What is POTS?

POTS stands for Postural Orthostatic Tachycardia Syndrome- which basically means a fast heartbeat when standing up.  But POTS is so much more than just a fast heart rate.  Just a like a fever is often a symptom of infection, tachycardia is just a symptom of a much larger problem.  POTS is a form of Dysautonomia-- or a dysregulation of the autonomic nervous system.  The autonomic nervous system controls all of the automatic responses and processes in the body-- such as heart rate, breathing, circulation, digestion, temperature control, and more.  POTS itself is not a disease, but a syndrome made up of a group of symptoms.

This 4 minute video provides a great overview of POTS:

What is POTS? from Dysautonomia International on Vimeo.

Symptoms for POTS can include:

• Fast heart rate upon standing
• Light-headedness, dizziness, pre-syncope (fainting), or fainting
• Blood pooling and poor circulation
• Blood pressure dysregulation
• Shortness of breath
• Heart palpitations
• Chest pain
• Brain fog
• Extreme fatigue
• Tremors
• Sensitivity to light, sound, and movement
• Migraines
• Motor discoordination
• Digestive motility problems
• Peripheral neuropathy (nerve damage and nerve pain)
• Exercise intolerance
• Excessive or decreased sweating
• Poor temperature regulation
• More…

Source: Dysautonomia International

Facts about POTS:

• POTS diagnosis is determined by a change in heart rate from laying to standing of >30 BPM for adults or >40 BPM for teens. 
• POTS can affect anyone, but primarily affects women ages 12-40 (estimated 1 in 100 teens)
• Although it is rarely heard of, it is not a rare disease (estimated 1-3 million Americans)
• Average time to it takes for a patient to get diagnosed is 4-6 years
• POTS can vary in severity; 25% of POTS patients are disabled
• The quality of life for a POTS patient is comparable to that of COPD or congestive heart failure
• THERE IS NO CURE FOR POTS!

Causes:

POTS can be caused by another underlying illness or can appear without a cause (idiosyncratic).  Common underlying ailments or co-morbidities include:

• Autoimmune disease
• Lyme disease
• Mast Cell Activation Disorder (MCAD)
• Hypermobility
• Ehlers Danlos Syndrome (EDS)

POTS can be triggered by a trauma, surgery, or viral infection in which the body responds to the trauma, but when the event is over the autonomic system never "resets". 

Source: Dystautonomia International

Treatments:

• Salt (to increase blood volume)
• 2-4 liters of fluids (water and electrolytes)
• Compression socks/garments to improve circulation
• Raising feet to reduce effects of gravity
• *Exercise
• Medication options to reduce adrenaline, lower heart rate, or increase fluid retention and blood volume
• Treating any underlying conditions can also help

*The term "exercise" is used loosely here.  Many POTS patients are exercise intolerant.  However, mild to moderate exercise can help, especially exercises that strengthen the leg muscles to increase blood flow and venous return.  Often times exercise has to be done in laying or sitting position, as vigorous or upright exercise can make symptoms worse.  Sadly, lack of exercise can also make POTS worse from de-conditioning.  It's a vicious catch 22!

Want to know more?

Learn more about the Physiology of POTS

Read about Living with POTS