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9 Things you Need to Know About POTS

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Imagine that you are sailing through life – working, taking care of your family, spending time with friends- when suddenly you become unwell. You begin to feel dizzy, exhausted, and out of breath. Activities you once took for granted, such as taking a shower, now feel like monumental tasks. You experience heart palpitations, nausea, and brain fog.  

At first, you dismiss the symptoms as a passing virus. You wonder if you’ve contracted Lyme disease, Covid, or another chronic illness. Your visit with your doctor is unremarkable, and you are reassured that all is fine. Perhaps you check in with a cardiologist, only to be told that your heart looks great. “Am I crazy,” you wonder? 

No, you aren’t crazy. You may very well be one of the million people in the United States with a condition called POTS. 

What is POTS?

POTS is a perplexing condition that impacts how blood flows through the body. This neurological disorder occurs when the autonomic nervous system is not working correctly.

The autonomic nervous system (ANS) is the body’s “autopilot mode.” This branch of the nervous system controls functions we don’t normally think about, such as blood pressure, heart rate, digestion, sweating, and body temperature. 

What does POTS stand for? 

POTS is not a disease in and of itself. Instead, it’s a cluster of symptoms that are frequently seen together. 

P = Postural (Refers to the position of the body such as standing, sitting, or lying down) 

O = Orthostatic (Relating to standing still in an upright position)

T = Tachycardia (A fast heart rate greater than 100 beats per minute)

S = Syndrome (A group of symptoms that often appear together) 

What happens in POTS?

Typically when an individual changes positions, such as going from sitting to standing, gravity pulls some of the blood down towards the stomach, hands, legs, and feet. The body quickly compensates by constricting the blood vessels and raising the heart rate slightly to maintain blood flow to the brain and heart. While the heart rate may rise for 10-20 seconds, it quickly adjusts and returns to normal. This entire process, dictated by the ANS, occurs without even noticing changes in the body. 

For someone with POTS, the nervous system cannot compensate for the changes in position. As a result, the heart rate skyrockets at least 30 beats per minute as the body tries to keep the blood flowing to the upper half. In individuals with POTS, blood pressure is typically maintained on standing or may even increase. However, symptoms develop as blood pools in the lower part of the body. 

There are several variations of POTS, including: 

  • Hyperadrenergic POTS: Occurs as a result of an overactive sympathetic nervous system
  • Neuropathic POTS: Occurs due to poorly functioning nerves
  • Hypovolemic POTS: Occurs as a result of low blood volume 
  • Deconditioned POTS: Occurs as a result of a sedentary lifestyle

Things you should know about POTS  

It is not a disease 

POTS is not a disease in and of itself. After all, a disease has a defining cause, distinguishing symptoms, and possible treatments. On the other hand, POTS is defined as a cluster of related symptoms without a clear cause. 

It is not rare

Although POTS may not be well known, it’s certainly not rare. POTS syndrome is estimated to affect between 1 and 3 million people in the United States. This number is expected to rise in the coming years, especially with the advent of Covid. In fact, studies show that many individuals recovering from Covid experience POTS. 

POTS symptoms impact the entire body

POTS is often considered an “invisible illness” due to the absence of obvious symptoms. However, it is a devastating condition that affects the body and the mild. Those with POTS often feel sick, unheard, and even crazy. In fact, POTS is often misdiagnosed as anxiety or panic attacks.  

POTS is most commonly known for causing dizziness and, in some cases, fainting upon standing. POTS patients are often exhausted. Other hallmark signs of POTS include:

  • Heart palpitations 
  • Racing heart 
  • Chest pain 
  • Headache
  • Nervous, jittery, or anxious feeling 
  • Nausea
  • Abdominal pain or bloating 
  • Generalized chronic pain 
  • Temperature dysregulation (feeling hot or cold) 
  • Excessive or lack of sweating 
  • Shortness of breath
  • Insomnia
  • Brain fog
  • Weakness
  • Bladder dysfunction
  • Tremors
  • Exercise intolerance 

It can be debilitating 

While some people can live and function normally with POTS, others are completely disabled by the condition. According to research, approximately 25 percent of POTS patients cannot attend work or school. In more severe cases, people compare the disability in POTS with that of heart failure. 

It has many underlying causes

As with many chronic illnesses, mainstream medicine has difficulty pinpointing the cause of POTS. However, there is likely a hormonal link, as it’s sometimes triggered by pregnancy or puberty. 

Moreover, POTS is an inflammatory condition. An activated immune system, such as a virus, can “switch on” the disorder. For example, many POTS patients recall having an infection right before their symptoms began.

Other possible causes/triggers for POTS include: 

It is often misdiagnosed

Because POTS is so poorly understood, patients often go a long time without a diagnosis. In fact, only 25 percent of patients are diagnosed within the first year of symptoms, and the average diagnosis time is nearly six years. 

Moreover, a quarter of POTS patients saw ten doctors before their diagnosis. Most concerning, almost 70 percent of patients were diagnosed with anxiety first, even though research shows that POTS patients are no more likely to be anxious than the general public. 

There are natural ways to alleviate POTS symptoms

Many individuals with POTS are told they need medication to manage their symptoms. Unfortunately, most drugs used for POTS do not work and may even aggravate the symptoms. Natural methods of reducing symptoms include: 

  • Ensuring proper hydration
  • Performing light to moderate exercise daily (swimming, light rowing, and recumbent biking are excellent choices for those with POTS)
  • Wearing support tights or compression stockings during the day
  • Avoiding alcohol or caffeine
  • Including more salt in your diet 
  • Getting chiropractic care
  • Practicing mindfulness or meditation daily
  • Spending time in the sun
  • Ensuring quality sleep 

Diagnosing POTS should not be difficult 

While POTS is a neurological disorder, it is most often diagnosed and treated by a cardiologist due to the involvement of the heart. Your doctor will take a thorough history and do a physical exam. If POTS is suspected, further testing will occur. 

