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POTS Syndrome: Unveiling the Symptoms, Causes, and Treatment

Updated: 2 days ago

Have you ever experienced sudden dizziness or lightheadedness when standing up too quickly? What if you consistently feel dizzy when you stand up? Have doctors or family members dismissed your feelings and symptoms as simple anxiety? Are you feeling faint or having noticeable heart palpitations in your chest? If these symptoms are consistent in your life, you might be dealing with POTS or Postural Orthostatic Tachycardia Syndrome. Overlooked by many medical professionals, this syndrome can be challenging to identify. Not to worry, there are treatment options that can help you get your life back on track.

In this blog post, we will unravel the mysteries of POTS syndrome, exploring its symptoms, causes, and treatment options. Read on to discover valuable insights into this complex condition and find the answers you’ve been searching for. Also, there are Dysautonomia and POTS-related online resources at the end of this post!

Also, check out our discussion with Dr. Lauren Zigman, a local Charlotte chiropractor who details her personal POTS experience in this interview.


Table of Contents:


What is Postural Orthostatic Tachycardia Syndrome (POTS)?

Johns Hopkins Medicine defines POTS’ acronym in the Conditions and Diseases section of their site as:


  • Postural: related to the position of your body

  • Orthostatic: related to standing upright

  • Tachycardia: increased heart rate

  • Syndrome: a group of symptoms


POTS syndrome is a rapid heart rate increase in response to standing. It falls under the umbrella term ‘Dysautonomia,’ which refers to the dysfunction of the Autonomic Nervous System (ANS).


According to the NIH, The Autonomic Nervous System controls bodily functions such as blood pressure, digestion, heart rate, breathing, and other functions without thinking about them (2023). In individuals with POTS, the ANS doesn’t operate correctly, leading to inadequate blood flow to the heart and brain. This triggers rapid heart rate palpitations and a range of other challenging symptoms.

What Is Dysautonomia?

Dysautonomia encompasses various conditions, including POTS affecting over 70 million people worldwide, according to Dysautonomia International. In the United States alone, before the onset of COVID-19, over 3 million people had POTS. In the aftermath of the pandemic, more than 6 million people are experiencing POTS-related symptoms.


Dysautonomia; subset of conditions.

Who Does POTS Syndrome Primarily Affect?

Although primarily observed in females (85% of cases), POTS can affect individuals of any sex, gender, race, or demographic, according to Bourne et al. (2021). Men can still have POTS, but it is predominant in females and commonly develops in young adults, according to Johns Hopkins Medicine.

The Common POTS Patient Story

The typical patient story for someone with POTS involves fluctuating symptoms that may come and go. Unfortunately, POTS often goes unrecognized by many health practitioners, leaving patients misdiagnosed with anxiety or panic attacks or undiagnosed entirely. This misdiagnosis occurs because adrenaline spikes in people with POTS, leading to symptoms that resemble anxiety. Consequently, patients often feel confused and hopeless, unaware of their actual condition. However, with proper treatment, those diagnosed with POTS can experience significant improvement, up to 80%, according to the Cleveland Clinic.


What Are The Symptoms Associated With POTS?

POTS manifests in a wide range of symptoms that can vary in severity, significantly impacting daily life. Symptoms can worsen when standing or sitting upright. While each individual may experience different symptoms, the following table lists commonly associated symptoms. Please note that bold-colored symptoms represent common symptoms that medical professionals look for in identifying the presence of POTS:

Shortness of Breath

Stomach Problems

Fibromyalgia

Brain Fog

Dizziness

Malnutrition

Chest Tightness

Lightheaded-ness

Light & Sound Sensitivity

Random Body Pain

GI Tract Problems

Headaches & Migraines

Fainting

Blood Pooling

Fatigue

Tingling

Heat & Cold Intolerance

New Onset Allergies

Neuropathy

Irritable Bowel Syndrome (IBS)

Bladder Dysfunction

Exercise Intolerance

Nausea

Vertigo

Sleep Disturbances

Insomnia

Anxiety

Depression

Shaking & Sweating

Heart Palpitations

Rapid Heart Rate while Resting

Blurred Vision

Tremors

Loss of Speech

And More

What is The History of POTS Syndrome?

The term POTS was recognized and used by Low et al., and others dating back to 1940 (Agarwal, 2007). Despite gaining recognition as a legitimate medical condition, it continues to be misunderstood and misdiagnosed in the modern medical community less than a century later.


What Causes POTS Syndrome?

