It is estimated that  from 500,000 to 3 million Americans have a condition called POTS: postural orthostatic tachycardia syndrome. For someone suffering from POTS, simply standing up causes a rapid increase in heart rate. This can result in a wide variety of other symptoms such as dizziness, brain fog, and nausea.

The belief is that the symptoms of POTS are the result of a lack of proper blood flow to the brain. When you are sitting the blood tends to pool more in the lower body and the heart has an easy time pumping blood to the brain. Upon standing, blood stays  in the lower half of the body and there is difficulty getting it quickly to the brain. This causes the heart to beat faster in an effort to correct for this.

As with many medical conditions for which they lack a specific treatment or drug there is a range of theories as to the causes of POTS.  As is the case with many conditions POTS appears to be a group of distinct and different imbalances, linked by their common symptoms. Women are about 5 times more likely to have POTS than men.

Look to the Nervous System

If we slow down and consider what system is responsible for ensuring blood gets to the brain regardless of what we are doing we might first think of the heart. But, the heart is the pump. What sends messages to the heart to pump?

The Autonomic Nervous System is the key controller of messages to the heart to speed up or slow down depending on what you are doing. 

There is an epidemic of imbalances in the Autonomic Nervous Systemic (ANS) often referred to as Dysautonomia. Regardless of whether this is the cause of POTS or not, it is an element that is present and it only makes sense to bring the ANS back into balance.

Oftentimes long term stress disrupts the messaging in the Hypothalamic Pituitary Adrenal Axis (HPA Axis) that results  in a failure to ensure adequate brain blood flow.

Balancing the ANS

Balancing the ANS is a combination of a number of approaches including:

• Removing irritation and pressure to the ANS. This involves irritation to the Vagus Nerve in the upper neck and down in the pelvis. This also includes correcting irritation to the Sympathetic Nervous System in the mid and lower spine.
• Correcting Dysfunctional Breathing Patterns that perpetuate ANS imbalance.
• Corrective Practices to restore greater balance to the ANS.

Other Treatments Showing Promise for POTS

In more traditional healthcare  a number of treatments show promise for POTS. One of these treatments, interestingly enough, is to eat more salt. Getting more salt can increase the blood volume, makign it easier for the heart to get blood to the brain.

What Is POTS?

Postural orthostatic tachycardia syndrome is a great example of medicine making things confusing. Let’s take it one word at a time:

• Postural: Refers to the position of your body
• Orthostatic: caused by an upright posture, or standing up
• Tachycardia: Rapid heart beat
• Syndrome: characterized by a set of associated symptoms

When you break it down, it’s not so complicated. POTS is a set of symptoms that are triggered when someone stands up. The classic sign of POTS is the rapid heartbeat, but a range of other symptoms may also show up, including headache, brain fog, dizziness, blurred vision, heart palpitations, tremors, nausea, and even fainting.

POTS Diagnosis

The gold standard for diagnosing POTS is the tilt table test. More commonly, doctors can check for rapid heartbeat by having the patient stand without assistance after lying flat on their back.

To be diagnosed with POTS, the patient’s heart rate must increase by at least 30 beats per minute in adults, or 40 beats per minute in adolescents when they rise to a standing position. First, you would want to rule out other conditions such as dehydration, adverse medication reactions and  orthostatic hypotension.

What Causes POTS?

Reduced blood flow to the brain, is probably the biggest cause of POTS symptoms. Less blood flow means less oxygen which means more problems and  more symptoms.

The triggering event is standing up because when people stand, gravity pulls blood into the lower body. To offset the impact of gravity, hormones—like norepinephrine and epinephrine—are secreted to help constrict blood vessels and facilitate getting blood into the upper half of your body. It seems that people with POTS don’t respond normally to these hormones or are not secreting in a timely manner.

Sodium for POTS

Sodium is an electrolyte found in salt (sodium chloride). One of its most important jobs is to regulate fluid balance inside and outside of your cells. Increasing odium increases blood volume, which helps blood reach all throughout your body, including your brain.

Many hypovolemic POTS patients have shown low levels of renin and aldosterone—hormones that help retain sodium —it makes sense that consuming sodium could help restore their blood volume. 

The million dollar question remains: Does getting more salt improve POTS symptoms?

 Research indicates that intravenous saline can help restore blood volume in people with POTS, leading to a reduction in heart rate.  

Simply eating a high-salt diet and drinking salty water have both been shown to be effective treatment for people with POTS and similar conditions such as orthostatic hypotension (OH). You can mix your own sodium beverage at home, consume sodium-rich foods or try a high-sodium electrolyte drink mix.

Other Treatments For POTS

Some lifestyle changes may also reduce POTS symptoms. Aerobic exercises like jogging, cycling, and swimming can help with POTS. Make sure to hydrate with fluids and electrolytes.  

If you have POTS, work with your doctor to come up with a holistic treatment plan. Since medicine does not have an answer it can help to work with both an MD to monitor your condition and a practitioner focused on whole body balance and function.

POTS Summary

Here’s a quick recap of  postural orthostatic tachycardia syndrome, or POTS:

• An estimated 3 million Americans may have POTS, more common in adolescents and women.
• POTS symptoms include fatigue, dizziness, headache, difficulty concentrating, and nausea.

If you are interested in exploring how chiropractic might help your body achieve greater balance and potentially alleviate the symptoms of POTS you can schedule your visit with Life Chiropractic of Grass Valley here: Schedule Here

About Dr. Berkowitz  

Bringing more than 3 decades of practice experience, Dr. Bill Berkowitz focuses on balancing and corrective care, applying his expertise to provide patients with predictable, repeatable and measurable results.

Dr. Bill consistently strives to enhance the well-being of his patients by addressing the root imbalances of their problems and promoting optimal balance, alignment, and function of the spine and nervous system.  

Bill’s wealth of knowledge and experience has allowed him to develop a nuanced understanding of the human body and its intricate connections. With each adjustment, he supports the body in returning to a state of balance that goes beyond mere symptom relief, focusing instead on long-term correction for his patients’ well-being.