Understanding POTS: A Naturopathic Approach (Postural Orthostatic Tachycardia Syndrome)

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that affects how the body controls blood pressure and heart rate. In people with POTS, standing up can cause a big rise in heart rate, which can lead to symptoms like dizziness or feeling faint. POTS can be difficult to live with, but with a comprehensive naturopathic approach, addressing the underlying causes, people can find ways to manage their symptoms and improve their overall well-being.

What Are the Symptoms and Signs of POTS?

POTS can cause a wide range of symptoms that can vary in severity and often change in intensity through the day. The most common symptom is a quick increase in heart rate (tachycardia) —30 beats per minute or more—within 10 minutes of standing. But there are other common symptoms too, including:

Heart-related signs of POTS:

Feeling dizzy or lightheaded when standing

Palpitations (feeling your heart pounding)

Shortness of breath

Chest pain or discomfort

Brain and nervous system symptoms of POTS:

Trouble focusing or “brain fog”

Feeling very tired, even with enough sleep

Headaches, including migraines

Tremors or shakiness

Digestive symptoms of POTS:

Nausea or stomach discomfort

Bloating, abdominal pain

Diarrhea or constipation

Other POTS symptoms:

Sweating too much or too little (poor temperature regulation)

Anxiety

Feeling hot or cold more easily

Discomfort with exercise

These symptoms can be worse if you’re stressed, dehydrated, standing for a long time, or exposed to heat. Living with POTS can make normal activities like going to work or school, playing sports really hard.

POTS is often misdiagnosed, or takes a long time to diagnose because its symptoms overlap with other conditions like anxiety disorders, chronic fatigue syndrome and fibromyalgia (and you may have a combination of these).

What Causes POTS?

POTS can develop due to various factors, many of which are interconnected. While the exact cause is still not fully understood, several contributors include:

Infections: Viral infections, such as Epstein-Barr virus (EBV), Lyme disease, and more recently, COVID-19, are often linked to the development of POTS. Post-viral dysautonomia is a known trigger.

Hormonal changes: POTS often worsens during periods of hormonal fluctuation, such as menstruation, pregnancy, and menopause, hinting at a hormonal connection.

Chronic stress or trauma: Physical trauma, extended bed rest, or emotional trauma may trigger POTS in susceptible individuals.

Autoimmune conditions: Evidence suggests a link between POTS and autoimmune diseases like lupus, where the body’s immune response leads to autonomic nervous system dysfunction.  POTS is also associated with several autoimmune conditions, such as those affecting the thyroid (eg; Hashimoto’s), joints (eg: Rheumatoid arthritis) and blood vessel linings.

Genetic predisposition: POTS can run in families, particularly in females, suggesting a genetic link.

Deconditioning: Periods of inactivity, such as after surgery or during illness, can lead to a deconditioned cardiovascular system, contributing to POTS.

How Can Naturopathic Medicine Help POTS?

Naturopathic medicine emphasizes treating the underlying causes of disease and supporting the body’s natural healing mechanisms. When it comes to POTS, a combined approach can include dietary interventions, nutritional and herbal support, mind-body techniques, and other holistic therapies to reduce symptoms and improve autonomic function.

1. Staying Hydrated and Balancing Electrolytes

Drinking plenty of water is one of the best ways to help with POTS. People with POTS often don’t have enough blood volume, meaning they don’t have enough blood circulating through their body. Drinking 2-3 liters of water a day and increasing salt intake (by adding salt to meals/water, or consuming coconut water) can help keep blood pressure stable.  Tracking blood pressure is important to make sure the salt isn’t excessive.

2. Eating Anti-inflammatory Foods

Eating a healthy diet can help reduce inflammation in the body, which is important for people with POTS. Including fresh fruits and vegetables, lean proteins, and healthy fats like olive oil and nuts. Foods rich in antioxidants, like berries and spinach, help fight inflammation.  A whole-foods diet ensures more balanced blood sugar in the body which can be a factor in POTS.  Avoiding foods that can cause inflammation, such as processed foods, sugar, gluten, and dairy – this is where food sensitivity testing can help to identify your specific triggers.  Adding omega-3 fats from fish or flaxseed can help, too.  High-sodium foods: incorporating naturally salty foods like pickles, olives, and broths helps maintain blood pressure levels and reduce symptoms of orthostatic intolerance.  Small, frequent meals: eating smaller meals more frequently can prevent postprandial hypotension (a drop in blood pressure after meals), which is common in POTS patients.

