POTS: Electrolytes and Getting Your Life Back

Postural Orthostatic Tachycardia Syndrome (POTS) is an abnormality of the functioning of the autonomic nervous system (the involuntary portion of your nervous systems). 

Postural: posture, i.e. standing, sitting, lying, etc.

Orthostatic: moving in an upright position

Tachycardia: abnormally rapid heart rate

Simply put, it is a type of orthostatic intolerance, which is an inability of the body to coordinate the heart and the blood vessels upon standing. If you suffer from POTS, the parts of your brain and nerves that control things that you typically don’t have to think about - like breathing, heart rate, sweating, and blinking - are affected, and your brain can't quite sync your blood pressure with your heart rate.

If you suffer from POTS, your heart rate increases when you go from lying down to standing, or sitting to standing, which tends to be accompanied by dizziness. Essentially, your body isn't able to maintain blood pressure with big shifts and your heart has to pump much faster in order to keep up. This isn't the same as orthostatic hypotension, another common syndrome, which is low blood pressure when standing; orthostatic hypotension actually generally needs to be ruled before a patient can be diagnosed with POTS.

A Quick History on POTS

Although many people are under the impression that POTS is a fairly new syndrome, this couldn’t be further from the truth! The term “POTS” was coined in 1993 by a team of researchers from Mayo Clinic, led by Dr. Phillip Low. However, the illness has been around for quite some time and was known by many other names throughout history, such as DaCosta’s Syndrome, Mitral Valve Prolapse Syndrome, Soldier’s Heart, Chronic Orthostatic Intolerance, Postural Tachycardia Syndrome and Orthostatic Tachycardia. Since Dr. Low and his team named the set of symptoms over 20 years ago, research has grown quite a bit to learn more about this mystifying illness.

Currently, there are generally three variations of POTS: hyperadrenergic POTS (overactivity of the nervous system), neuropathic POTS (issues with nerves controlling blood vessels), and hypovolemia POTS (low blood pressure). 

What are the Symptoms?

More than likely, you won’t notice changes in your heart rate with POTS. Instead, when you're having an episode, you may notice other symptoms ranging from mild to severe. Symptoms tend to vary but they typically include a combination of the following:

  • Decrease in blood pressure when going from lying or sitting to a standing position
  • Increase in blood pressure when going from lying or sitting to a standing position
  • Increase in heart rate when going from lying or sitting to a standing position
  • Low blood volume (hypovolemia)
  • High levels of norepinephrine when standing 
  • Headaches
  • Fatigue
  • Lightheadedness
  • Vertigo
  • Shaking
  • Fainting
  • Heart palpitations
  • Chest pain
  • Shortness of breath
  • Nausea
  • Bloating
  • Brain fog 
  • Feeling cold, especial in the feet and hands
  • Exercise intolerance
  • Purple color or flushed in the lower legs when going from lying or sitting to standing

Although anyone can be affected by postural tachycardia syndrome, it's most prevalent among women, specifically in their teens, 20s, and 30s. In fact, about 80% of cases are diagnosed in women ages 15 to 50.

What Causes POTS?

To be clear, POTS is not a disease - it is a syndrome, or a group of symptoms, that always has an underlying condition. If you get diagnosed, your doctor may link it to a condition that you already have, like alcoholism or diabetes. Some common conditions associated with POTS include chronic fatigue/chronic fatigue syndrome, Ehlers-Danlos syndrome, joint hypermobility syndrome, and post lyme disease syndrome. 

You may even have a condition that causes POTS without knowing it, like heavy metal toxicity for an example. You'll generally undergo a tilt table test to help confirm the diagnosis. If your cardiologist or neurologist is not able to pinpoint the cause, he will likely label your variation of POTS as primary or idiopathic POTS. 

To this day, the cause of POTS is not always 100% clear. That's because the condition doesn’t trace back to one specific root cause for every person that has it. However, it does seem that POTS symptoms are often triggered by life events, such as:

  • Pregnancy
  • Puberty
  • Traumatic blood loss
  • Major surgery
  • Viral illness
  • Monthly period

POTS and Electrolytes

Electrolytes are essential minerals that conduct an electric current in the body. They help to facilitate the actions of the nervous system, maintain proper fluid balance, and allow muscles to contract. 

POTS is a form of “dysautonomia” which is a disease of the nervous system. There are many different types of dysautonomia, but POTS has to do with blood flow specifically and how it changes based on the posture of the body. 

After getting the diagnosis, there are typically two things that you are likely to hear from your physician: drink more water, and increase your electrolyte intake - sodium specifically - so you retain more fluid!

As we mentioned, the main issue with POTS is the always-changing blood pressure, specifically in the upper half of the body. According to a recent study published in the medical journal Circulation, adequate hydration can actually help regulate blood pressure and heart rate. Both of these are things that can greatly help a POTS patient comfortably stand for longer durations of time. In addition, increased salt intake has also been found to improve symptoms of POTS because it naturally raises blood volume.

Treatment of POTS

There isn't a one-size-fits-all solution when it comes to treatment options. In fact, for many, it takes quite a bit of trial and error to determine which treatment is best to relieve their specific symptoms. 

In terms of prescriptions, fludrocortisone, midodrine, and beta blockers are common options because they help with circulation, blood pressure maintenance, and reducing heart rate, respectively. 

In many cases, lifestyle changes are often part of treatment for POTS. Wearing compression stockings is one of the most common recommendations. Additionally, by increasing your water intake and adding more sodium to what you eat, you can increase your blood volume to help lessen the severity of your symptoms. A great way to do this is by simply incorporating a great hydrating supplement into your diet like the ones found at Adapted Nutrition!

Adapted Nutrition is an exceptional company that provides high-quality supplementation that comes from natural sources. For example, their Hi-Lyte Salt Capsules come from natural sea minerals and deliver rapid rehydration which is ideal for those living with POTS! Not a fan of swallowing capsules? Adapted Nutrition also offers hydrating supplementation in concentrate and powder form, too, making it easier than ever to fuel your body with the minerals it needs to support your lifestyle.

A Final Word

If you are living with POTS, you know firsthand how debilitating it can be, and with no real cure, it can get a little frustrating to say the least. The good news is that staying hydrated and increasing your electrolytes can really help. If you are looking for ways to possibly ease your symptoms, we highly recommend giving Adapted Nutrition’s hydrating supplements a try  - you will thank us later!

Sources:

https://pubmed.ncbi.nlm.nih.gov/25546918/

https://www.ninds.nih.gov/Disorders/All-Disorders/Postural-Tachycardia-Syndrome-Information-Page#disorders-r2

https://myheart.net/pots-syndrome/importance-of-water/

http://www.dysautonomiainternational.org/page.php?ID=30#:~:text=The%20term%20%22POTS%22%20was%20coined,Philip%20Low.