Understanding POTS: Symptoms and Treatment
POTS (Postural Orthostatic Tachycardia Syndrome) can cause a range of symptoms, but the most notable is tachycardia, or a rapid heart rate, even with minimal exertion. For example: Your heart rate might climb to levels seen in running, even if you're just walking to the kitchen or lying down on the couch. Or, you might feel heart palpitations, but these are usually not due to irregular rhythms; your heart is simply beating too fast.
Other common POTS symptoms include low blood pressure, which can cause extreme fatigue, brain fog, and even a subtle sense of panic or doom. This happens because your body struggles to get blood to the brain. Cold fingers and toes and increased likelihood of Raynaud's phenomenon due to issues with blood vessel regulation. Mottled or purplish legs, as blood pools in the lower body.
Diagnosis: Do You Need a Tilt Table Test?
A tilt table test (or inversion test) is often used by cardiologists to officially diagnose POTS. It’s designed to provoke symptoms by monitoring your blood pressure and heart rate during positional changes.
However, a root-cause-focused approach might make the test unnecessary. If you already have symptoms of tachycardia and blood pressure dysregulation, addressing the underlying causes can be more effective than pursuing an official diagnosis.
Root Causes of POTS
POTS isn’t a single disease but rather a result of deeper imbalances in the body. There are two main types of POTS:
One is structural or trauma-induced POTS, which is caused by nerve damage (e.g., from surgery, car accidents, or congenital structural differences). If the vagus nerve is affected, it disrupts the autonomic nervous system's ability to regulate heart rate and blood pressure.
The other is inflammation-driven POTS. In most cases, POTS arises from chronic inflammation. The primary driver of this inflammation? Histamine.
What Is Histamine, and Why Does It Matter?
Histamine is a chemical produced by white blood cells to defend against perceived threats like infections and toxins. While it serves an essential role, excessive histamine triggers inflammation and wreaks havoc on the body.
Histamine can be triggered by infections (parasitic, viral, bacterial, fungal), environmental biotoxins, such as mold or harmful bacteria and toxic exposures, like heavy metals or gases.
Symptoms of Histamine Overload
In addition to exacerbating POTS, high histamine levels can cause:
Brain fog, fatigue, and ADHD-like symptoms.
Gut issues, including food sensitivities and loose stools.
Skin problems, such as rashes, hives, or itching.
Flushing after showers or meals.
Breaking Down the Histamine Cascade
To address POTS effectively, we need to tackle histamine at every level of its "cascade." Here’s how:
Stabilize Mast Cells (The Source of Histamine)
Mast cells are responsible for releasing histamine. By stabilizing them, we reduce histamine production at the source. This can be achieved through hHerbs and supplements designed to calm overactive mast cells as well as supporting the body’s immune response to prevent overreaction to triggers.
Support the Liver (Histamine Processing)
The liver plays a critical role in removing histamine from the bloodstream. Ensuring liver function is optimized helps the body clear excess histamine efficiently.
Boost Kidney Function (Breaking Down Histamine)
The kidneys contain an enzyme (DAO) that breaks down histamine. Supporting kidney health ensures proper histamine degradation and removal.
Use Antihistamines (Blocking Histamine Receptors)
Antihistamines prevent histamine from binding to receptors, reducing symptoms like flushing, itching, and brain fog. However, histamine still circulates in the body, so this isn’t a complete solution.
Utilize Binders (Mopping Up Histamine)
Binders act as a “mop” to capture and remove histamine and toxins from the gut, preventing reabsorption. This step is crucial for long-term relief.
A Holistic Approach to Healing POTS
Remove the Triggers
The first step is identifying and removing the root cause of the histamine response, whether it’s mold, hidden infections, or other toxins. This process requires accurate testing and assessments (e.g., mold-specific testing beyond standard inspections). Along with a gradual detoxification, starting with peripheral pathways like the liver and gut before addressing deeper sources.
Address Nutritional and Hormonal Factors
Progesterone helps stabilize histamine levels, while estrogen can make symptoms worse. Women with POTS may notice symptom fluctuations during their menstrual cycle.
Vitamins like B12, folate, and magnesium play vital roles in histamine processing.
Avoid Common Pitfalls
Stay away from restrictive diets. While avoiding high-histamine foods might provide short-term relief, overly restrictive diets often backfire, leading to increased sensitivities.
Beware of starting with the wrong treatments. Jumping into aggressive protocols (e.g., killing infections) without stabilizing histamine or opening detox pathways can worsen symptoms.
Tools to Support Healing
Conventional medications: When used strategically, medications can serve as a temporary Band-Aid while addressing root causes.
Herbal remedies and supplements: These can stabilize mast cells, reduce inflammation, and support detox pathways for long-term healing.
Final Thoughts
POTS is a complex condition, but with a root-cause approach, it is possible to achieve significant relief and even recovery. By targeting histamine, addressing inflammation, and supporting the body’s detox pathways, we can effectively tackle the underlying drivers of POTS symptoms.
This journey requires patience and a comprehensive strategy, but every small step moves you closer to better health. I would love to walk with you through this.
If you have any questions or are ready to get started, book a FREE discovery call with me below.
