What is POTS?
POTS, or postural orthostatic tachycardia syndrome, is a condition affecting an estimated one to three million Americans. More women than men are affected. Another term used to define this condition is dysautonomia, or dysfunction of the autonomic nervous system.
Many people with POTS are not aware that they have this condition and have seen multiple doctors due to the diverse symptoms from this condition. The symptoms are diverse and include things like lightheadedness, difficulty thinking, brain fog, intolerance of exercise, headaches, blurry vision, palpitations and nausea. Sometimes this condition can cause syncope or fainting. Many times this compilation of symptoms gets labeled as anxiety or even panic attacks.
Seeing functional medicine physicians may help you to uncover things you can do to improve your life and decrease your symptoms. Find a certified functional medicine physician in your area: Institute of Functional Medicine As with any information you find online, finding a licensed medical professional is pertinent for conditions and symptoms such as these.
Symptoms of POTS:
Due to the fact that the autonomic nervous system lives in most organs and tissues the symptoms of POTS are diverse. The autonomic nervous system is responsible for so many things in many areas of the body. This system usually controls and regulates things like temperature, blood pressure, heart rate, airway flow, blood flow to the gut, and higher level brain function.
When the autonomic nervous system (ANS) is dysfunctional it causes many things to happen in the body. Bringing back what is called homeostasis to this system is so important to improving quality of life.
What happens in POTS?
If you have POTS you may note that your blood pressure drops upon standing. You may also cross your legs most of the time unconsciously which serves to help raise low blood pressure. You may also note that you are cold when no one else is.
These are symptoms of POTS and long standing stress on the autonomic nervous system. Sometimes the immune system is also dysfunctional with POTS. Chronic exposures to things that amplify the immune response can create overwhelming states of inflammation that may lead to POTS. Chronic fatigue and mitochondrial dysfuction also may be present with POTS (learn more about chronic fatigue here: Chronic Fatigue and Mitochondria
Here are a list of symptoms you might experience:
- Palpitations or heart racing
- Low blood pressure
- Poor temperature regulation
- Nausea and poor digestion
- Intolerance of exercise
- Night sweats/temperature regulation dysfunction
- Blurry vision
- Brain Fog and difficulty concentrating
It is important to mention that low blood pressure can also have other causes such as dehydration and low blood volume which do not mean you have POTS. These are separate issues that need to be addressed in a different fashion all together. Make sure to find physicians that understand and look for both as a possibility to make sure your treatment is complete.
Types and Causes of POTS?
Neuropathic POTS is a term used to describe the condition when it is associated with damage to the small fiber nerves or neuropathy.
Hyperadrenergic POTS is from elevated stress hormones like cortisol and norepinephrine.
Hypovolemic POTS is from abnormally low levels of blood volume.
Secondary POTS is from another inflammatory condition such as mold or Lyme.
Between one and three million people in the US have this condition, the majority are women. POTS may begin after a recent viral illness like Covid or after other events such as following surgery or other stressful health events. POTS is often associated with conditions where there is an overwhelming burden on the nervous and immune systems.
Although POTS can run in families, no single gene has been associated with POTS to date. These is a strong association between POTS and various joint hypermobility disorders including Ehlers-Danlos syndrome. Recent evidence has also highlighted an overlap between POTS, joint mobility and mast cell disorders. Some of these will have a genetic origin.
How is POTS diagnosed?
The diagnosis of POTS can be complicated due to the wide range of symptoms and the symptoms may vary in each patient. Most often this condition has been present for many months before diagnosis can be made.
Some doctors may recommend a tilt table test to help with diagnosis.
What can be done?
For patients experiencing POTS it is important to make sure they take precautions to prevent issues when blood pressure drops upon standing. It is very important to seek attention from medical professionals who understand the condition and take an approach to look for underlying issues such as chronic inflammation.
Annie Hopper developed a program termed DNRS (Dynamic Neural Retraining System) for those patients with chronic overactivation of the fight or flight response.
It is important to remember that chronic inflammation can also cause activation of fight or flight. Trauma is important to address as this can also activate fight or flight and the sympathetic nervous system. Finally, many patients with mold and mycotoxin illness may experience symptoms of POTS due to the chronic activation of their immune system. Training parasympathetic responses and vagal activation can help to bring about homeostasis after removal of the inflammatory agents may help.
POTS is a very complicated disorder with diverse symptoms that requires an understanding from your physician. Seek attention and find a physician or care provider who is experienced and one whom you trust.
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disclaimer: None of the information here is considered to be replacement for/nor intended to diagnose or treat any condition that should be properly evaluated by your personal medical professional. If you feel that you need urgent attention please seek attention immediately at an emergency or urgent type facility.
Dr. Jennifer Kessmann
Dr. Jennifer Kessmann has been practicing medicine for over thirty years. She began with a love for prevention and nutrition which carried her to Functional Medicine. She also is a 500 hour yoga teacher and implements pieces from that training when it applies and may help. Each patient is treated personally and as a unique individual. Our team understands the gift of bringing back optimal health. Contact us today.