How to treat POTS

What is POTS?

POTS stands for Postural orthostatic tachycardia syndrome (POTS). It is a condition that affects the blood circulation of the body. It involves the ANS and sympathetic nervous system of the body. ANS or autonomic nervous system of the body controls the vital systems of the body, whereas the sympathetic nervous system regulates the fight or flight response of the body.

The major symptom of POTS is orthostatic intolerance. Development of symptoms is seen when the person stands up from a supine position. Lightheadedness, fainting, or rapid increase in a heartbeat is seen. Blood flow regulation within the body is done by heart rate and blood pressure. People who suffer from POTS have difficulty in managing their heart rate response. As a result, their blood pressure is not steady and stable.


The symptoms of POTS are different for different people. The symptoms appear and disappear over a period of time. With proper diet, medications, and physical activity, the quality for life for POTS patients can be improved. Also, if an underlying cause is diagnosed and treated, there are chances for the symptoms of POTS to subside.

There are mainly three types of POTS:

Neuropathic POTS:  The de-nervation of nerves leads to the poor blood supply in the body, especially in the legs and core body.

Hyperadrenergic POTS: Over-activity of the sympathetic nervous system.

Low blood volume POTS: Low blood volume leads to POTS. This symptom at times overlaps between neuropathic POTS and hyper-adrenergic POTS.

Women between the ages of 13-50 years mostly suffer from POTS. Patients may develop POTS after a viral infection, trauma, or prolonged illness. People with autoimmune disorders like Sjogren’s syndrome or celiac disease are at a higher risk of developing the disease.

People having POTS generally suffer from a host of symptoms. The symptoms seen are:

  • Extreme high or low blood pressure
  • High or low heart rate
  • Chest pain
  • Dizziness or lightheadedness
  • Fainting
  • Prolonged fatigue
  • Abdominal pain
  • Temperature deregulation
  • Anxiety
  • Blurred vision
  • Forgetfulness
  • Headaches and body ache
  • Insomnia
  • Exercise intolerance
  • Excessive or lack of sweating
  • Diarrhea or constipation

All of these symptoms do not occur together. Usually suffering from two or more of these symptoms is common.


POTS includes a lot of symptoms. Therefore doctors diagnose many other diseases before they come up with POTS.   Patients may have symptoms for months or even years before being properly diagnosed.

The most widely used diagnostic test for POTS is the tilt table test that measures the heart rate and heart pressure with a gradual change of posture and position. Besides this, the other tests that are done to diagnose POTS are:

  • Blood and urine tests for POTS
  • QSART (a test that measures the activity of autonomic nervous system)
  • Autonomic breathing test
  • Echocardiogram
  • Blood volume studies


The medications that are prescribed to patients of POTS are:

Salt tablets, fludrocortisone, pyridostigmine, midodrine and beta blocker

Use a pill reminder to help you in taking pills.

Wearing thigh-high medical compression stockings may be prescribes as they help the proper circulation of blood.

Always carry a blood pressure monitor that’ll help you check your blood pressure and pulse. Make sure your machine’s reading and the reading obtained by your doctor is co-related.

You may be checked-in into a cardiac rehab program. Although POTS does not affect the heart as such, the exercise template could help you in improving your health and managing symptoms.

Diet and nutrition:

The most effective way to control any condition is probably managing your diet. The following changes in your diet can help you to manage POTS symptoms:

  • Increase your sodium intake from 3000mg/day to 10,000mg/day.
  • Drink 2-2.5 liters of water per day. You could replace the water with a sports drink but keep a count on the calories.
  • Consume numerous small meals instead of heavy meals.
  • Consumption of high fiber meals might help reduce blood glucose levels.
  • Have a balanced diet. Include generous amounts of fruits and vegetables in your diet.
  • Plan your meals and stock your resources accordingly. People with POTS may not always have the strength to go for grocery shopping and preparing meals.
  • Cut down on processed food. Although processed food is easier to prepare, it is harmful to your body.
  • Always consume healthy snacks that include broth, pickles, olives, or salted fish.
  • If required, consult a dietary and nutrition expert to help you with your diet.

Vital information tracking:

It is important to constantly monitor your vital information like blood pressure and pulse at the same time daily. This will help to keep track of your health. Also, check your vital information whenever you are not feeling well.

Heart rate/pulse: It is important to keep track of your heart rate. Normal heart rate ranges from 60-100 beats per minute.

  • Heart rate below 60 beats per minute is called bradycardia.
  • Heart rate above 100 beats is called tachycardia.

Blood pressure: Blood pressure has two components: systolic and diastolic.

Normal blood pressure is between 90-120mmHg for systolic and 60-80mmHg for diastolic.

Patients of POTS can have moments of hypertension with the systolic pressure going over 140 and diastolic pressure going over 85.

Exercise and physical activity:

Exercise will not only keep your POTS symptoms at bay but will also improve your overall health. The following types of exercise are prescribed for POTS patients.

Isometric exercises: These are simple exercises that contract your muscles without moving your body in real.

Slow transition:

Get up slowly from the supine position to a sitting position. Then slowly go from sitting to standing position. Wait at every position for some time. If you feel dizzy at any point, stay in that position for some time or go back to the previous position.

Walking program:

Start with a basic walking plan. Count the number of steps you can take without feeling sick or dizzy. Increase the number of steps gradually. You can use fitness trackers as well. Add a few steps every week. You can also practice basic yoga.


Maintain a proper sleeping schedule. Sleep and wake up at a certain time. Avoid daytime napping and get enough rest at night. Avoid excessive mobile or laptop usage as these can interfere with the quality of your sleep.  Use a pill reminder to improve your life.