Dear Alice,

I was diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS) a few months ago. I'm 21, and they think that a virus damaged nerves in my brain, causing the condition. It's really thrown my life into a tailspin. On my cardiologist's orders, I'm taking meds 7 times a day and consuming a very high liquid, high salt diet to try to control the symptoms and live a normal life. He says that if the nerves in my brain recover, I may get better. My question is this: how can I encourage the nerves in my brain to heal? I've been trying to eat fish and fruits, but are there other things I can do?

Thanks for any help,

— Dizzy and Disoriented

Dear Dizzy and Disoriented,

Postural orthostatic tachycardia syndrome (POTS) is a challenging condition that may affect your ability to perform conventional physical activities. POTS is often caused by autonomic dysfunction, which can result from viral and bacterial infections, pregnancy, or trauma. Individuals with POTS experience an abnormal increase in heart rate upon changing bodily positions, such as from lying down to sitting up, or moving their arms above their head. While the root cause of POTS remains unknown, your health care provider’s inclinations match current research findings for causes and treatment.

Just as there is no established cause for POTS, there is also no known cure. However, by making important behavioral adjustments, you can take control of your symptoms. You mention that you’re already taking prescribed medication; therefore, it'll be good to focus on the nonpharmaceutical methods known to improve symptoms of POTS. This means embracing healthy habits, such as getting consistent exercise, eating a balanced diet, getting plenty of restful sleep, and having mental determination.

The increase in heart beat characteristic of POTS may inhibit your ability to stand, walk, or engage in mild exercise, causing dizziness, lightheadedness, and an overall sensation of instability. As you probably know from experience, sitting down may quickly alleviate these uncomfortable symptoms. However, to increase your level of tolerance for exercise, it is recommended that you sustain physical activity at a reasonable level and work to improve leg and core strength via strength training. By doing so, your heart and veins will be able to distribute more blood to your extremities during exercise, which will reduce the severity of your symptoms.

You can start by engaging in twenty minutes of cardiovascular exercise three times per week. Speak with your health care provider to assess where you can begin with your physical activity training. For example, if exercising upright is too much, s/he may recommend beginning with horizontally oriented cardiovascular exercises such as swimming, recumbent biking, and rowing. While moderate exercise may help alleviate some of your symptoms, try not to overdo it — instead, stick to a conservative level of activity. Quality of rest after physical activity is also very important. You may find that sleeping with your head elevated by several pillows allows you to rest easier than lying with your head flat on your bed.  

Maintaining a healthy diet will support brain function and heart health, which may in turn placate some of your symptoms. As recommended by your health care provider, continue to drink lots of fluids and consume a high salt diet. You may also find it helpful to cut junk foods out of your diet, and consume plenty of omega-3 healthy fats. These are found in fish, olive oil, grass-fed meats, and omega-3 fatty acid supplements made from fish oil.

Last but not least, it is important that you get psychological support. Individuals with POTS often suffer from high levels of anxiety and tremulousness. You may find that activities such as journal writing, meditating, and drinking herbal tea have calming and therapeutic effects.

Maintaining a positive attitude and dedicating yourself to the lifestyle adjustments discussed above may help you conquer the negative symptoms you’re experiencing due to POTS.

Here’s to your health (in every position)!


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