There is an evidence that increased capillary permeability in the standing position is related to a deficit in the sympathetic nervous system. The leakage of this fluid leads to various clinical conditions which frequently puzzle the consulting physician because despite the frequency of this condition intelligent physicians and patients are unaware of the cause of their condition. One of the most common manifestations is the inability to lose weight despite proper dieting. A randomized study comparing the efficacy of a
diuretic, a converting
enzyme inhibitor,
spironolactone and a
sympathomimetic amine on
weight loss in diet refractory women found that only the latter in the form of
dextroamphetamine sulfate demonstrated significant
weight reduction over a six month time span. In fact, the
dextroamphetamine sulfate proved effective when given in the next 6 months to the three groups failing to respond for the first 6 months. The diagnosis of a deficit in
sympathomimetic amines is established by demonstrating an abnormal clearance of a water load in the erect position and exclusion of other conditions that are associated with an abnormal free water clearance, e.g.,
hypothyroidism, renal or
liver disease or
congestive heart failure. The original definition of an abnormal water load test was excretion of <55% of a 1500 ml water load in 6h but we found that <75% defines a greater population who suffer from this problem. There are several conditions that have proven refractory to conventional theory that respond quickly and effectively to
sympathomimetic amines. There have been many anecdotal reports of relieving interactable
pain syndromes quickly and efficiently with
sympathomimetic amine theory, despite failure with a multitude of other
therapies. These include
interstitial cystitis and
pelvic pain that was attributed to
endometriosis, gastrointestinal
pain including
esophagitis and
gastroparesis,
headaches,
joint pain,
fibromyalgia, and
carpal tunnel syndrome. It is not clear if the improvement in
pain is related to a decrease in fluid retention or a direct effect of the
sympathomimetic amines on the sympathetic nervous system.
Sympathomimetic amine theory has helped other conditions besides
pain, e.g., chronic
fatigue, vasomotor symptoms in young women not associated with decreased ovarian egg reserve, and
chronic urticaria resistant to all other
therapies. Thus, these studies strongly suggest that physicians be aware of this condition involving a deficit in the sympathetic nervous system when faced with various enigmatic complaints especially if standard
therapy has not proven effective.