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In the medical world, some conditions like POTS remain shadowed by misinformation, leading to harmful, delayed diagnoses and misconceptions. Postural Orthostatic Tachycardia Syndrome is one such condition that affects mostly female patients. It is a chronic condition that causes an abnormally large increase in heart rate when standing up or sitting up; it can also include dizziness, fainting, and fatigue. While there’s no cure, several treatments and lifestyle changes can help manage POTS symptoms.

“No one ever heard of dysautonomia/POTS when I had it, nor was it taught in medical school, internship, residency, or fellowship,” said Dr. Margaret Aranda, MD, PhD, CPT, who is trained in anesthesiology and critical care. ”No one ever heard of someone who stands up and then faints. They all assumed I was lying.”

Other doctors didn’t take Aranda seriously. Sadly, they assumed she was faking it or exaggerating. They chalked her up as a histrionic female, offering her Valium and counseling. “Just because they never heard of what I had, they assumed it did not exist,” she said. 

“Why is it ignored/underdiagnosed? There’s so little focus on dysautonomia because traditional doctors don’t have pharmaceuticals for it,” writes Elizabeth Moriarty, Clinical Herbalist and CEO/Product Formulator at Luminary Medicine Company. “No one will focus on education because they’re taught by pharmaceutical [companies].”   

Medical professionals continually misunderstood and dismissed Aranda’s symptoms…until she met Dr. David S. Cannum, a renowned Los Angeles-based cardiologist. When he performed a tilt-table test, he observed her fainting and acknowledged her symptoms with compassion. 

The tilt table is a reliable but expensive test in which a patient lies on a gradually tilted upright table while their heart rate and blood pressure are monitored. According to Dysautonomia International, there are only 56 Dysautonomia specialists in America. 

Dr. Aranda’s persistence and ultimate POTS diagnosis have helped raise awareness and contributed to the growing recognition of POTS as a condition.

The Science Behind POTS

POTS is a form of autonomic nervous system dysfunction, and this neurologic problem is reflected in one’s blood pressure. If the blood pressure drops when the patient stands, causing symptoms like lightheadedness, it is called orthostatic hypotension. If the blood pressure stays normal but the heart rate gets faster, it is called POTS.The hallmark of POTS is a significant heart rate increase upon standing, often accompanied by various symptoms that disrupt daily life.  

In healthy individuals, the body compensates for the pull of gravity when standing by constricting blood vessels and increasing heart rate. In POTS patients, this mechanism falters, causing the heart rate to increase by 30 beats per minute or more within 10 minutes of standing. Blood pools in the lower body due to insufficient blood vessel constriction, resulting in symptoms like dizziness, palpitations, nausea, and even fainting.

Did you know that dysautonomia is a notable feature of Parkinson’s Disease, the Autism spectrum, and Ehlers-Danlos syndrome EDS /hypermobility syndromes? It’s also associated with ADHD, autoimmunity, and chronic inflammatory gut conditions.  

POTS is also associated with mast cell activation syndrome. This condition occurs when the mast cells in the body release too much of a substance like histamine, causing allergy-like symptoms.  

Symptoms and Their Impact

POTS symptoms can vary widely, both in type and intensity. The supposed syndrome (signs and symptoms that often repeat themselves in patients and creates a disease pattern) can include the following:

  • Rapid heart rate (Tachycardia): a sudden, uncomfortable increase in heartbeat
  • Lightheadedness and dizziness: especially upon standing, potentially leading to fainting
  • Fatigue and weakness: persistent exhaustion
  • Brain fog: difficulty concentrating, poor memory, and trouble focusing
  • Nausea and gastrointestinal issues: digestive symptoms like bloating or diarrhea
  • Exercise intolerance: an inability to tolerate physical activity

Other symptoms include:

  • Trouble sleeping
  • Trouble concentrating
  • Anxiety
  • Blurred vision
  • Impaired concentration or memory
  • Chest pain or tightness
  • Constipation
  • Heartburn
  • IBS
  • Insomnia
  • Painful menstrual cramps and premenstrual syndrome
  • Blurred vision
  • Excessive sweating or lack of sweating
  • Difficulty with concentration
  • Forgetfulness
  • Exhaustion
  • Shakiness
  • Temperature deregulation
  • Abdominal pain
  • Bloating
  • Reduced cerebral blood flow with prolonged sitting
  • Chronic fatigue
  • Fibromyalgia
  • Elevated anxiety
  • Dehydration
  • Eye floaters
  • Motion sickness

Causes And Risk Factors 

An estimated three to six million people are suffering from POTS, and most of those are women. It isn’t exactly clear why POTS or any of the other types of dysautonomia develop, but it usually begins in adolescence or early adulthood. 

The exact factors in each person vary, related to changes in the autonomic nervous system, adrenal hormone levels, and total blood volume. Regardless of the cause, POTS is often triggered by anything that creates metabolic stress or changes in blood volume. 

