POTS (Postural Orthostatic Tachycardia Syndrome) Explained: Subtypes, Symptoms, and a Holistic Path to Recovery

Vagus nerve inflammation is a key factor in POTS

Since 2020, the number of people with POTS (Postural Orthostatic Tachycardia Syndrome) has more than doubled. This complex syndrome is marked by a rapid heart rate when standing up but also includes such symptoms as anxiety, light headedness, dizziness, fainting, fatigue, migraines, and problems with blood circulation in the arms and legs. An excellent international advocacy and informational organization, Dysautonomia International, can be found here.

In a 2019 study of 4,835 people, the symptoms broke down amongst the participants as 99% experiencing lightheadedness, 97% had tachycardia, 94% experienced presyncope, 94% had headaches, and of the 4,835 persons in the study, 94% had difficulty concentrating.

POTS, which can have a sudden or gradual onset, can be further broken down into three subtypes showing additional symptomology concurrent to the baseline POTS criteria. 

1.       Hyperadrenergic – characterized by elevated norepinephrine levels exhibiting; increased blood pressure, extreme tachycardia, heart palpitations, tremors, migraines, and or nausea/vomiting. Mast cell activation syndrome is most commonly seen alongside this subset.

2.       Neuropathic – characterized by small fiber damage causing less norepinephrine to be released, creating dysfunction in regulation of the constriction of the blood vessels in the limbs and abdomen leading to; discoloration of feet, pooling of blood in the limbs, and a loss of sweating in the extremities. This subset often occurs after physical trauma (surgery or illness) and may have an autoimmune component. 

3.       Hypovolemic – characterized by low plasma, red, and white blood cell volume related to low levels of circulating renin and aldosterone, both of which originate in the kidneys and are used by the body to increase blood volume and blood pressure. Muscle weakness and decreased endurance are hallmarks of this subset. 

Current western medicine solutions are pharmaceuticals, isometric exercises, eating smaller more frequent meals, and increasing salt intake. This can help some of those suffering but there are many more who get limited relief or, if it does put it in remission, find that it can come back with a vengeance.

At Neurological Acupuncture of New Hampshire (link to home page) we treat POTS using a multifaceted protocol based on the most current research and my twenty-six years of clinical experience treating patients with Traditional Asian Medicine.

·         Acupuncture – A total of 8-10, hair thin Japanese needles are used to stimulate points on the arms, legs, abdomen, and ear during a relaxing 45 minute treatment. Most patients find working with the Vagal nervous system so relaxing they take naps after the quick, painless, needles have all been inserted.

·         Customized Traditional Asian herbal formulas  – Depending on how the patient is presenting their POTS and their medical history, herbal formulas are often prescribed as a way to keep the treatment working in between acupuncture sessions. The herbs are taken in either powder or capsule form depending on preference.

·         At home Vagus nerve exercises – They are easy to learn and have a powerful restorative effect on the Vagus to help speed positive treatment results. We stack specific, clinically effective, exercises together to increase vagal tone and overall effectiveness.

·         Guidance on the “Three Free Therapies” of Traditional Asian Medicine

·         Dietary guidance – Based on the individual, a basic guideline is created and can be expanded upon depending on the patient’s interest or clinical need.

Outcomes – Having treated over 12,000 patients since 1997, I stand by my statement which I always tell new or perspective patients; if I am going to be able to help you, you should start noticing an effect within the first 3 visits. It will not necessarily go away within that time period but you should notice some level of change, either in the intensity or the duration of one or more symptoms. While this is the signal that I will be able to help, it does not inform as to completeness of the final result at the end of the 8-10 treatments.

These first four treatments are spaced out between once or twice a week and if improvements are seen, treatment continues but becomes spaced out to once every two weeks for two to three treatments. Again, if improvement holds, we space out visits to once per month or as needed. The goal is to help the body be able to regulate itself without any outside intervention and last twenty-six years of treating people, spacing out treatments in this way greatly facilitates this.

How to book an appointment: First, schedule a complementary consultation here - https://neuroacupuncturenh.janeapp.com/ Email - paul@neuroacupuncture.com, or Call (603) 630-9430