Orthostatic dysregulation (OD) is most common during adolescence, with approximately 5-10% of junior high and high school students in Japan believed to be affected. According to Japanese clinical guidelines, this condition is classified into four subtypes: “instantaneous orthostatic hypotension (INOH)”, “postural tachycardia syndrome (POTS)”, “vasovagal syncope (VVS)” and “delayed orthostatic hypotension (delayed OH)”. Additionally, it is noted that various factors, including idiopathic causes, nutritional deficiencies, developmental disorders, and mental health issues, may contribute to its onset.

On the other hand, cases of OD symptoms have been reported among adult patients with chronic fatigue syndrome (ME/CFS), and it has been clarified that increased oxidative stress is involved in some of these cases. Additionally, there are cases where symptom improvement has been observed through antioxidant therapy.

Based on a summary of previous studies and initial data obtained, this report examines the trends in the association between each subtype of pediatric OD and oxidative stress markers, and discusses the potential involvement of oxidative stress in pediatric OD and implications for future treatment strategies.