title: Adolescent fatigue, POTS, and recovery: a guide for clinicians.
abstract: Many teenagers who struggle with chronic fatigue have symptoms suggestive of autonomic dysfunction that may include lightheadedness, headaches, palpitations, nausea, and abdominal pain. Inadequate sleep habits and psychological conditions can contribute to fatigue, as can concurrent medical conditions. One type of autonomic dysfunction, postural orthostatic tachycardia syndrome, is increasingly being identified in adolescents with its constellation of fatigue, orthostatic intolerance, and excessive postural tachycardia (more than 40 beats/min). A family-based approach to care with support from a multidisciplinary team can diagnose, treat, educate, and encourage patients. Full recovery is possible with multi-faceted treatment. The daily treatment plan should consist of increased fluid and salt intake, aerobic exercise, and regular sleep and meal schedules; some medications can be helpful. Psychological support is critical and often includes biobehavioral strategies and cognitive-behavioral therapy to help with symptom management. More intensive recovery plans can be implemented when necessary.
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Kizilbash
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Shelley P
authors.initials: SP
authors.lastname: Ahrens
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Bruce
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Gisela
authors.initials: G
authors.lastname: Chelimsky
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Sherilyn W
authors.initials: SW
authors.lastname: Driscoll
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Harbeck-Weber
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Robin M
authors.initials: RM
authors.lastname: Lloyd
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mack
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Dawn E
authors.initials: DE
authors.lastname: Nelson
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Nelly
authors.initials: N
authors.lastname: Ninis
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Paolo T
authors.initials: PT
authors.lastname: Pianosi
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Julian M
authors.initials: JM
authors.lastname: Stewart
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Weiss
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Fischer
mesh_terms: D000293:Adolescent; D001341:Autonomic Nervous System / Q000503:physiopathology*; D015928:Cognitive Behavioral Therapy; D004244:Dizziness / Q000209:etiology / Q000503:physiopathology*; D015444:Exercise; D015673:Fatigue Syndrome, Chronic / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D054971:Orthostatic Intolerance / Q000503:physiopathology* / Q000628:therapy; D054972:Postural Orthostatic Tachycardia Syndrome / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D013575:Syncope / Q000209:etiology / Q000503:physiopathology*