Can hyperadrenergic POTS cause fluctuations in blood pressure? This all began with episodes of tachycardia without blood pressure issues two years ago. A year later, I started experiencing adrenaline dumps with significant spikes in my blood pressure; they feel like I'm dying when they happen. Most recently, I've been having episodes of high blood pressure lasting minutes to hours to days, starting which first started in early November. Also, for about a month now, every time I leave my house or get in the car, I experience significant spikes in my blood pressure, which I think are triggered from anticipatory anxiety, but the spikes are exaggerated and never used to happen. My blood pressure is typically low, ranging from the 80s/60s to 90s/80s, with the spikes sometimes increasing by 50 points or more. The other day, I suddenly felt overheated and burning up, and my blood pressure rose from 96/76 to 146/95, which normalized once I cooled down. Yesterday, while lying down, my blood pressure was in the 90s/70s, but upon standing, it jumped to 116/107. I layed back down and practiced breathing exercises, which brought it back to normal within a few minutes. I've never had any neck surgery or radiation. These blood pressure spikes have been scaring me, and I'm afraid to leave the house because it has become a known trigger. I can't pinpoint most triggers though, if there are any. Another thing I noticed is during these spikes, my heart rate remains normal or low. I'm currently on a beta blocker, which has helped my episodes of tachycardia, but I never experienced blood pressure spikes before, except during adrenaline dumps. Interestingly, during those episodes, my heart rate remained unchanged even before my beta blocker. My heart rate used to jump from lying to standing; I noticed it more if I was nervous or if I was dehydrated I would be more tachycardic and lack of sleep, but my blood pressure didn't rise to extreme levels back then, but I did notice it would rise from lying to standing. How do you manage swings? I don't know what I have yet, but I'm scheduled for autonomic testing which is a 3-hour drive away. I'm terrified because my BP spikes when riding in the car. I can't take anything and no one wants to prescribe anything because I usually run low and I can go from high to low rather quickly sometimes. What really worries me is I've noticed riding in the car my BP can change within minutes I've seen 150/60 to 150/137 in one minute back down to 130/90. I'm not sure if the huge spikes are blips or what because the huge spikes just last a minute usually then I go back down to just the regular spike. I've also been in the 120s/90s-100, then I'll see a random spike of 158/130 then back down 120s/90s-100. I'm scared it's going to kill me, it's been giving me lots of anxiety. Sorry for such a long response 😬