POTS Syndrome --- Causes and
Top 10 Natural Remedies
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Last updated February 9, 2017 (originally published January 13, 2013)

By Alison Turner, Featured Columnist

Have you ever felt dizzy after standing up too quickly? Most
likely you have; but has dizziness after standing up ever
prevented you from going to work or school?  If so, you
may suffer from POTS syndrome.

Technically known as "postural orthostatic tachycardia
syndrome", POTS has signature symptoms of debilitating
dizziness and a quickened heart beat after rising from a lying

While the exact number of people with POTS is unknown, it
is currently estimated that at least 500,000 people in the
United States are affected. Of these 500,000, 25% are
unable to work because of the condition. What exactly
causes POTS? Are there any natural remedies that help POTS

The National Institute of Neurological Disorders and Stroke
defines POTS as "a group of disorders that have orthostatic
intolerance (OI) as their primary symptom."  

When someone experiences orthostatic intolerance, an
"excessively reduced volume of blood" returns to their heart
when they stand up after lying down, resulting in
lightheadedness or fainting.  

In addition to these symptoms of orthostatic intolerance,
patients with POTS experience an increase in heartbeat of
around thirty beats per minute within ten minutes of rising.  
This could render people unable to exercise because of
fainting and dizziness.

Who gets POTS, and why?  POTS can happen to anyone at
any age, though between 75 and 80 percent of people
afflicted are women between the ages of 15 and 50.    
Adolescents who have POTS usually show symptoms within
one to three years of their growth spurt, and the condition
especially manifests after a period of inactivity from illness or
injury, after which the teen cannot return to normal activities
because of the dizziness and fatigue arising from upright

The causes behind POTS are still unclear, though many
experts believe the condition may arise from neuropathic
conditions. New research has also identified that two very
different kinds of  POTS.  One type of POTS results from a
loss of function of the nerves in your lower body or in the
periphery of your body.   This type of POTS is called
"neuropathic" POTS.  

A second kind of POTS is not related to nerve dysfunction,
and it is called "non-neuropathic" POTS. The causes of this
type of POTS are also not known but may include
"deconditioning, hypovolemia, low grade inflammation,
oxidative stress and genetic causes", according to a 2013
study led by Dr. Christopher Gibbons from Harvard Medical
School's Department of Neurology.

What do we do if we have POTS?  There is no fix-all for
POTS, though there are drugs and therapies used to target
specific symptoms (such as low blood volume).  Read the list
below for ten treatments and associations for POTS that
have been studied and suggested by experts from around
the world.

Top 10 Natural Remedies for POTS Syndrome

1.        Try Exercising – But Only For A Little While.

If you already have POTS, it’s probably hard to imagine
exercising through all of that lightheadedness .  And if you
don’t have POTS, the challenge of such activity is easy to
imagine.  But what if exercising didn’t mean training for a

Work from researchers out of Texas suggests that patients
with POTS can – and should – exercise; even exercise for as
little as three months might be enough to alleviate symptoms.

The reason that exercise may work is that POTS may be
caused by "cardiac atrophy"  --- which is what it sounds like.
Cardiac atrophy occurs when the muscle that is your heart
atrophies, shrinks, because of non-use. The heart is a
muscle. You have to work it out, regularly, or it will lose
muscle mass.

In 2012, Benjamin Levine with the Institute for Exercise and
Environmental Medicine at the Texas Health Presbyterian
Hospital and the University of Texas Southwestern Medical
Center in Dallas, along with colleagues from both
institutions,  responded to previous observations that
exercise intolerance is "associated with a reduced stroke
volume" in patients with POTS, which "may be the cause of
the high heart rate (HR) at rest and during exercise.”  

Levine and his team set out to determine how physical
reconditioning with exercise training could improve exercise
performance in 19 patients with POTS.  Participants
underwent three months of reconditioning training, after
which time their heart rate decreased at any level of oxygen
uptake, and heart rate recovery was faster after training.  

The team concluded that "short-term exercise training
improves physical fitness and cardiovascular responses
during exercise in patients with POTS."

Sometimes all we need for inspiration is a light at the end of
a tunnel that doesn’t go on forever: if you have POTS and
would like to alleviate its symptoms, give light exercise a
three-month trial.  Anyone can do anything for three
months, right?

Women, Orthostatic Intolerance, and POTS: A
Complicated Cycle.

A woman’s menstrual cycle --- research from 2010 suggests
---  not only affect her emotions, body weight, and skin, but
also the manifestation of symptoms if she has POTS.

