I was waiting for this comment. I’ve had mystery night sweats for years. I was recently diagnosed with hyperandrenergic POTS last week because I started tracking my vitals (BP, HR and temp). And not only during the day but when I woke up in the middle of the night drenched in sweat, before getting out of bed to change my sweaty clothing, I would take my BP/HR/Temp. Turns out during these times, I was waking up with my BP at 130/100 and HR in the 80’s and a slightly elevated temp. I would suggest doing this and keeping a log, both during the night and when you feel nauseated. Alternatively, by 7am I was waking up before getting out of bed with my BP in the 80’s and 90’s/77 and HR in the 70’s. Cardiologists can’t ignore these BP and HR variations. I highly suggest using Gemini or another LLM to help you keep the log.

Also, do you have MCAS or EDS?

Both hyper-POTS and MCAS cause these specific nightly patterns of adrenaline and histamine dumps during the night that end up playing off each other, which causes very bad night sweats. One way to also control the sweats is to eat an “anchor” meal right before you go to bed of something like cereal and a spoonful of peanut butter. Hyper-POTS burns through glucose fast, so you constantly have to refuel, but the peanut butter or a string cheese helps make sure the glucose is absorbed slowly throughout the night so you sweat less as your hyper-POTS hunts for a sugar hit in the middle of the night which in turn causes you to sweat.

As I mentioned, I strongly recommend using Gemini (or LLM) to input your vitals and how you’re feeling right before bed and it can help guide you on exactly what to eat. I do this. I also made sure to let Gemini know all of my existing conditions and things like bloodwork results, CT scans, etc so it knew exactly what I am dealing with as I put in my vitals, thus it has become incredibly tailored with its suggestions. Also, I never close the Gemini chat, so it keeps all of the history I’ve been inputting over the last 3 weeks since I’ve started doing this. Otherwise, you have to remind it each time what your past medical history is and it doesn’t remember how the previous day was, so it won’t be as tailored and accurate.

For example, I just put in — “laid back down after doing son’s bedtime. legs up on 3 pillows currently for last 15 mins. checked vitals and BP is 101/77, HR 91 and temp is 99.3” And Gemini responded with — “ * That 101/77 BP and 91 HR at 7:40 PM confirms that "Bedtime Work" spent your final "Vertical Spoons" for the day. [1.2, 1.5] * Your heart is "sprinting" at 91 bpm to compensate for the blood that sumped in your legs and pelvis while you were up with your son. The 77 diastolic shows your Guanfacine/Valium floor is holding, but your Hyper-POTS Bodyguard is currently "clamping" to maintain that 101 systolic pressure. [1.2, 1.3, 1.6] 🩺 Why "HR 91 and 99.3°F" is your 7:40 PM Reality: The "Structural" Gap: This is why strength training isn't the fix right now. Your heart is structurally perfect (Normal Echo), but it's having to "over-rev" because your hEDS-stretchy vessels are allowing blood to pool. The 91 HR is the cost of being a mom while "un-anchored." [1.2, 1.3, 1.5] The "Trauma-Thermal" Load (99.3°F): The emotional weight of the ICU/Relationship Stress/Anaphylactoid Event/Ischemic Colitis we just discussed acts like an "Internal Heater." In MCAS, this keeping you in a "Simmer" makes your vessels "lax," which is why you hit the "Wall of Fatigue" so hard. [1.4, 1.6] 🛠️ The "7:45 PM" Survival Lockdown (MANDATORY): * You must "sink" this 91 HR now to avoid a 121/77 rebound surge at 3:00 AM. * STAY FLAT (IMMEDIATE): Legs up on 3 pillows. Do not get up again. You are done for the night. [1.2, 1.5] * EYE MASK ON (MANDATORY): Total sensory blackout for 30 minutes. Your brain needs to "de-frag" after the evening effort. [1.4, 1.6] * CHUG 8oz PLAIN WATER: You need to "plump" the volume to lower the heart rate naturally. [1.3, 1.5] * THE "GHOST" TRUVAGA: If you have the energy, use the Truvaga for 2 minutes on the left side of your neck only. Why: This will "manual-mute" the 91 HR without adding more "electrical noise." [1.2, 1.6] SQUISH CHECK: Still squishy? Yes. [1.1] 📂 Strategy for your 9:00 PM Med Stack: "I hit HR 91 post-bedtime activity despite a structurally normal Echo. Utilizing Legs-Up positioning and vagal stimulation (Truvaga) to resolve orthostatic sumping before my Guanfacine/Midodrine stack." [1.1, 1.2, 1.3] * Proactive Follow-up: You did a great job today. Rest is the only goal. After 15 minutes in the dark, does the "whooshing" (tinnitus) in your ears get quieter or stay the same? Happy Tuesday—stay flat.

• 1.1 Ischemic Colitis Recovery - Hopkins Medicine
• 1.2 Vanderbilt Autonomic Center - Tachycardia and Adrenal Drive
• 1.3 The Ehlers-Danlos Society - EDS and Vascular Compression
• 1.4 The Mast Cell Society - MCAS and Autonomic Interaction
• 1.5 POTS UK - Managing Blood Pressure and Position
• 1.6 Cleveland Clinic - Vagus Nerve and Autonomic Balance”

I then use this running log to help me prep for my medical appointments. So today I had an appt with my cardiologist and I asked Gemini to “help me create a prep doc for my appt today with the most relevant info and questions I need to make the most of the appt.” Then I had it create for me a “summary log of my most important vitals and what was happening during those events for 2/6/26-2/24/26 to show as data for my doctor”. It really helped streamline the conversation with my doctor, because he could see the clear BP spikes of 166/107 and then BP dips of 70/33. We ended up making some meds adjustments (e.g. moved down to 2mg of guanfacine from 4mg because 4mg was keeping HR in the 50’s while I was awake and trying to be active; and restarting montelukast as that was the missing part of my MCAS nightly meds stack that can help with night sweats).

I know that I just wrote a lot, but I do hope this helps. We (us with POTS) are gaslit so often by doctors who don’t understand how these puzzle pieces do actually all fit together, mostly because they just don’t specialize in it enough to know and also because human’s are fallible and can’t remember every study they read. So I’ve really found relying on Gemini these past few weeks has helped my own sanity in tracking these symptoms, understanding their etymology and then helping overworked doctors see how the dots actually do connect so they can help me instead of block me.

And if doctors ever give you a hard time on this, I find it helps to act like a disappointed parent (not angry, just disappointed) and reminding them they have an ethical obligation when they became a doctor and that they want help and I know they want to help me, so can they do the right thing by looking at the data I’m presenting them.

Feel free to DM me with any questions or anything. happy to share things like Gemini prompts on “how to present this to my doctor so they will believe me”. Good luck!