POTS Postural Orthostatic Tachycardia Syndrome

I believe limbic trauma – adult or childhood adverse events – can lead to POTS. This is different to orthostatic hypotension – big mouthful – when your blood pressure drops too much when you stand or change your position. Be sure to consult a health care provider to exclude other causes, like dehydration, anemia, hormonal abnormalities, or side effects from drugs.

Blood Pressure and heart rate are regulated in the limbic system. Triggers can be subconscious – you can see something that triggers trauma and you not even know it. Other triggers can be bright lights, a certain taste or sound, fatigue, sight of blood, or any physical or emotional stress, usually emotional.

Some people then have an instant rise in pulse or a drop in blood pressure. POTS is when only the pulse changes – usually going up by 30% from baseline. The blood pressure can drop, or go up, but not change significantly.

I have a patient with me today, helping me discuss POTS. She explains that when she’s focused on anything serious, especially when she is helping somebody, her symptoms improve. When working or helping a person, her performance improves. She is stronger and overexerts herself, unfortunately suffering afterwards.

Being able to do more some days or some parts of the day is puzzling. Part of this may be an adrenaline surge. Definitely when less stressed, a person has less symptoms. When distracted, the brain occupied with other things, you can feel better.

Beware of overexertion. Pacing is very important. More pain causes more fatigue and erratic heart rates.

Patients with POTS may have tremors, headaches, migraines, chronic fatigue syndrome, fibromyalgia, autoimmune disorders, allergic conditions, or celiac disease.

Speak to your health care professional before trying any of the treatments.

Water – 3 liters per day; Salt – 5ml (2 teaspoons per day) Waist high compression garments.

Propranolol can be used, usually 10 to 20mg four times a day

There are other medications, like midodrine 5mg every 4 hours, three times a day

or ivabradine 5mg twice a day if propranolol contra-indicated.

Inflammation needs to be treated. Speak to your health care provider. Use the body to calm the Limbic System.

If you have severe past emotional trauma, you need counselling, maybe even EMDR therapy. 

Low impact exercise is vital. Try the QiGong and Yoga on the link above calming the limbic system. 

Good luck and take care


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