In 2010, a team of researchers including Qi Fu with the
Institute for Exercise and Environmental Medicine at the
Texas Health Presbyterian Hospital in Dallas  observed that
hundreds of thousands of American premenopausal women
suffer from POTS; accordingly, the team observed how
certain factors of the menstrual cycle affect POTS symptoms
in these women.  The blood profile and kidney-adrenal
hormones of ten women with POTS and eleven healthy
controls were measured while the patients were lying down
and during two hours of standing.  

Data showed that in patients with POTS, the cardiac output
and stroke volume were lower and total peripheral
resistance was greater in the early follicular phase of the
menstrual cycle, among other differences.  The team writes
that "the menstrual cycle modulates the renin-angiotensin-
aldosterone system and affects hemodynamics during
orthostasis in POTS."  

Bottom line, if you're a premenopausal woman with POTS,
your cycle may be affecting the symptoms you're
experiencing -- consult your physician for more detailed

When Teens Have POTS: Beta Blockers.

When adolescents suffer from POTS, the condition manifests
as debilitating fatigue, dizziness, and discomfort – not an
easy burden to bear on top of the drama of high school.  
There are, fortunately, a few medicinal options for teens
with POTS that may help lighten the load.

In 2009, Dr. Philip Fischer with the Division of General
Pediatric and Adolescent Medicine at the Mayo Clinic in
Minnesota and a team of other experts at the same
institution  assessed the efficacy and impact of drug therapy
on the quality of life in adolescents with POTS.  The team
conducted a chart review analysis on 47 adolescents who
had been evaluated by the Mayo Clinic for POTS.  

The two most commonly prescribed drug therapies in these
patients were midodrine and beta blockers; 100% of
patients taking beta blockers reported improvement, and
62% of those taking midodrine reported such progress.  

The report finishes by declaring that both drugs resulted in
overall improvement in the health of the adolescent POTS
patients, though those taking beta blockers were more likely
"to credit the role of medications in their improvement."  

If your teen suffers from POTS, ask you doctor about beta-
blockers – the kid might even thank you for it in a few years.

Increase Blood Volume to Decrease Orthostatic
Intolerance: the Magic of Salt

Usually when we read about our health and salt we hear
words like “less” and “moderation.”  But surprisingly, when
it comes to POTS, salt may actually be a part of the solution
rather than the problem.

Part of the orthostatic intolerance symptom from POTS
comes from the pooling of blood.  Fortunately, researchers
have been pondering pooling for some time now, and have a
few tricks up their sleeves: adding salt, for example, (a
procedure more dramatically known as “saline loading”) is
one way experts attempt to increase blood volume to
decrease pooling.   

In 2011, Dr. Hongfang Jin with the Department of Pediatrics
at Peking University First Hospital in Beijing and other
researchers at the same university  investigated whether salt
supplementation could help children with POTS.  The team
measured the serum sodium and urinary sodium excretion
from 30 children with POTS (and 10 controls without), as
well as the relationship between urinary sodium and the
severity of POTS symptoms.  

Patients with POTS showed lower urinary sodium excretion
than the control children, and the severity of POTS
symptoms was negatively correlated with urinary sodium

These results suggest "the effectiveness of salt
supplementation in children and adolescents with POTS."
The way that salt may help out people with POTS is a good
reminder that every body is different: salt supplementation
may be a good idea for an adolescent with POTS, but less of
a good plan for that child’s father with high blood pressure,
for example.

Increasing Blood Volume with Oral Medication

If you’re wary about salt supplementation (see above) but
want an increase in blood volume to lessen those dizzying
POTS symptoms, experts in Nashville may have an alternative.

In 2012, a group specialists including Dr. Satish Raj with the
Autonomic Dysfunction Center at Vanderbilt University in
Nashville  investigated whether increasing blood volume via  
a drug called desmopressin could mitigate the excessive
increased heart rate when standing and the "disabling
chronic orthostatic intolerance" in patients with POTS.  
Thirty patients with POTS underwent trials with
desmopressin (DDAVP), and were then tested for blood
pressure, heart rate, and other symptoms while seated and
after standing for various periods of time.

The standing heart rate of POTS patients was "significantly
lower" after DDAVP treatment, and the report concluded that
oral DDAVP "significantly attenuated tachycardia and
improved symptoms in POTS."

If you have POTS, or suffer its symptoms, it might be time to
ask your doctor about DDAVP or other treatment options.

[You can also increase your blood volume by shrinking more
water. Blood is over 70% water, so drinking more water will
help to increase blood volume, according to a 2011
Consensus Statement on the Definition of POTS, by a
consortium of doctors led by Dr. Freeman of Beth Israel
Beaconess Medical Center in Boston, Massachusetts.]

Can’t Pay Enough Attention?--Could Be POTS.

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drinking more water can help POTS syndrome
Simply drinking more water can raise your blood pressure and
help POTS syndrome.