Sometimes, the first episode of POTS occurs after a health event such as:   

  • Viral infection: They precipitate a response with antibodies. If POTS is linked to autoimmune problems, a viral infection will probably trigger an attack.
  • Trauma: Car accidents, bone fractures, and other trauma, like a head injury, can activate the adrenal glands, triggering tachycardia and other POTS symptoms. Emotional traumas like the death of a loved one and intense fear can also cause this effect. 
  • Surgery: Even if someone is not conscious during surgery, their bodily organism responds the same way: adrenal glands are activated, and this can trigger a flare-up.
  • Pregnancy: During pregnancy, new blood vessels are formed, and your blood circulation changes even more if you have POTS syndrome.  
  • Genetics: Some claim that some families have a hereditary predisposition.  

COVID-19, Bioweapons, And Vaccines 

Dysautonomia International reported that the number of POTS cases has doubled since the start of the COVID-19 pandemic. According to the National Institute of Health, recent reports suggest that a significant percentage of COVID-19 survivors develop POTS within 6 to 8 months of infection.

According to a new research study from the Smidt Heart Institute at Cedars-Sinai, patients injected with a COVID-19 mRNA vaccination can get POTS, among the other 9,000 adverse effects of the vaccines! Rockefeller Medicine would like you to think that those sufferers already had pre-existing conditions, but many health professionals who champion the immune system disagree.

“POTS has absolutely gone up due to the jab, 100%,” agrees Dr. Aranda, who has observed the prevalence of the condition increasing post-COVID-19, in patients both with and without vaccinations.   

While most doctors don’t acknowledge POTS or vaccine injuries, Peng-Sheng Chen, MD, who also holds the Burns and Allen Chair in Cardiology Research at Cedars-Sinai, concedes that this study’s findings suggest “it may be helpful to keep an eye on patients with underlying health issues after COVID-19 vaccination to monitor for post-vaccine POTS.” 

There is also a link between POTS and the SARS-CoV-2 infection, which many believe was a bioweapon that was engineered in a lab. “SARS-CoV-2 infection-induced stress may activate the sympathetic nervous system (SNS), leading to neuro-hormonal stimulation and activation of pro-inflammatory cytokines with further development of sympathetic storm,” reads a study titled Covid-19-Induced Dysautonomia: A Menace of Sympathetic Storm.

Other studies and reviews have also reported the neuroinvasive nature of SARS-CoV-2 that only further results in neurological complications. One theory is that the virus may cause the immune system to attack itself.  While COVID-19 mainly targets the respiratory system, it can also affect other organ systems, including the autonomic nervous system. Recent research suggests POTS may be one long-term consequence that can start within six to eight months of the viral infection.    

The Epoch Times also reported on the marked increase in referrals to POTS clinics since the pandemic, with a considerable number of cases reporting symptoms starting post-COVID infection or vaccine. Global case reports also suggest a trend of individuals developing POTS after mRNA COVID-19 vaccinations. 

Long COVID-19 and POTS 

Long COVID, sometimes called chronic COVID-19 or post-acute COVID-19 syndrome, occurs when a person’s symptoms persist after recovering from a SARS-CoV-2 infection. They can develop new symptoms that last weeks, months or even years. 

As the nation moves further from the pandemic, marked rates of long COVID-19 remain steady. In March 2024, the CDC reported that seven percent of all adults—roughly 17 million people—reported having long COVID-19.

“Among the 60 percent of U.S. adults who have had COVID, roughly 3 in 10 report having long COVID at some point, and roughly 1 in 10 report having long COVID now,” according to the CDC.   

“POTS is utterly under-diagnosed. There’s precious little about it available on the internet and given that it’s the primary presentation of long-term COVID-19, whether the person was vaxxed or not. Given that this represents 7 percent of the U.S. population, so many people need information,” said Dr. Aranda.

Diagnosing and Managing POTS || A Multifaceted Approach 

Unfortunately, POTS remains grossly under-diagnosed and often misunderstood, often resulting in treatment delays. For patients like Sarah (not her real name), understanding POTS has been the first step toward regaining a sense of control over her life. She has been suffering since she was young (and possibly from a vaccine).

“When I went to my family doctor, they were shocked that my standing results didn’t make me pass out. He sent me to specialists, but they were not POTS-informed.  I spent a couple of years bed-bound with no leads until the Cleveland Clinic in Ohio officially diagnosed me. The doctor there said that my symptoms would have been more manageable if I had been diagnosed sooner,” shared Sarah.  

Once you know you have POTS; there are things you can do.  

What You Drink and Eat 

Maintaining high-quality hydration is among the most immediate actions one can take to relieve POTS symptoms. Increased fluid and good salt intake are vital. Molecular hydrogen is an obvious choice for people who require vigilant attention to hydration.