The causes of POTS syndrome are unclear, as there can be various contributing factors.

For example, genetic predisposition, viral infections, vitamin deficiencies, mycotoxin infections, hormonal imbalances, autoimmune diseases, physical trauma, and neurological disorders can all play a role in its development. Identifying and addressing these underlying causes is crucial for effective POTS treatment.


How is POTS Syndrome Diagnosed or Identified?

POTS syndrome can be challenging to identify due to its complex nature and lack of mainstream medical awareness. Medical professionals rely on a thorough medical history review, physical examination, specialized autonomic testing, functional medicine testing, and tilt table exams to identify the presence of POTS. However, if your heart rate consistently rises by 40 beats per minute (bpm) when going from sitting or lying to standing or your heart rate surpasses 120 bpm when standing or sitting upright, you can fit within the criteria to be diagnosed with POTS.


Can POTS Syndrome be Cured?

Unfortunately, there is no cure for POTS syndrome. However, with growing research, hopefully, a cure can be found. For now, proper symptom management is key.


What is the Treatment for POTS Syndrome?

While there is no cure, treatment strategies can drastically improve the quality of life for patients affected by this condition.


Lifestyle modifications, such as maintaining a balanced diet, hydrating, and avoiding triggers, can benefit a person’s overall health. Similarly, some medications, physical therapy, and other supportive measures like compression garments and relaxation exercises can provide relief.


Furthermore, functional neurology utilizes various rehabilitation techniques to enhance neurological function and restore balance in the Autonomic Nervous System, thus improving POTS. These may include eye exercises, sensory stimulation, targeted brain training, and vestibular rehabilitation. At Better Brain & Body, our GyroStim is one of our primary vestibular rehabilitation technologies that help our POTS patients. Moreover, this syndrome can improve through vagal nerve stimulation, a topic covered in our blog post about gammaCore, a non-invasive migraine relief device. The ANS can be regulated by stimulating the vagus nerve and restoring balance to control heart rate, blood pressure, and digestion. Better Brain & Body also utilizes our mild hyperbaric oxygen therapy (HBOT), tilt-table therapy, Vielight red light therapy, neuromodulation, and Alpha-Stim treatments to help treat POTS. Please visit our therapies page to learn more about each of these therapies.


Also, check out our discussion with Dr. Lauren Zigman, a local Charlotte chiropractor who details her personal POTS experience in this interview.


Reviewed by Dr. Alicia Brown, DC, DACNB.


Dysautonomia & POTS-Related Resources:

Sources:

Agarwal, A K et al. “Postural orthostatic tachycardia syndrome.” Postgraduate medical journal vol. 83,981 (2007): 478-80. doi:10.1136/pgmj.2006.055046

https://pubmed.ncbi.nlm.nih.gov/17621618/

Bourne, Kate M et al. “Symptom Presentation and Access to Medical Care in Patients With Postural Orthostatic Tachycardia Syndrome: Role of Sex.” CJC open vol. 3,12 Suppl S44-S52. 4 Sep. 2021, doi:10.1016/j.cjco.2021.08.014

https://pubmed.ncbi.nlm.nih.gov/34993433/

Dysautonomia International (n.d.). What is dysautonomia? http://www.dysautonomiainternational.org/page.php?ID=34 Johns Hopkins Medicine (n.d.). Postural Orthostatic Tachycardia Syndrome (POTS). https://www.hopkinsmedicine.org/health/conditions-and-diseases/postural-orthostatic-tachycardia-syndrome-pots Kesserwani, Hassan. “Postural Orthostatic Tachycardia Syndrome Misdiagnosed as Anxiety: A Case Report with a Review of Therapy and Pathophysiology.” Cureus vol. 12,10 e10881. 10 Oct. 2020, doi:10.7759/cureus.10881

https://pubmed.ncbi.nlm.nih.gov/33178533/ National Institute of Neurological Disorders and Stroke (n.d.). Dysautonomia. National Institutes of Health. https://www.ninds.nih.gov/health-information/disorders/dysautonomia#:~:text=The%20ANS%20is%20charge%20of,by%20problems%20with%20the%20ANS Wells, Rachel et al. “Postural tachycardia syndrome: current perspectives.” Vascular health and risk management vol. 14 1-11. 29 Dec. 2017, doi:10.2147/VHRM.S127393

https://pubmed.ncbi.nlm.nih.gov/29343965/


https://my.clevelandclinic.org/health/diseases/16560-postural-orthostatic-tachycardia-syndrome-pots






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