Clinical Research Directory

Inclusion Criteria: * meets criteria for postural tachycardia syndrome (POTS) 1. a heart rate increase of ≥30 beats/min within 10 minutes of upright posture; 2. lack of orthostatic hypotension (blood pressure fall ≥ 20/10 mmHg within 3 minutes of standing); and 3. chronic symptoms during upright posture over at least 6 months, in the absence of any other acute cause. * in the follicular phase of the menstrual cycle (days 5-13 of a 28-day cycle) * POTS with primary central sympathetic activation (psPOTS) as defined as having resting MSNA ≥ 25 bursts/min * able and willing to provide informed consent. Exclusion Criteria: * pregnancy, * smoker, * BMI\>30 kg/m2, * deconditioned status (if available VO2max\<80% of predicted) * unable to withdraw from medications known to affect autonomic function, blood pressure or blood volume * systemic illnesses known to produce autonomic neuropathy, including but not limited to diabetes mellitus, amyloidosis, monoclonal gammopathies, and autoimmune neuropathies. * arteriosclerotic disease of carotid artery. History of neck surgery. * conditions associated with inflammatory processes, such as coronary artery disease, hypertension, smoking, hypercholesterolemia (or on statin therapy), rheumatoid arthritis, diabetes, * treatment with oral corticosteroids, current infections (e.g., urinary tract infection), or use of non-steroidal anti-inflammatory drugs. * other factors which in the investigator's opinion would prevent the subject from completing the protocol including clinically significant abnormalities in clinical, mental or laboratory testing.