“What you eat greatly affects your daily life with POTS,” says Richard N. Fogoros, MD. “Symptoms of dizziness, lightheadedness, fatigue, and brain fog can be greatly minimized by choosing the correct way of eating for POTS.”  

Dr. Fogoros advises that a high-salt diet for POTS treatment is crucial because it increases both blood volume and blood pressure when there is also a high fluid intake. The following foods are good examples of foods that are high in salt: anchovies, bacon, cheese, miso soup, olives, pickles, salted nuts, soy sauce, salsa, soups, and broths. 

“I personally would advise only to eat organic.  Foods to avoid would be sugary foods and potatoes (high levels of starch can cause fatigue). Sugar (can cause spikes and crashes and result in fatigue), white bread (blood sugar hike), grapes (a diuretic effect that may increase blood volume), parsley (diuretic effect), alcohol (known to impair smooth muscle response to regulate blood pressure…Instead of tightening to prevent hypotension, blood vessels can even relax and worsen the problem), and coffee (can cause an increase in adrenergic hormones and result in a flare-up),” Dr. Fogoros said.

Allopathic Medications

Beta-blockers may reduce upright tachycardia, fludrocortisone, and midodrine can be prescribed to control heart rate or improve blood volume.  Sarah, on the other hand, was given Ivabradine, commercially known as Corlanor, which is actually an FDA-approved drug for heart failure! She’s still trying to heal her root issues. 

Therapy

Cognitive-behavioral therapy (CBT) is a type of psychotherapy that can help treat a range of mental and emotional health issues, most commonly anxiety and depression, but can be useful for other mental and physical health problems too. CBT has been shown to help with the mental and emotional strain of chronic illness by helping to improve coping strategies, leading to better symptom management and an enhanced quality of life.

CBDV/CBD

POTS/dysautonomia is associated with autonomic nervous system dysfunction, so Cannabidiol—better known as “CBD”—can help tremendously. CBDV and CBD, which protect and support nerve health, can be beneficial and are non-psychoactive. Cannabinoids are anti-inflammatory and immune-regulating, and CBDV is particularly noteworthy as a neurological anti-inflammatory.  

“There are many inflammatory, neuropathic symptoms and suggestions of autoimmune involvement,” explains herbalist Elizabeth Moriarity, who was first introduced above. As an experienced clinical herbalist, she’s formulated functional cannabis therapeutic tinctures using whole plant medicine.

CBDV, like CBD, has been shown to possess anti-inflammatory properties. And since inflammation is a root cause of many POTS symptoms, CBDV can help alleviate some of the inflammation, thereby reducing symptoms.

Cannabinoids, including CBDV, can influence vascular tone and blood vessel dilation, which might help manage some symptoms of POTS.  CBDV also has anxiolytic (anxiety-reducing) effects, and in some studies, CBDV has been shown to reduce nausea and vomiting, which are all common symptoms of POTS.

Vagus Nerve Therapy 

The vagus nerve plays a crucial role in controlling heart rate, blood pressure, and digestion, all of which can be dysregulated in POTS patients. 

“The vagus nerve,” states Dr. Patrick Nemecheck D.O., “carries information from the organs to the brain, which is instrumental in regulating inflammation in the autonomic nervous system. While we typically think if we stimulate something, we are turning something ‘on,’ when it comes to the autonomic vagus nerve, this stimulation actually helps turn inflammation ‘off.’”  Look up Nemechek Protocol for details.

Therapy can stimulate the vagus nerve to reduce symptoms such as dizziness, fatigue, and rapid heart rate; while it can improve cardiovascular stability and overall quality of life. Techniques such as deep breathing exercises, electrical stimulation, and specific lifestyle changes can enhance vagal tone and support better autonomic function. 

Movement And Exercise

At first glance, POTS may seem like a cardiac issue. However, you can now see that it actually involves the brain, nervous system, intestinal tract, the production of stem cells, inflammation, and the chemicals in a person’s diet.

An exercise program for POTS may begin with swimming or using rowing machines, which do not require an upright posture. Studies have shown that POTS patients, on average, have smaller cardiac chambers than those without. Regular aerobic exercise has increased cardiac chamber size, slowed heart rate, and improved symptoms.  Fluids are important during exercise as decreased fluid intake reduces blood volume and makes one more likely to experience hypotension.

Support organizations, research, and educational initiatives are actively working to bring POTS into the spotlight because increased awareness among healthcare professionals and the public is crucial to improving outcomes.

Conclusion

If you or a family member have been diagnosed with POTS, the encouraging news is that this disorder is reversible. Almost two decades later, Dr. Aranda is healed, and enjoying life with her 21-year-old daughter. The key to recovery is to work to resolve the underlying sympathetic and parasympathetic nervous system dysfunction and not just try to mask the symptoms.   

 

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