The Truth About POTS: 27 Questions Answered!

What are the top 27 questions people are asking about America's. One of America's most intriguing mystery illnesses, one of the most commonly overlooked mystery illnesses, and one of the ones I see every day. So what am I talking about? I'm talking about pots, Postural orthostatic tachycardia syndrome. So I'm going to answer right now the 27 top questions people are asking me, my clinic, as well as their doctors and providers and practitioners around the country. So let's. Let's hop into it. The first question people are asking is, is POTS and dysautonomia the same thing? There are different kinds of dysautonomias. POTS is just one subset of dysautonomia. There's a one where your gallbladder doesn't work anymore called biliary dyskinesia. There's another kind of dysautonomia, referred to as gastroparesis, where your stomach stops working. POTS is one with an irregular irregularity and the dysregulation of your arteries and your heart, resulting in low blood pressure and low volume of blood to your extremities. So POTS is a subcategory of dysautonomia. The next question is, how is POTS diagnosed? Well, POTS can be diagnosed several ways. One is a tilt table test where someone lays on it and you put them back. You look to see if they have a change in their blood pressure in the pulse based on blood pooling in their feet. The other ways are you can actually do nerve biopsies, looking for nerve damage in the nerve endings. This one's not done by most places. There's one called a pseudomotor reflex, and it's looking to see if you can make someone sweat in their hands and feet, which is another kind of dysautonomia. So there's several different ways, but the most commonly way to diagnose it is based on symptoms and a tilt table test. Sometimes practitioners can do a poor man's tilt table test called a nasaline test. That's usually what I do in my office. I can't pick up most POTS with that by watching people lay down, sit, and stand. It's an unofficial, easy way that any practitioner in the country can actually look and find out if someone has pots. Not the most sensitive way to do it, but it's a really quick and easy way to get a general idea someone's symptoms may be related to dysautonomia. Next, how does POTS affect the body? Another great Question. Pots, by definition, has lower blood flow and lower blood pressure. So one of the results is you get less blood to the brain. So you get brain fog, slowness of thinking, tiredness, fatigue, and a host of other symptoms. You also get less blood flow to your GI tract. So you have gut issues, poor sludging your bowels, constipation, and sometimes the gut gets inflamed and you get diarrhea. You also have low blood flow to your brain stem, so it can affect all your body's regulatory processes. Hormone regulation, temperature regulation, mood regulation, a whole host of different regulatory processes. And these are just three or four of the ways that POTS can affect your entire body. Next, how much salt does someone usually typically need? Depends on the blood pressure and the pulse. Anywhere from 2 to 4 grams to up to 9 grams of sodium chloride several times a day. Something that's often not done is getting enough minerals like magnesium, potassium, and trace and ultra trace minerals. These are also important in patients with pots. Next question. POTS when laying down, and POTS when you go to the hospital. So when you lay down, one of the things that happens is blood will kind of pool. And your body and your brain, you're actually. What happens actually is your. Your kidneys feel, hey, there's not enough fluid in my body. And your kidney starts holding on to fluid more, and then you stand up. You can have irregularity in that sometimes. Actually, you can actually help treat this by actually sleeping on an incline. And so what happens is you get a little bit of that fluid pressure off of your kidneys, and you don't have such a big variation first thing when you get up in the morning, or by having sleeping with compression sock stockings at night, or by putting them on first thing in the morning. So it's really interesting how much your posture can change the pressures related to pots. Next, who diagnoses pots? Well, POTS is usually diagnosed by someone has a special expertise in blood pressure control, kidney function, autoimmune issues, and neurological issues. So sometimes you'll have neurologists that focus on pots. Sometimes you'll have nephrologists or kidney doctors who focus on POTs. And sometimes you'll have neurologists who focused on POTs. In the functional medicine world, because we actually look at all these systems and how everything's interconnected. You have functional medicine doctors or practitioners or alternative practitioners, whether nature paths or others, even physical therapists who actually focus on the physical aspect of pots. So lots of interesting things. So what is POT syndrome? I think I've already discussed that. Can POTS Go away. You know, that's a really interesting question. POTS can be put into remission, just like other autoimmune issues can be put in remission. There are four types of pots. One is autoimmune pots, One is adrenergic pots, which is a adrenal kind of POTS related to your adrenals and your epinephrine and norepinephrine. These people tend to have high blood pressure and crazy, crazy blood pressure fluctuations. There is neurogenic pots, which is usually the people with the