehringer-Ingelheim (consultant) Epirium Bio (shareholder) Esperion therapeutics (consultant).

    • Provenance and peer review Not commissioned; externally peer reviewed.