PoTS - symptoms, causes and solutions

If your heart is racing and it’s not from being excited, you might be suffering from something called PoTS (or Postural Orthostatic Tachycardia Syndrome). It is a condition when your heart rate increases very quickly after getting up from sitting or lying down, often making you feel dizzy or lightheaded.  

Other PoTS symptoms also include headaches, nausea poor sleep, weakness and fatigue, poor concentration and memory, and shaking/sweating.

Postural Tachycardia Syndrome (PoTS) is an abnormality of the functioning of the autonomic nervous system (ANS) (a malfunctioning ANS is sometimes called ‘dysautonomia’). The autonomic nervous system controls all bodily functions that we don’t have to think about, like digestion, bladder control etc. 

Although PoTS is still being researched, there are a number of holistic remedies such as pursuing mineral balancing and neuroplasticity work that could gently reverse symptoms.

There are also some helpful functional tests and blood tests that can show us what is going on in the body on a deeper cellular level that can cause the issues with rapid sudden heartbeat.   

PoTS links to other illnesses

While PoTS has its own diagnostic requirements, it’s often associated with other autoimmune illnesses or infections. For example, PotsUK, says on their website that "Many people with PoTS report allergy or intolerance type symptoms including skin, stomach and bowel problems. There has been increasing interest in a possible link between Mast Cell Activation Syndrome and PoTS. This is an area where more research is needed; however initial research does appear to show a link between MCAS and PoTS."  

PoTS may also be triggered by infections like Lyme disease, mould toxicity, and parasites. It’s also associated with hypermobility, vascular compression syndrome, and irritable bowel syndrome. There are some infections that put you at a higher risk for developing PoTS, including a coronavirus infection.

The condition became more well known after Ella Woodward, aka Deliciously Ella was diagnosed in 2011, which is when she decided to overhaul her diet, stopped eating sugary and processed foods and started the famous blog sharing her plant-based recipes and, in the process, coined the term ‘clean eating’.

She decided to only eat a vegan diet which helped her to overcome her illness however, if anyone had been eating a processed diet high in sugar and then moving to a wholefood plant-based diet, you would inevitably see positive results with your health. That said, a vegan diet is not for everyone, and it can be hard to cover all our nutritional needs, especially when ill, so let’s break down what probably happened when she turned to a plant-based diet and put her PoTS into remission.

PoTS and minerals – imbalances and deficiencies

When you increase your intake of fruit and vegetables, you not only increase your intake of fibre you also increase minerals. Minerals are substances naturally formed in the Earth.

Having adequate amounts of trace minerals and electrolytes in the diet is essential for improving PoTS. Trace minerals are micronutrients that are necessary for health but only in trace amounts. Trace minerals include iron, copper, iodine, chromium, manganese, molybdenum, selenium, and zinc. Marginal or severe trace element imbalances are considered risk factors for several diseases.

Many of these minerals can be found in fruit and vegetables but zinc and selenium are found in very high amounts in seafood and bioavailable iron is found in animal food. If you have digestive issues, then large amounts of fibre from hard-to-break-down plant foods could be a problem so having a balanced diet including all food groups is a good idea.

High rates of iron insufficiency, deficiency and anaemia have been reported in children and adolescents with PoTS. Bioavailable iron is found largely in animal foods like meat and organ meats.

Calcium is also very useful for PoTS and copper plays a huge role in many people who have the condition too. Dairy foods are an excellent source of calcium as well as sardines, leafy greens and seeds.

Taking a hair mineral test can be a useful way to assess what kind of mineral balance you have. It checks the mineral levels in your body and also heavy metals in your body. It’s very important you have it analysed by someone who is trained in how to read these tests.

PoTS, electrolytes and fluid imbalance 

Minerals like sodium, chloride, potassium, calcium, and magnesium are electrolytes. They play a variety of roles in the body like transmitting nerve impulses and contracting muscles. Electrolytes also help maintain fluid balance in the body. Sodium is important for fluid balance because it helps the body retain water.

Some research suggests that people with PoTS may have issues with maintaining fluid balance in the body. This is because some people with the condition experience something called hypovolemia. Hypovolemia is when someone experiences low blood volume. Consuming electrolytes helps to retain the water we drink and hence increases our blood volume.

Sodium and water like to stay together, so as sodium intake goes up, the amount of water that stays in the body goes up too. This helps to retain water and increases overall blood volume.

The Cleveland Clinic suggests that increasing the sodium in your diet from 3,000 milligrams (mg) to 10,000 mg per day is helpful. Please note that you want to use a mineral-rich salt, not just your regular table salt.

PoTS and vitamin Imbalances

Vitamin B1

Thiamine deficiencies are rare but the symptoms mimic PoTS. Research shows that when patients are supplemented with 100 mg/day some people see a dramatic improvement in PoTS. So, checking this first is recommended.

Vitamin B6

Pyridoxine deficiencies can cause fatigue so testing serum B6 is also recommended.

Vitamin B12

One study found deficiencies in vitamin B12 were much higher in adolescents with a fainting disorder which suggests that low B12 could lead to nervous system disorders.

Vitamin D

Deficiencies or low levels of vitamin D are linked to cardiac autonomic dysfunction so getting your levels tested and then supplementing adequately could help.

Support strategies

There are many possible underlying causes and conditions associated with PoTS including HPA axis dysregulation, autoimmune disorders, viruses, and hypoglycemia.

Suggestions to improve POTS naturally include;

• Optimal hydration with electrolytes.
• Whole food mineral-rich healing diet and avoiding processed foods.
• Improving your blood sugar and improving bowel movements.
• Eat small and frequent meals instead of a few large meals. Eating large meals can make PoTS worse as your body redirects a lot of blood in aid of the digestion process.
• Using nutrients to support and stabilise blood sugar and provide trace minerals along with adaptogenic herbs can be helpful.
• Regular chiropractic care, optimal sleep, and proper movement, along with stress reduction techniques and deep breathing exercises, can also improve PoTS.
• Vagus nerve support. The vagus nerve is part of the parasympathetic nervous system. You can stimulate the vagus nerve with stretching, breathing, massage, singing, humming and meditation.      
• Getting adequate testing done with blood work and hair mineral analysis to get to the root cause of why you have PoTS or accompanying illnesses.
• Choose healthy salty snacks such as broth, pickles, olives, sardines, anchovies and nuts. Avoid reaching for crips and crackers for salt.

References

• Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia Syndrome - PubMed
• Low iron storage and mild anaemia in postural tachycardia syndrome in adolescents - PubMed
• Increased salt consumption induces body water conservation and decreases fluid intake - PMC
• The essential trace elements - PubMed