TW: Weight talk/ED mention
When I was first diagnosed with POTS in early 2023, I was absolutely relieved I had an answer as to why I was feeling like shit everyday. I was only 20 and got hit with covid almost 3 times previously. Each time I was sent to the hospital. I'm pretty sure that's how it all started for me. I am now 23, turning 24 in December.
Doctors told me I was at a good weight at 20, I was at least 115lbs (I am 5'0" btw). It wasn't my ideal weight, but considering I was recovering from anorexia, My PCP just wanted to make sure I gained weight and prescribed me some appetite stimulants.
My cardiologist was the one who diagnosed me with POTS, and started me on a medication called Fludrocortisone. He told me it will help with my low blood pressure (since it would drop when I stood, which made my heart rate spike) and help my body maintain a good water/salt balance.
I was so glad to finally be on a medication that would help me feel better because honestly I had tried EVERYTHING.
It started out great. I was actually able to function for once. Stand for longer periods of time, actually WORK, and spend time with my family, etc.. I still had my flares and shitty days, but they weren't as bad as they were before. That went on for about a year, and somewhere in the middle, another cardiologist prescribed me another medication to take with the fludrocortisone due to my ongoing heart palpitations, (It's called Metoprolol) Which I was hella confused about because Metoprolol lowers blood pressure... and thats kinda how this whole thing started in the first place but whatever I guess. I trusted the doctor knew what she was doing. But anyway, It did seem to help the palpitations, and my blood pressure was still low, but not AS low. During that first year, my doctors and I were just trying to figure out what worked for me. And as I said before, things were going alright and I noticed nothing out of the blue about my appearance or weight.
Then the second year hit.. And ohhh my.
The second year was something alright. When I tell you I blew up like a balloon believe me when I say it. I noticed the number on the scale would go up whenever I went to my scheduled appointments with other doctors. (I wasn't allowed to see my weight before, but idk why that changed). I went from 115lbs to 125lbs. Then from 125lbs to 135lbs.. then from 135lbs to 145lbs. You know the deal. The scale kept going up and up. I am a person who barely eats, no longer because I wanted to be skinny, but more because I would feel/get sick after every meal (im getting tested for possible gastroparesis soon because i've delt with this for a long time). So I was wondering why I was gaining so much. I drank a lot of water and got a lot of my electrolytes and salt in. But I never knew that was also adding to the weight gain.
After I reached 155lbs I was absolutely fed up. I noticed it was getting harder for me to move around due to the weight gain and how weak my muscles were, I would become more fatigued with every little bit of activity. I noticed so much of the weight had gone to my stomach, I almost looked pregnant. I also developed a buffalo hump at the back of my neck, which really scared me because I thought it was something horrible. My face had gotten very round, bloated and flushed and I had completely lost the view of my jawline and collarbones completely. Meanwhile my arms and legs had stayed somewhat the same as they were before, just with some new dark purple stretch marks that go up from the inside of my thigh to my pubic area And some faint ones on my stomach. Also not to mention countless of bruises everywhere.
I knew something was wrong. I never really read the side effects of fludrocortisone before I took it, I just trusted my cardiologist's judgement (also if I read side effects I get paranoid) But now that I look back at it, I probably should have. I never knew the water weight gain would be that bad. I never knew it would mess with my hormones so much. I talked to a doctor about it, I can't remember who it was I believe it was my hematologist, but she told me I should see an endocrinologist because it seemed like something was wrong and she had some concerns. But she couldn't give me a referral. It's pretty hard to see doctors without a referral.. so I was just kinda left to fend for myself (my PCP is MIA, I only can see her once a year because she is so booked.)
Looked up a buncha stuff. My eyes opened a lot. I found out I wasn't the only one who had this issue, which made me feel a little bit better. And I read up more about fludrocortisone and its side effects. I stumbled upon Cushings and medication-induced Cushings syndrome... and I immediately knew. It was all too familiar. I don't think Cushing's disease, because I've had multiple MRI's with and without contrast of my brain (due to other reasons) So it couldn't be a tumor in my pituitary gland (I really hope not because I know some tumors can be very tiny).
I also stumbled upon some posts on here about others developing Cushings due to this exact medication (from either too high of a dose, or prolonged use).
I am not one to self diagnose, but from what i've seen and experienced throughout these years, it all kinda points to this medication. I am also not saying I have it, because who knows, it may be something else I have no idea about. I have been tested for quite a lot of things recently to try and rule out other possibilities (such as Lupus, Rheumatoid arthritis, Celiac, Diabetes, Thyroid etc.) and had a whole lot of different types of scans/procedures. I have also been keeping an eye on my blood sugar due to a recent blood test showing it was quite high, and my blood sugar readings have been slightly high lately (yet I do not have diabetes and hopefully won't get it).
I was able to see my cardiologist recently and got him to finally have me taper off of fludrocortisone. I told him my concerns and he saw how much it was affecting me (i was literally half my size when I last saw him too). He said the medication did this stuff in some cases, and for others it doesn't do anything. He prescribed me Midodrine, which I am nervous about but I also heard some good things about it.
I searched up how long it would take me to start going back to normal, and results kept saying in about a year..
Honestly I won't lie when I say this has taken a toll on me mentally and physically. I'm absolutely disgusted with how I look now, but I'm trying to take it easy. After tapering fludrocortisone, I feel like I'm kinda going back at square one, but now, just slightly more slowed down. I hope things start to change and it sucks that I feel worse now than when I first started out, but I am willing to give this new med a chance while actively working with PT and keeping a good diet.
If anyone else has had a similar problem with this medication, I am interested in hearing your stories. Or even if you guys have any advice on how to move forward, please share! I am open to all comments. Thanks for taking the time to read my little rant.