Postural Orthostatic Tachycardia Syndrome (POTS)
What is POTS?
Postural orthostatic tachycardia syndrome (POTS) is a condition that causes a number of symptoms when you transition from lying down to standing up, such as a fast heart rate, dizziness and fatigue. While there’s no cure, several treatments and lifestyle changes can help manage the symptoms of POTS.
What are POTS Symptoms?
What are POTS triggers?
Are there different types of POTS?
How does POTS get diagnosed?
If you have symptoms of POTS, a GP may check your blood pressure and heart rate before and after you stand up. They may refer you to a cardiologist or neurologist who will perform blood tests, urine test, a tilt table test, heart and blood pressure tests (e.g., ECG, echocardiogram, and 24-hour blood pressure and heart rate monitoring).
How can you treat POTS?
There is no cure, however some medications and lifestyle changes can help as well as treating any underlying MCAS symptoms. If you suddenly feel faint or dizzy, you can try lying down and raising your legs, crossing your legs with one in front of the other while standing, rocking up and down on your toes, clenching your buttocks and tummy muscles, and clenching your fists. You can also increase your electrolyte, salt and fluid intake and try compression garments.
Where can you learn more?
The POTScast
POTS UK
The Dysautonomia Clinic
Treatments for POTS
Dietitian Savita Sandhu on POTS electrolytes and POTS diet
Postural orthostatic tachycardia syndrome (POTS) is a condition that causes a number of symptoms when you transition from lying down to standing up, such as a fast heart rate, dizziness and fatigue. While there’s no cure, several treatments and lifestyle changes can help manage the symptoms of POTS.
What are POTS Symptoms?
- Dizziness or light-headedness
- fainting or almost fainting
- noticeable heart palpitations
- heart rate over 100
- chest pain
- shortness of breath
- shaking and sweating
- problems with your stomach or digestion
- constipation
- diarrhea
- bloating
- headaches
- vision problems
- your hands and feet looking purple
- weakness or extreme fatigue
- problems with thinking, memory and concentration like brain fog
What are POTS triggers?
- feeling hot
- eating refined carbs like white bread
- not drinking enough fluids
- drinking alcohol
- resting too much
- exercise
- being on your period
- hormonal changes
Are there different types of POTS?
- Neuropathic POTS: Neuropathic basically means nerve disease. The nerve supply to the vessels in the lower limbs known as the sympathetic nerves is responsible for stimulating the vessels to tighten up and squeeze blood back up to the heart when needed, such as when standing. In POTS syndrome, the sympathetic nerve supply to the lower limbs does not function properly and so there is pooling of blood in the lower extremities rather than being returned back up to the heart. This leads to dizziness on standing, known as orthostasis, and increase in heart rate, known as tachycardia. This is the most common form of POTS.
- Hyperadrenergic POTS: Hyperadrenergic basically means high adrenaline. Adrenaline and nor-adrenaline (epinephrine and nor-epinephrine) are natural stimulants within the body, the same ones released in the flight or fight response. Hyperadrenergic POTS patients have high levels of nor-epinephrine in their blood. As you can imagine these would lead to increasefd heart rate and blood pressure. In the more common neuropathic form of POTS, there is lower blood pressure and higher heart rate when standing. In hyperadrenergic POTS, there is often both increased blood pressure and heart rate when standing.
- Secondary POTS: Secondary POTS refers to POTS syndrome that occurs as a result of another underlying condition that leads to damage of the nerves that usually control the redistribution of blood. These conditions include diabetes, lupus, alcoholism and chemotherapy. As part of the work up for POTS, a screening to rule out secondary causes is usually performed.
How does POTS get diagnosed?
If you have symptoms of POTS, a GP may check your blood pressure and heart rate before and after you stand up. They may refer you to a cardiologist or neurologist who will perform blood tests, urine test, a tilt table test, heart and blood pressure tests (e.g., ECG, echocardiogram, and 24-hour blood pressure and heart rate monitoring).
How can you treat POTS?
There is no cure, however some medications and lifestyle changes can help as well as treating any underlying MCAS symptoms. If you suddenly feel faint or dizzy, you can try lying down and raising your legs, crossing your legs with one in front of the other while standing, rocking up and down on your toes, clenching your buttocks and tummy muscles, and clenching your fists. You can also increase your electrolyte, salt and fluid intake and try compression garments.
Where can you learn more?
The POTScast
POTS UK
The Dysautonomia Clinic
Treatments for POTS
Dietitian Savita Sandhu on POTS electrolytes and POTS diet
