Yes, it can! It did for me… I was diagnosed as Hyperadrenergic POTS (high epinephrine when vertical) as the likely contributor. This contributed to some of the shaking, tremors and hyperadrenergic presentation at the time (I felt like I was on amphetamines all of the time). It kept me from fainting, however (my son was not so lucky in that department). Hyperadrenergic POTS is a beast, yet others often think it is “anxiety”. Been there?