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

Nikita Mittal; Ariel Portera; Pam Taub

doi:10.1136/bcr-2021-245012

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

BMJ Case Rep. 2021 Nov 11;14(11):e245012. doi: 10.1136/bcr-2021-245012.

Authors

Nikita Mittal¹, Ariel Portera², Pam Taub³

Affiliations

¹ Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, La Jolla, California, USA [email protected].
² Division of Family Medicine, Department of Medicine, University of California San Diego, La Jolla, California, USA.
³ Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, La Jolla, California, USA.

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.

Keywords: cardiovascular medicine; cardiovascular system.

Publication types

Case Reports

MeSH terms

Catechol O-Methyltransferase / genetics
Female
Heart Rate
Humans
Middle Aged
Norepinephrine
Postural Orthostatic Tachycardia Syndrome* / drug therapy
Postural Orthostatic Tachycardia Syndrome* / genetics
Tilt-Table Test
Vitamin B Complex* / therapeutic use

Substances

Vitamin B Complex
COMT protein, human
Catechol O-Methyltransferase
Norepinephrine