Successful treatment of postural orthostatic tachycardia and mast cell activation syndromes using naltrexone, immunoglobulin and antibiotic treatment.

This study presents a successful case of treating a patient with both severe POTS and MCAS, employing a combination of low-dose naltrexone (LDN), intravenous immunoglobulin (IVIg), and antibiotics for small intestinal bacterial overgrowth (SIBO). The patient experienced a significant and lasting improvement with this treatment regimen. The study highlights the novel application of IVIg, commonly used in autoimmune neuromuscular diseases, as a potentially valuable treatment for POTS. LDN, known for its paradoxical effect of increasing endorphins which modulate immune responses, was also used effectively. Additionally, addressing SIBO is suggested as an important aspect in POTS management.