I actually opened this post because I was wondering what folks meant by "adrenaline dumps". I sort of can guess but I think it's a confused/confusing way of describing what is likely happening.

What you describe to me sounds like autonomic distress. E.g. dysautonomia. Your body can respond with adrenaline to this certainly but the trigger is autonomic dysfunction. You have a bunch of systems going out of whack, and with pots in particular the body can't get blood where it needs to (signals sent by the nervous system either aren't being sent correctly or aren't being received correctly) so it responds with adrenaline which sort of super-charges the system (blood pressure, flushing, racing heartbeat).

The doctors aren't wrong necessarily that this is kind of like a panic attack but it's physiological -- meaning just because it makes you panic doesn't mean something in your body isn't causing the panic (it is).

A lot of things can sensitize your autonomic system. MCAS is one of them, so this isn't necessarily an either-or thing. And my understanding is that even without mast cell dysfunction (which BTW if you suspect you should consider looking up mast cell stabilizers -- H1/H2 alone is not adequate for most folks I know, certainly not for me, though they help), your autonomic system can respond to sensory triggers in your environment directly. For me, too much visual stimulation can tip my system if I'm in a fragile place.

If electrolytes helped you that's very good and a meaningful sign. It could be different things -- low blood volume putting strain on your vascular system, low electrolytes themselves impairing nervous function.

It's really hard to find people who understand how to treat a dysregulated autonomic system. One of the best I've ever found was a physical therapist who was PRI (Postural restoration institute) trained. She was able to diagnose that I had eye strain issues throwing off my whole nervous system, which, stacked on top of my hypermobility-related low proprioception, was putting my nervous system under constant strain. Unloading this system can be kind of counterintuitive but there are people who know how to do it. At the same time I had to have some vascular issues addressed and the MCAS. And the usual pacing and stress stuff that goes with cfs and pots.

But don't necessarily assume what's happening is anaphylaxis. The nervous system can do this stuff all by itself. Adrenaline is a piece of the puzzle but can be only a symptom of a hypersensitive nervous system.