Managing my POTS

Dear Dizzy and Disoriented,

You’re among good company — nearly 450,000 people in the United States have a postural orthostatic tachycardia syndrome (POTS) diagnosis, which sometimes results in a loss of nerve supply, as you’re experiencing. What can you do to encourage the nerves in your brain to heal? Common recommendations include maintaining a balanced diet, being physically active, and avoiding alcohol. However, there’s often not much a person can actually do to help their nerves heal without professional treatment such as medication or surgery. Read on for more about POTS, nerve damage, and recommended lifestyle adjustments.

POTS involves the body’s inability to balance blood vessel squeeze and heart rate response, thereby affecting circulation, or blood flow. The condition is often caused by dysfunctions in the autonomic nervous system, which can result from viral and bacterial infections, pregnancy, or trauma (such as head injury). People 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. There are various forms of POTS, one of the most common being neuropathic. In neuropathic POTS, a loss of nerve supply leads to poor blood vessel muscles, especially in the legs and core. Why? When peripheral nerves — which carry information to and from the brain — don’t work properly, this is considered peripheral neuropathy. The resulting symptoms depend on which nerve(s) (and how many) are damaged. Damage to the nerves to your heart may cause you to feel lightheaded or faint when you stand up, which is a common symptom of POTS.

It sounds like you’re already engaging in lifestyle changes that help manage POTS, such as consuming lots of liquids and salt. As for encouraging the nerves in your brain to heal, little is actually known about what a person can do without treatment advised by a medical professional. That being said, literature on POTS suggests that other lifestyle adjustments may reduce some of the symptoms and promote healing. One example of this is eating a balanced diet in order to support brain function and heart health. In addition to drinking lots of fluid and consuming a high salt diet, you may also find it helpful to limit consumption of food lacking in nutrients, and to continue consuming the omega-3 healthy fats (such as fish) that you’ve already incorporated into your diet. Other recommendations include engaging in consistent physical activity (at the discretion of your health care provider), getting plenty of restful sleep, avoiding alcohol, and tending to your mental well-being. Psychological support — whether from a mental health professional or through some scheduled self-compassion — may help mediate the anxiety and tremulousness that those with POTS often experience. You may find that activities such as journal writing, meditating, and drinking herbal tea have calming and therapeutic effects.

As mentioned, these lifestyle and behavioral adjustments may not be enough to help your nerves heal. But — whether you know it or not — you’re already promoting your health and well-being by working collaboratively with your provider and seeking out the latest information on managing POTS, which may ultimately be the most you can do.

Best wishes as you continue to tend yo your body and mind,