Dr. Jessica Schrand

Live Well Wellness Center

Since the COVID-19 pandemic, there has been an uptick in people developing Postural Orthostatic Tachycardia Syndrome or POTS-like symptoms, especially in Arizona. The syndrome is a condition characterized by an overly active sympathetic nervous system. This leads to an excessive fight-or-flight response when you stand up.

Those with the syndrome often experience a very high heart rate, sometimes increasing by 30 beats per minute when standing up. This happens because blood pressure drops, and the body compensates by speeding up the heart. Common symptoms include dizziness, fatigue, brain fog, and headaches. It can even cause you to pass out.

While the exact cause of POTS is unknown, it does have a lot of triggers, such as lack of sleep, physical activity, illness, and one of its most prominent triggers is heat. POTS is underdiagnosed. However, because of high temperatures, it is more frequently diagnosed in desert climates.

Thankfully, there are therapies and lifestyle changes that can provide some symptom relief. It typically focuses on improving circulation, supporting the nervous system, and addressing underlying causes such as heat or illness. It is not uncommon for patients with POTS to have mold exposure, chronic viral infections, a history of Lyme disease, or mast cell activation syndrome. Its connection to underlying illness is one of the reasons we’ve seen more diagnoses since the pandemic.

If this is the case, IV therapy can be beneficial, and thankfully, there are IV clinics located across the Valley. Hydration is very important, especially when the underlying cause is illness or heat-related. Heat increases sweating and fluid loss, which can dehydrate the body and reduce blood volume. This makes it more difficult for the body to maintain blood pressure when standing up.

IV therapy helps by providing rapid hydration, bypassing the digestive system, and delivering fluids and electrolytes directly into the bloodstream. For extreme cases, it’s a good idea to get IV fluids two to three times a week to manage symptoms. Increasing salt intake and wearing compression stockings can also be very helpful.

Acupuncture can also be beneficial. It is a gentle way to help regulate the autonomic nervous system, which is often out of balance with POTS. It supports better circulation, reducing symptoms and does not need to be done consistently to be effective.

Lower-body exercise is another excellent way to manage the condition. Building lower-body and core strength can help blood flow return to the heart more efficiently. Start with recumbent exercises like Pilates. It will help your body exit fight-or-flight mode while also limiting blood pressure changes, since you are lying down. The key is to increase exercise gradually. If you are noticing an exacerbation of symptoms the next day, you did too much.

You can also take supplements to relieve symptoms. The key is to take those most effective for electrolyte balance. LMNT electrolytes are effective due to their high sodium content, which helps maintain blood volume and prevent dizziness. You can also add sodium capsules to water.

Some simple lifestyle changes can easily help relieve POTS symptoms, especially in the heat. Hydrating early and often is pivotal. Aim for at least two to three liters of fluids daily with electrolytes. Try to avoid outdoor activities in the heat and opt for indoor exercises. If you do want to participate in an outdoor activity, planning it in the mornings and evenings can be helpful.

If you feel like your heart races, you get lightheaded when standing, or you feel extreme fatigue without a clear cause, it’s worth getting evaluated by a provider familiar with dystutonomia, a group of disorders where the autonomic nervous system malfunctions. POTS can easily impact your everyday life, even making it difficult to get out of bed. However, with the right provider and effective symptom management, you can return to a regular daily life.

Schrand has been practicing naturopathic medicine in the Phoenix area for a decade and often works with POTS patients. For information on Live Well Wellness Center, go to https://livewellwellnesscenter.com. Please submit comments at yourvalley.net/letters or email them to AzOpinions@iniusa.org. We are committed to publishing a wide variety of reader opinions, as long as they meet our Civility Guidelines.