blue feet. And those people tend to have more the low blood pressure that's chronically low. They feel cold all the time. So different kinds of pots, and with these different pots, you get different symptoms, but there's a lot of overlap between these three different kinds. Can POTS call seizures? Usually when you see a seizure or seizure like activity in someone with pots, it's actually a pseudo seizure. What I mean by that is you have less blood flow to your brain. And so what happens is a person describes almost like a curtain being drawn down their vision or like a cartoon coming down their vision, and they actually will lose blood pressure to their brain, pass out. What can happen was they lose blood flow to the brain. They get these pseudo seizures where they'll shake and quiver and shake. It's almost like when someone gives blood and they, they pass out and they might shake and have a pseudo seizure from that kind of. It's actually called a vasovagal response. And pots, you can have these all the time. And sometimes they can be so bad to look like a seizure. But POTS proper typically does not cause actual seizures when your brain has hyperactivity causing muscle contractions. Can POTS kill you? Pots? If you look at some of the older literature, there's not really an association with decreased longevity if you have pots. But I have had some patients over treated. I had one young lady actually who was given IV fluids twice a week, a liter, and it didn't turn out very well. So sometimes people get over medicated. POTS has a lot of other comorbidities or comes with other things. So if you have POTS and mast cell or POTS and chronic Lyme or POTS and hypermobility, which go hand in hand, there's a lot of new connection with that. It's all connected. So those things can actually affect how long someone lives. But POTS proper by itself doesn't directly make people live less long. Can it kill you? It's more likely POTS doesn't kill you per se. It's what it can be associated with there are a lot of people with lots of depression just feeling bad because a lot of young people have this happen to them and they can't do all the usual things they do, which can cause a lot of depression, suicidality, which is a high, high risk already in young people. And if you have pots, it makes it even higher. Can POTS be cured? There are cases of it being cured, actually. There was a case in Texas of a patient with pots who had iVigg, which is a type of immune treatment with their SIBO treated, which is a gut infection and low dose naltrexone. And they had 100% resolution of their symptoms with that trifecta treatment, treating their, their gut, treating their immune system and treating their neurological system, which by the way, guess what? POTS sits in all three of those places. I do a lot of similar therapies in my Office using oral IgG, naltrexone and then treating people's SIBO and have pretty good results. The issue just becomes all the other things related with pots. A lot of patients I see have POTS and hypermobility, POTS hypermobility and chronic Lyme mold issues. So on the patients I see a little more complicated aren't just simple POTS and POTS alone. Next question. Can POTS cause chest pain? It can. It's usually through palpitations. If someone has POTS with Lyme or tick borne illness, they might have a lot of other joint issues and chest pain. Or if they have severe hypermobility, they can actually have the ribs dislocate or the cards stretch and tear and have chest pain with that as well. Will POTS show up on an ekg? It does not, no. Next question. Will POTS show up on mri? No, it will not. Will POTS from COVID go away? This is an interesting one. Will POTS from COVID go away? Actually, POTS is one of the symptoms of long Covid. So when I see patients post Covid with POTS and practitioners like myself, doctors like myself, we tend to put it into a group of long Covid symptoms. And I actually have patients have had patients with post Covid. POTS have it actually go into remission through addressing their hypermobility, their undiagnosed sleep apnea, the mold issues, their gut problems, the nutrient deficiencies, and a whole host of other things. Yes, post Covid, POTS can go away, but it's typically related to. It's part of the post Covid syndrome. There's also a lot of other things we do with post or long Covid to treat the immune overactivity, the residual spike protein and something we're seeing right now a lot with post Covid POTS and other things is a reactivation of underlying infections, whether it's herpes or mono or reactivation of a tick borne illness. That's a big, big deal. So those are the questions I went through those actually these are the most commonly asked questions on Google searching and with patients that I've seen in my clinic. So hopefully this was helpful. If so, let me know. This is a big issue. POTS is a mystery illness that's commonly overlooked under diagnosed and undertreated. It's something I see on a routine basis in my office and it's usually associated with other things. It's connected to hypermobility which is a connective tissue issue. It's associated with autoimmune issues. It's associated with gut issues as well as MCAs and then a whole host of other things that we take care of on a daily basis. So hopefully this was helpful to help those who are looking to get more information about POTS know what's going on. And again, this is super common. Take care, we'll talk to you soon.