UNDERSTANDING POTS
- POTS stands for Postural Orthostatic Tachycardia Syndrome.
- Your body has an automatic control system that manages your heart rate, blood pressure, digestion and other functions without you having to think about them.
- With POTS, this system struggles to keep your circulation steady when you stand up. Your heart may beat faster, and you may feel dizzy, shaky or unwell.
- A racing heart does not necessarily mean there is something wrong with the structure of your heart. POTS involves how your nervous system regulates your heart rate and circulation.
- POTS is not caused by anxiety, although an adrenaline surge can feel like anxiety even when you are not worried.
- Its effects can reach beyond standing. You may also notice difficulties with thinking clearly, digestion, managing stress and maintaining your energy.
- It can feel as though your body is struggling to keep its everyday functions steady. Our aim is to support that steadiness and make daily life more manageable.
WHAT MAY BE HAPPENING
- In some people, mast cell activity may contribute to symptoms. Mast cells are part of your immune system and release chemicals such as histamine.
- These chemicals can relax and widen blood vessels, which can cause blood pressure to drop.
- If more blood collects in your legs, less returns to your heart. Your heart may speed up to compensate.
- Your body also needs enough fluid circulating in your bloodstream. Aldosterone is a hormone that helps your kidneys hold onto salt and water.
- If you are losing too much salt and water, this may contribute to low blood pressure and feeling unwell when standing.
- Your body may release adrenaline to help maintain circulation. This can leave you feeling shaky, wired or as though you are vibrating inside.
- You may also experience brain fog, visual disturbances, heavy or aching legs, fatigue and crashes after activity.
- These responses can be your body’s attempts to compensate and keep you functioning.
WHAT DO YOU NOTICE?
- Do you feel dizzy when you stand up?
- Does your heart race in the shower?
- Do you feel shaky or have internal tremors?
- Does breathwork make you feel more unsettled?
- Do you crash after walking or other activity?
- Do you feel exhausted but unable to relax?
OUR FIRST PRIORITY: HELPING YOU FEEL STEADIER
- We will begin with the basics: regular nourishment and blood sugar stability, fluid balance, manageable activity and gentle ways to settle your nervous system.
- We will look at whether changes in your blood sugar coincide with your symptoms.
- A continuous glucose monitor, or CGM, may help us see your glucose patterns throughout the day if it is appropriate for you.
- We will build gradually, paying attention to how you respond.
- Detoxification programmes can aggravate symptoms, so these can wait while you work on the foundations.
SALT, FLUIDS AND POTASSIUM
- Sodium helps your body retain fluid and can raise blood pressure.
- Potassium is also important for fluid balance, blood vessel function and normal muscle and nerve activity.
- Potassium is best obtained from potassium-rich foods rather than supplements. Examples include potatoes and sweet potatoes, avocados, bananas, oranges, tomatoes, spinach and other leafy greens, beans, lentils and fish.
- Do not start potassium supplements unless they have been specifically recommended and monitored by your clinician, as too much potassium can be harmful, particularly with kidney disease or certain medicines.
- If extra salt and fluids are appropriate for you, we will agree an amount suited to your blood pressure, health and medicines, then increase gradually.
- If you use a home water-filter system, filtration may reduce some minerals. We can discuss whether adding minerals back into your fluids is appropriate for you.
- Sea salt can provide sodium and small amounts of other minerals, but it is not a reliable source of potassium. We will not use salt as a substitute for potassium-rich foods or prescribed potassium.
- If extra salt is medically appropriate, we may increase gradually and spread it out across the day rather than taken all at once. Start with a low amount and increase only as tolerated and agreed.
- We will focus on getting potassium from food.
- Increasing salt or potassium is not suitable for everyone, particularly people with high blood pressure, kidney or heart disease, or those taking medicines that affect fluid or potassium levels. Check with your clinician before making these changes.
GENTLE WAYS TO SUPPORT YOUR NERVOUS SYSTEM
- Try comfortable, gentle breathing through your nose.
- Keep breathing gentle, without forcing deep breaths.
- You could try humming or gargling.
- Gentle breathing from your diaphragm may be helpful if it feels comfortable.
- If you are considering a device such as Pulsetto, discuss its suitability with your clinician.
HELPING WITH BLOOD POOLING
- Compression garments may help reduce blood collecting in your legs. Not too tight! They need to fit appropriately.
- Notice whether your legs feel heavier or more uncomfortable in the afternoon.
- Resting with your legs raised may help you feel more comfortable.
- Gentle approaches we can discuss include osteopathy, craniosacral therapy and gentle lymphatic work.
WHAT WE WILL HOLD OFF ON
- We will avoid starting several supplements or treatments at once.
- At this stage, we will be cautious with B vitamins, methyl donors, sulphur donors and supplements aimed at detoxification or increasing cellular energy, including NAD.
- We will hold off on detox programmes, coffee enemas, liver flushes, metal detoxification and peptides.
- Cold plunges, saunas, fasting, intense breathwork and strenuous cardio may be too much while you are struggling to feel stable.
- We will pay attention to your individual tolerance and build at a pace you can manage.
RECOGNISING WHEN YOUR SYMPTOMS FLARE
- You may notice that symptoms are worse at particular times of day or around certain points in your menstrual cycle.
- Overnight and early morning: changes in histamine levels and the release of chemicals from mast cells may contribute to waking up already feeling unwell in some people.
- Late afternoon: around 5 to 6 pm, you may feel shaky, dizzy, irritable or exhausted. As cortisol naturally falls towards evening and your body moves towards rest, you may become more aware of the day’s fatigue.
- Around ovulation: rising oestrogen may encourage histamine release and mast cell activity, contributing to increased symptoms in some people.
- These are possible patterns rather than something everyone will experience.
- Keep a simple record of when symptoms appear, where you are in your menstrual cycle and what was happening beforehand.
- Understanding your own pattern can help us plan activity, meals and rest around the times you find most difficult.
- Our aim is to help you recognise your limits, respond to symptoms and feel more confident managing your day.
WOULD YOU LIKE SUPPORT?
If you would like to work with me on nutrition and lifestyle approaches to help you feel steadier and manage your symptoms, please get in touch.
Together, we can explore your symptom patterns and work towards practical, manageable steps that suit your needs, alongside your medical care.
Lisa Cahill
Evolve Female Wellness
www.evolvefemalewellness.com
lisa@evolvefemalewellness.com
This guide provides general information and does not replace individual medical advice, diagnosis or treatment.