What they did:

Measured norepinephrine (the “fight‑or‑flght” hormone) in legs versus arms to see if nerves were working correctly.

What they found:

People with neuropathic POTS release less norepinephrine in their legs, so vessels don’t tighten well when standing—blood pools in the legs, and the heart races to compensate.

Why it matters for you:

•  You might be in this group if you feel heaviness or swelling in your legs when upright.
• Treatments include: Compression stockings or abdominal binders; midodrine (a “pressor” drug) to tighten blood vessels; physical therapy focused on lower‑body strength.

🔗 Full study:  https://www.nejm.org/doi/full/10.1056/NEJM200010053431404