POTS symptoms may also get worse when you get a common cold or an infection. Sports drinks are OK, but watch calories and if you have food sensitivities to these drinks’ ingredients. Postural orthostatic tachycardia syndrome (POTS) is a condition that affects circulation (blood flow). Medication is only used after a trial of non-pharmacological (without medication) treatment such as increased fluids, salts, compression and exercise. The best sleep hygiene and good rest comes from staying consistent with your sleep schedule every day. POTS diagnosis can be complicated because the symptoms can affect a wide range of organ systems, and the most bothersome symptom for each patient may differ. Physical therapy can make a difference for some people with POTS. Don’t over-rely on snack chips and crackers for salt. Those who can’t stand upright may start exercising in a horizontal or reclined position. Diet with high fiber and complex carbohydrates may help reduce blood glucose (sugar) spikes and lessen POTS symptoms. ; You may be prescribed thigh-high medical compression stockings.These stockings help push the blood up from the legs to reduce POTS symptoms. Some medications that have been reported to significantly affect autonomic testing results include: chlorpromazine, thioridazine, tricyclic antidepressants, bupropion, mirtazepine, vanlafaxine, clonidine, alpha blockers, beta blockers, calcium channel blockers, opiates and topical capsaicin (Sandroni, 1998). POTS is an acronym that stands for Postural Orthostatic Tachycardia Syndrome. Some people with POTS can develop hypotension (a drop in blood pressure) with prolonged standing (more than three minutes upright). These technologies can interfere with sleep quality. In many cases, your primary care physician is qualified to treat POTS. POTS can run in families, but no single gene associated with the majority of cases of POTS has been identified. He also talks about treatment options for myositis and POTS, as well as the current research in the field. The absence of symptoms doesn’t necessarily mean that the cause of POTS is gone as well. The latest information about heart & vascular disorders, treatments, tests and prevention from the No. POTS is a form of dysautonomia — a disorder of the autonomic nervous system. This can greatly affect all aspects of personal, school, work and social life. These nerves regulate the constriction of the blood vessels in the limbs and abdomen. POTS symptoms arise from a combination of the following: Lower amount of blood in the circulation, Excessive pooling of blood below the level of the heart when upright. Hypovolemic POTS is a term used to describe POTS associated with abnormally low levels of blood (hypovolemia). The key characteristics of POTS are the specific symptoms and the exaggerated increase in heart rate when standing. Postural orthostatic tachycardia syndrome (POTS) is a blood circulation disorder characterized by two factors: A specific group of symptoms that frequently occur when standing upright, A heart rate increase from horizontal to standing (or as tested on a tilt table) of at least 30 beats per minute in adults, or at least 40 beats per minute in adolescents, measured during the first 10 minutes of standing. Pharmacologic treatments often take a three-pronged approach and may include: They may include: Valsalva maneuver to test the response of the autonomic nerves that control the heart. While some people with POTS have anxiety disorders similar to the general population, POTS is not caused by anxiety. For example, a blood pressure reading of 120/80 represents the systolic number as 120 and the diastolic number as 80. Be careful of fad diets or diet supplements for weight loss. It diverts blood away from the central circulation to the skin and increases loss of fluids through urine. These drugs are sometimes used in POTS patients, but probably not as often as the SSRI and SNRI drugs. Plan grocery store shopping using a list to make sure you pick up healthy food choices and POTS care (hydration and salty supplements). Cleveland Clinic is a non-profit academic medical center. Beneficial salty snacks may include chicken or beef broth, vegetable broth, pickles, olives, salted fish like sardines/anchovies and nuts. A mutation in the norepinephrine transporter gene appears to affect only a tiny portion of POTS patients. That’s why a tilt table test is necessary to measure the body’s true response to standing without adaptive habits. This branch of the nervous system regulates functions we don’t consciously control, such as heart rate, blood pressure, sweating and body temperature. Drink 2-2.5 liters per day of fluids. Pharmacological Treatment of POTS The initial pharmacological approach is to withdraw medications that might be predisposing to tachycardia (such as diuretics, vasodilators, and norepinephrine transporter blockers). Wearing compression garments may help some people reduce excessive blood pooling in the legs. Quantitative sudomotor axon reflex test (QSART) to measure response of the autonomic nerves responsible for regulating sweating. Since POTS affects women of childbearing age, a common question is whether having POTS will affect the outcome of the pregnancy. In some cases, other tests are warranted. Several medications are used for dysautonomia treatment and the management of POTS, although the effectiveness of a given medication varies based on the type of dysautonomia, comorbid conditions and other individual factors. Most people’s POTS symptoms respond to a combination of diet, medications, physical therapy and other treatments. A slow heart rate under 60 beats per minute is called bradycardia. Blood pressure has two components, systolic and diastolic. There is no information on the effectiveness of ADHD medications in POTS. Dysautonomia International estimates that POTS affects between one and three million people in the U.S. You may need a dietary and nutrition consult ordered by your doctor to help you with your diet. POTS may begin after an apparent or confirmed viral illness, but it can also appear following surgery and other health events. When this changes, we will update this web site. Policy, Cleveland Clinic is a non-profit academic medical center. Then the table is raised to an almost upright position. Most people need 7 to 10 hours sleep at night. Please understand that our phone lines must be clear for people with urgent and acute medical care needs. Rehabilitation physicians can help as well in developing an exercise plan that works for you. As the nervous system continues to release epinephrine and norepinephrine to tighten the blood vessels, the heart rate increases further. Avoid Alcohol Alcohol can worsen symptoms for POTS patients. Researchers are still determining the cause of these extended symptoms, but some COVID-19 "long-haulers" may actually be dealing with POTS. The classification of POTS is the subject of discussion, but most authorities recognize different characteristics in POTS, which occur in some patients more than others. Measuring heart rate can give you insight as you deal with POTS. Your heart rate, blood pressure and often blood oxygen and exhaled carbon dioxide levels are measured during this test. While no single medication is effective for everyone with POTS, most people with frequent symptoms affecting their quality of life need some form of medication. The vast majority of adolescents and young adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have POTS or related forms of orthostatic intolerance. This may help you wake up more easily. For example, it is dangerous to blend Aspirin or NSAIDs (like Advil, Motrin, or Aleve) with anticoagulant drugs or blood-thinners (such as Coumadin, Xarelto and Pradaxa), because the combination increases the risk of internal and external bleeding. Not specific to POTS, but if you're on any prescription medications it's important to run any OTC meds you want to take by your pharmacist to make sure there's no interaction, or to tell you how to modify or limit the dose for it to be safe. Taking and writing down your vital information (blood pressure and pulse) can give you insight and better control over your POTS, and helps your doctor fine tune your treatment. Exercise and physical activity are key to managing POTS. 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