The gold standard for diagnosing POTS is through a tilt table test.  During this test, patients are secured to a table while lying flat. The table is then slowly tilted to simulate standing up. Heart rate and blood pressure are monitored during the procedure. 

Besides a tilt table test, your doctor may order additional testing to rule out other conditions that mimic POTS. You may have an EKG, cardiac ultrasound, and home-heart monitoring. In addition, your doctor may order tests that measure blood volume, sweating, and breathing.

POTS can be cured 

As with most chronic diseases, POTS can be cured if the root cause can be identified. The NHD team will order testing that aims to find the cause of your POTS symptoms. This testing may include: 

  • Advanced CV Analysis:  This comprehensive test gives an in-depth review of the cardiovascular system and beyond. Lab results review inflammation, diabetes markers, thyroid health, omega-3 status, vitamin D, and more.
  • Micronutrient Testing – Since vitamin deficiencies interfere with autonomic function and detoxification, it’s important to examine if you have the right balance of vitamins and minerals inside and outside your cells. 
  • Triple Toxin Test Panel – Toxins are a leading cause of nerve damage in the body. This comprehensive test looks for 31 mold mycotoxins, various heavy metals, and 27 environmental toxins. 
  • Wheat Zoomer – The gut microbiome is closely connected to nervous system function. Leaky gut is a contributing factor in POTS. This test takes an in-depth examination of gut health.
  • Neural Zoomer Ultimately, POTS is a nervous system and brain issue. This test detects autoimmune activity toward brain and neurologic function, assisting in the diagnosis of POTS. 

Results from these tests will be used to guide potential treatment options. 

Next steps

Energy conservation is critical if you or a loved one have been diagnosed with POTS. And yet, most people spend precious time and energy chasing answers and trying to quell the symptoms of this debilitating condition. 

Sadly, most conventional doctors fail to consider the possible root causes of POTS. However, with proper examination and treatment, it’s entirely possible to reduce symptoms or even heal from POTS altogether. Contact Natural Heart Doctor to fill out an application to work with one of our expert practitioners today.

Eat Well, Live Well, Think Well 


Medical Review: Dr. Lauren Lattanza NMD 2022

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Frequently Asked Questions

I’d like to receive an online second opinion from Natural Heart Doctor. What do I do next?

You can initiate a second opinion online through our website at any time. To begin, select the team member you’d like to speak with and open an account.

Click here for cardiologist Dr. Jack Wolfson.

Naturopathic Medical Doctor Dr. Lauren Lattanza. Get details.

Naturopathic Medical Doctor Dr. Tonia Rainier. Get details.

Click here for  Natural Heart Doctor Health Coach.

Alternatively, you can email health@naturalheartdoctor.com. A member of our care team will help guide you through the process of starting a second opinion.

What is the cost of a Natural Heart Doctor Online Second Opinion?

The cost for most second opinions varies by team member. This fee includes information collection, a phone or video consultation, a second opinion from a Natural Heart Doctor specialist and guidance throughout the process from your personal Care Team at Natural Heart Doctor.

Cardiologist Dr. Jack Wolfson’s Second Opinion Fee is $1500.

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Naturopathic Physician Dr. Tonia Rainier’s Second Opinion Fee is $250.

Note: We apply the Online Second Opinion Call fee as a credit to any future consultations with Natural Heart Doctor, should you choose them.

Will my insurance cover the cost of a Natural Heart Doctor Online Second Opinion?

Most likely, no. Most health plans do not cover online second opinions or consultations. You are responsible for the cost of our second opinion. Natural Heart Doctor cannot file a claim with your insurance carrier, nor can we provide a procedure (CPT) code for this service.

What is the timeline to receive an online second opinion?

We do our best to schedule your second opinion as quickly as possible. Typically, it takes 5 to 7 business days after your information has been collected to receive your phone or video online second opinion.

What information do you need in advance of our call?

Our office will send you a short questionnaire to complete and return. We DO NOT need your complete medical records.

How many questions can I ask the expert during our call?

You may ask a maximum of five questions. This is to ensure that the expert has sufficient time to devote to each question. All questions must be finalized before your online meeting.

What should I expect to receive once my second opinion is complete?

You will receive a summary of our discussion along with our second opinion. The second opinion will be in written form. After you have reviewed the second opinion, a Natural Heart Doctor clinician will follow up with you by phone to address general medical questions about the information provided in the second opinion.

What if I have follow-up questions for the expert after I have reviewed my second opinion?

If you have a clarifying question about an expert’s response to one of the questions in your second opinion, and the Natural Heart Doctor clinician is unable to address it, then you may request a follow up session for an additional fee. 

Is my medical and payment information secure?

Natural Heart Doctor is strongly committed to protecting the privacy and security of all our patients. Our website meets all federal requirements for protecting personal health information under the Health Insurance Portability and Accountability Act (HIPAA). All financial transactions are processed by Natural Heart Doctor securely using industry standard payment processing tools.

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If you would prefer an in-person appointment at Natural Heart Doctor instead of an online second opinion, please call (480) 535-6844 for details and scheduling.

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