3. Taking the Right Supplements

Nutritional imbalances are common in individuals with POTS, and targeted supplementation can help address these deficiencies. Blood tests can be used to identify deficiencies, and supplements can be tailored to each individual’s needs. Common deficiencies in POTS include:

Vitamin B12: Important for nervous system function and energy production.

Vitamin D: Low levels are common in POTS and are linked to immune function and overall health.

Magnesium: Supports muscle function, nervous system regulation, and cardiovascular health.

Iron: Anemia or low iron levels can exacerbate symptoms such as fatigue and brain fog.

Naturopathic doctors may recommend supplements that support mitochondrial function and reduce fatigue, such as Coenzyme Q10 and L-carnitine.

4. Using Herbal Remedies

Herbal medicine is another natural way to help manage POTS. Certain herbs can improve circulation and reduce stress. Some commonly used herbs include:

Ashwagandha: a calming herb that may help ease the impact of stress on the nerves.

Hawthorn: can support the heart and improve circulation.

Licorice root: supports blood pressure and adrenal function. However, it should be used cautiously, as it can raise blood pressure in some individuals with existing high blood pressure.

Ginkgo biloba: improves blood flow to the brain and can help reduce dizziness and brain fog.

5. Wearing Compression Garments

Wearing compression socks, high-waist tights or abdominal binders helps improve circulation and prevent blood from pooling in the legs, which is a common issue in POTS. These garments can help reduce dizziness, fatigue and heart rate spikes when standing.

6. Gradual Exercise

Exercise can be tricky for people with POTS because their heart rate increases too quickly. However, with the right plan, exercise can actually improve POTS symptoms. Starting with gentle, recumbent exercises like yoga, cycling, swimming or rowing, where the person stays in a lying-down or seated position is generally recommended. Over time, they can work up to more upright exercises.

7. Acupuncture and Mind-Body Support

POTS is often worsened by stress, so managing stress is important. Mind-body practices like yoga, meditation, deep breathing, and biofeedback can help balance the parasympathetic and sympathetic nervous systems, making them useful tools in managing autonomic dysfunction in POTS. Naturopathic medicine also uses acupuncture to balance the body’s energy and help reduce dizziness, palpitations and fatigue.

8. Homeopathy for POTS

Homeopathy is another tool that naturopathic doctors use to support people with POTS. Remedies are chosen based on the person’s unique symptoms.

Intravenous treatments for POTS

Intravenous (IV) saline water can be an effective treatment for individuals with Postural Orthostatic Tachycardia Syndrome (POTS) by improving blood volume, stabilizing blood pressure, and reducing symptoms like dizziness, brain fog, fatigue, and fainting.  The direct hydration with electrolytes may help reduce symptoms relatively quickly and can be a part of a broader treatment program.  Specific vitamins and minerals can be added to customize the treatment based on individual needs.

Addressing the Root Causes of POTS

Our naturopathic approach to helping those with POTS aims to treat the root cause, not just the symptoms.  This can involve addressing chronic infections, supporting hormonal balance, balancing the immune system in underlying autoimmune conditions, or vulnerabilities such as those with fibromyalgia or chronic fatigue.

Conclusion

POTS can be a tough condition to live with and a comprehensive approach can help manage symptoms and improve quality of life. From drinking more water and eating the right foods to using herbs and supplements, there are many natural ways to help the body function better. With the right support, people with POTS can feel stronger, more energetic and more in control of their health. 

Call us at 905-597-7201or contact us online to schedule your assessment and develop a customized treatment plan. To your good health, Dr. Rahim Habib ND

 

References

Wells, R., et al. (2021). Postural Orthostatic Tachycardia Syndrome (A Functional and Naturopathic Approach to POTS (Postural Orthostatic Tachycardia Syndrome)

Raj, S. R., et al. (2020). Postural Orthostatic Tachycardia Syndrome. Circulation, 141(8), e276-e293.

Grubb, B. P. (2008). Postural Tachycardia Syndrome. Circulation, 117(21), 2814-2817.

Fung, E., & Gibbons, C. H. (2016). Autonomic Dysfunction in Postural Tachycardia Syndrome. Autonomic Neuroscience, 193, 76-80.

Chen, L., et al. (2017). The Role of Probiotics in Treating POTS. Journal of Digestive Diseases, 18(7), 389-396.

National Dysautonomia Research Foundation. Postural Orthostatic Tachycardia Syndrome (POTS) Overview. dysautonomiainternational.org.