Natural Remedies For POTS

What Is POTS?

Postural Orthostatic Tachycardia Syndrome (POTS) is when your heartbeat increases quickly after getting up from a lying down or sitting position. 

It has long been defined as a disorder of the peripheral nervous system. Newer studies suggest it should also be looked at as a central nervous system disorder. (1) It is characterized by symptoms such as chronic dizziness, headaches, cognitive dysfunction, and sleep disturbance. (2) 

POTS is an invisible and dynamic condition, which unfortunately results in unfair assumptions against those with the disorder. Outsiders may accuse individuals with POTS of laziness or attention seeking. Those who don’t know what’s wrong with their bodies and lack access to medical care to get a diagnosis can often isolate themselves. In doing so, they cut themselves off from critical help. Many develop anxiety and depression and report a poorer quality of health life. (3)

READ MORE: A Functional Medicine Guide To Overcoming Anxiety + Depression

Symptoms Of POTS

People with POTS experience some or all of the following symptoms: (4)

• Dizziness or lightheadedness
• Headaches
• Brain fog
• Exercise intolerance
• Extreme fatigue

It’s not challenging to see how these symptoms can interfere with daily functioning. Understanding the underlying issue helps solve the puzzle.

Severity Of Symptoms 

Like many conditions, POTS ranges in severity from a mild annoyance to completely debilitating. For example, some people may find daily activities like waiting in a long grocery line beyond their capabilities. It can interfere with working ability, as the condition worsens when standing or sitting upright for extended periods.

Causes of POTS

POTS can have various causes depending on the type of disorder that manifests in the body. 

The main types of POTS and their causes are: 

• Neuropathic POTS: Caused by nerve dysfunction in the hands and feet (5,6)
• Hyperadrenergic POTS: Caused by too-high volumes of norepinephrine in the blood (5,7)
• Hypovolemic POTS: Caused by reduced blood volume (5)

It should also be noted that deconditioning is another issue, which may sustain the symptoms of POTS in those who have already had this syndrome. For example, someone who is on bed rest may experience a worsening or prolonging of their symptoms. (8)

Diagnosis Of POTS

Getting a diagnosis for POTS is not easy. 

The test for POTS typically involves a 10-minute stand test, tilt-table test or both. While the practitioner changes your position, they’ll measure your blood pressure and heart rate. Increases of more than 30 beats per minute while standing indicate POTS. A decrease in blood pressure is also a clue. Other underlying causes and diseases should also be investigated. 

There is no single, clear indicator that diagnoses POTS. Much of the evaluation process is focused on excluding other conditions that mimic POTS, or may exacerbate symptoms. Based on these forms of testing, decisions on treatment can be made. (9)

How Does Functional Medicine Approach POTS?

Functional medicine takes a unique approach to treating POTS. Like any other symptoms, we look to the cause of why you’re experiencing these difficulties, rather than seeking to mask them. Our thorough forms of testing are designed to uncover the source of your issues so we can remove these roadblocks to your progress. 

Common Co-Occurrences

Functional medicine examines multiple factors that influence your bio-individuality, which includes looking for co-occurring issues that might be causing your symptoms. There are other diseases and symptoms commonly associated with POTS, such as (10)

• Type 1 diabetes
• Amyloidosis
• Sarcoidosis
• Alcoholism
• Lupus
• Sjogren’s syndrome
• Heavy metal intoxication 

A functional medicine practitioner will examine each of these factors to determine if they contribute to the problem and if so, to what degree. In doing so, we can recommend the correct avenue of treatment for any underlying issues we find.  

How To Manage POTS

There are several things you can do on your own to manage POTS. 

Avoid Standing Positions

Standing upright for more than 10 minutes can lead to dizziness and fainting. In severe cases, even remaining seated upright and motionless can spur symptoms. Consider bringing a chair when you go somewhere that you know involves longer periods of standing. 

Wear Compression Garments

POTS may be improved by wearing compression garments, according to research (11). You can buy these over the counter at most stores, or find them online. 

Stay Hydrated

Since blood volume is impacted by hydration, drinking enough water can have a positive effect on POTS symptoms. (12) Carry a water bottle with you anywhere you go. Remember to increase your intake in hot weather or when you exercise. 

Ease Into Exercise

Though exercise intolerance is associated with POTS, that doesn’t mean you should avoid it altogether. Instead, start slowly and consider horizontally-oriented forms of exercise, such as swimming or rowing. As you get used to it, you can consider more upright exercises. (13)

READ MORE: The 10 Most Hydrating Foods + Beverages 

Nurture Your Microbiome

POTS patients tend to report gastrointestinal issues such as diarrhea, constipation, nausea, and vomiting. (14) As such, it’s important to consider the health of your microbiome and nurture it. Research suggests POTS may have an effect on the composition of gut microbiota. (15)

To learn more about what you can do for your microbiome, check out my Complete Functional Medicine Guide To Restoring Microbiome Health.

Manage Your Stress Levels

All diseases, particularly those of the nervous system like POTS, are affected by stress. There are plenty of warning signs that your health is affected by stress. If you suspect that stress is playing a part in your symptoms, look at my article The Most Effective Ways To Manage & Reduce Stress In Your Life.

Avoid Heat

Higher temperatures have been shown to worsen POTS. (16) Therefore, you might want to consider what you can do to reduce your exposure to heat. 

Cut Out Alcohol

As you know, I’ve chosen to cut alcohol out of my life. Since it can affect your nervous system, you may see an increase in POTS symptoms when you drink alcohol. (17) Consider decreasing your use or saving it for special occasions if outright quitting doesn’t feel like an option for you. 

Consider Taking Supplements

Certain supplements and herbs may help. For example, l-carnitine, glucosamine, and CoQ10 have shown some effectiveness with pre- and probiotics (18). Licorice, rhodiola, eleuthero, and ashwagandha may ease POTS symptoms, although they may interfere with other medications.

Your best bet is to consult with your doctor before supplementing to make sure it is appropriate for you.