POTS / Dysautonomia

Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia — a dysfunction of the autonomic nervous system that controls heart rate, blood pressure, digestion, and temperature regulation. The hallmark feature is an abnormal increase in heart rate of 30 or more beats per minute (or above 120 bpm) within 10 minutes of standing, without a corresponding drop in blood pressure.

While POTS has been recognized for decades, it surged into public awareness after COVID-19. Viral infections are one of the most common triggers, along with surgery, trauma, pregnancy, and autoimmune flares. The underlying mechanisms typically involve some combination of low blood volume (hypovolemia), peripheral neuropathy affecting the small nerve fibers that regulate blood vessel constriction, and excessive norepinephrine release (hyperadrenergic POTS).

POTS rarely exists in isolation. It frequently co-occurs with Mast Cell Activation Syndrome (MCAS), Ehlers-Danlos Syndrome (EDS), small fiber neuropathy, chronic fatigue syndrome, and autoimmune conditions. Understanding these overlapping conditions is critical for building an effective recovery protocol — treating one without addressing the others often leads to limited progress.