POTS or Postural Orthostatic Tachycardia Syndrome affects the parts of the nervous system that control functions like heart rate, blood pressure, breathing, digestion, etc. In POTS, the autonomic system does not regulate blood flow effectively when moving from a lying down to upright position. This results in an abnormally large increase in heart rate as the body tries to compensate, leading to symptoms like dizziness, fainting and fatigue.
POTS is estimated to affect around 1 million people in the UK. Women under the age of 50 are most commonly affected. The exact cause is often unknown but may involve autoimmune dysfunction, genetics, viruses, pregnancy or trauma.
Recognising Symptoms of POTS
The defining symptom of POTS is a heart rate increase of 30 beats per minute or more within 10 minutes of standing up (postural tachycardia). Other key symptoms include:
- Dizziness or fainting when standing up
- Fatigue
- Exercise intolerance
- Headaches
- Nausea
- Chest pain
- Brain fog and concentration problems
- Insomnia
- Temperature regulation problems
- Gastrointestinal issues
Common Triggers for POTS Symptoms
Here are some common triggers that can exacerbate POTS symptoms:
- Standing for long periods – Prolonged upright posture can cause blood to pool in the legs and worsen symptoms. Take regular breaks to sit or lie down.
- Warm environments – Heat causes blood vessels to dilate, exacerbating blood pooling. Use cooling techniques like fans, cold drinks, and ice packs. Avoid hot tubs and showers.
- Heavy meals – Digesting a large meal diverts blood flow to the gut. Eat smaller, more frequent meals.
- Dehydration – Low fluid intake thickens blood and makes symptoms worse. Drink 2-3 litres of electrolyte-containing fluids daily.
- Alcohol – Causes vasodilation and dehydration. Avoid or limit intake.
- Menstrual cycles – Hormonal fluctuations can worsen symptoms during periods. Track cycles to anticipate bad days.
- Stress – Releases hormones that quicken heart rate. Practice relaxing activities like meditation, yoga, or deep breathing.
- Lack of sleep – Disrupts circadian rhythms and causes fatigue. Maintain good sleep hygiene practices.
- Medications – Some drugs like diuretics, beta blockers, stimulants can exacerbate POTS. Check with your doctor.
Avoiding triggers when possible and using mitigating strategies can help minimise symptom flare ups. Keeping a symptom journal helps identify personal triggers.
Symptoms improve when lying back down. Episodes of POTS symptoms can last for hours or days and fluctuate in severity.
Managing POTS
While there is no cure for POTS itself, symptoms can be managed through a combination of lifestyle changes, medications and physical therapy:
- Increase fluid and salt intake – Drinking 2-3 litres of fluid and increasing salt intake can help manage blood volume and pressure.
- Compression stockings – Wearing medical compression stockings improves blood return from the legs and reduces pooling of blood in the lower body.
- Exercise – Building up endurance with recumbent exercises like rowing or swimming can improve strength and heart function.
- Raising the head of the bed – Sleeping with the head elevated can reduce nighttime symptoms.
- Smaller meals – Eating smaller low carb meals can help reduce gastrointestinal issues and post-meal fatigue.
- Medications – Drugs like beta blockers, IV saline, fludrocortisone and midodrine may be prescribed.
- Physiotherapy – Helps retrain blood vessels to regulate blood flow properly when standing.
Read this Comprehensive Guide to Treating Postural Orthostatic Tachycardia Syndrome (POTS) to learn more.
While living with POTS can be challenging, there are many ways to successfully manage symptoms and improve quality of life. Paying attention to triggers, staying hydrated and having a tailored treatment plan can provide relief.