Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that disrupts the body’s ability to regulate blood flow and maintain stable circulation. It falls under the umbrella of autonomic nervous system disorders, meaning it affects involuntary bodily functions—those you don’t consciously control.
For individuals with POTS, the simple act of standing triggers a cascade of physiological responses that feel anything but normal. Their heart races, dizziness sets in, and fatigue washes over them as if they had just finished an intense workout. This isn’t just occasional lightheadedness; it’s a daily battle against a body that struggles to adapt to gravitational shifts.
The Autonomic Nervous System’s Role in Blood Flow Regulation
The autonomic nervous system (ANS) is responsible for keeping the body balanced and functioning efficiently. It consists of two main branches:
- The Sympathetic Nervous System (Fight or Flight): This system kicks into gear during stressful situations, increasing heart rate, constricting blood vessels, and preparing the body to respond to challenges.
- The Parasympathetic Nervous System (Rest and Digest): This system promotes relaxation, slows heart rate, and supports digestion and recovery.
In a healthy body, these systems work together seamlessly to regulate blood pressure and circulation. When you stand up, the ANS ensures that blood moves upward against gravity, keeping your brain adequately supplied with oxygen.
For those with POTS, this balance is disrupted. Blood pools in the lower extremities, leaving the brain deprived of oxygen. In response, the heart begins to beat rapidly in an attempt to compensate, but this overcorrection often fails to restore proper circulation, leading to a cascade of debilitating symptoms.
Why Standing Feels Like an Intense Workout
Imagine running a sprint with no warm-up, no hydration, and no recovery time. That’s what standing feels like for many people with POTS.
The moment they rise from a seated or lying position, their heart rate can spike by 30 beats per minute or more. This rapid increase isn’t due to exercise—it’s the body desperately trying to maintain blood pressure and prevent fainting.
Unlike in a workout, where the body adjusts efficiently to increased exertion, individuals with POTS experience:
- Dizziness and lightheadedness due to decreased blood flow to the brain.
- Extreme fatigue as their body works overtime just to maintain basic functions.
- Heart palpitations that create an unsettling sense of panic.
- Brain fog that makes it hard to think clearly or focus on tasks.
It’s not about being out of shape or needing more cardio. It’s about an autonomic system that isn’t responding appropriately to movement.
The Symptoms of POTS: Beyond a Racing Heart
While a rapid heart rate is the hallmark symptom of POTS, the condition comes with a host of additional challenges that affect the entire body.
Neurological Symptoms
- Brain fog and cognitive dysfunction
- Migraines and chronic headaches
- Sensitivity to light and sound
Cardiovascular Symptoms
- Chest discomfort or irregular heartbeats
- Low blood pressure when standing
- Blood pooling in the legs, leading to discoloration
Gastrointestinal Issues
- Nausea and bloating
- Slow digestion and irritable bowel symptoms
- Difficulty absorbing nutrients
Temperature Regulation Problems
- Excessive sweating or inability to sweat
- Heat intolerance, making warm weather unbearable
- Cold hands and feet due to poor circulation
Each of these symptoms arises because the autonomic nervous system isn’t properly managing bodily functions. The body is in a near-constant state of imbalance, leaving individuals feeling exhausted even after small exertions.
The Underlying Causes of POTS
POTS isn’t a standalone disease; it’s often a secondary condition triggered by another underlying health issue. Some of the most common causes include:
- Autoimmune Disorders. Many people with POTS also have autoimmune conditions such as lupus, Sjögren’s syndrome, or Hashimoto’s thyroiditis. These disorders cause the immune system to mistakenly attack the body’s own tissues, including nerves that regulate circulation.
- Post-Viral Syndromes. Viral infections can trigger POTS by causing long-term damage to the autonomic nervous system. This has been seen in cases of long COVID, Epstein-Barr virus, and other post-viral syndromes.
- Ehlers-Danlos Syndrome (EDS). EDS is a connective tissue disorder that affects the structure of blood vessels and joints. Because blood vessels are weaker in individuals with EDS, maintaining circulation becomes a greater challenge, increasing the risk of developing POTS.
- Mast Cell Activation Syndrome (MCAS). MCAS leads to abnormal histamine release, causing inflammation and excessive vasodilation. This can contribute to the dizziness and cardiovascular instability seen in POTS.
Managing POTS: Finding Balance in an Unpredictable Condition
While there is no universal cure for POTS, symptom management can significantly improve quality of life.
- Increasing Fluid and Electrolytes. Since blood volume is often reduced in POTS patients, drinking plenty of water and increasing salt intake can help stabilize circulation. Electrolyte-rich drinks like coconut water, bone broth, or electrolyte powders can be beneficial.
- Wearing Compression Garments. Wearing compression stockings can prevent blood from pooling in the legs, helping maintain blood pressure stability.
- Taking Medications for Symptom Control. Doctors may prescribe beta-blockers to slow the heart rate, fludrocortisone to expand blood volume, or midodrine to constrict blood vessels.
- Pacing and Energy Conservation. Many individuals with POTS experience post-exertional malaise, meaning their symptoms worsen after physical activity. Learning to pace daily activities, take frequent breaks, and avoid overexertion is essential.
- Exercise Therapy. Though challenging, gradual recumbent exercise, such as swimming or cycling, can help recondition the cardiovascular system without triggering severe symptoms.
- Dietary Adjustments. Anti-inflammatory foods, adequate protein intake, and stabilizing blood sugar levels can all support autonomic function.
Leave a Reply