I was diagnosed with POTS (Postural Orthostatic Tachycardia Syndrome) in 2013 (you can read more about my story here). I initially pursued help via the traditional medical community and pharmaceuticals. I had many ups and downs during that period, but didn't feel like I actually made any progress toward true remission. In 2015, I had another crash and found myself bedridden again. That began my true healing journey that led me to pursue healing via natural and holistic methods. Although I still am treating symptoms resulting from Lyme & co-infections, POTS has now been in remission for over 2 years.
During my healing journey, I began pursuing a Naturopathic Doctor degree. Upon completion of my studies, I had to complete a Doctoral Dissertation, and I chose POTS as the subject. The completed paper is a result of countless hours and many months reading and compiling information from thousands of pages of textbooks as well as 1000+ scientific articles and studies.
You can read the completed paper here. Please feel free to share with friends and groups, or email me your comments.
I attempted to marry my natural and holistic ideas on POTS with what data is currently available in the scientific literature. Below, I will attempt to briefly summarize a few points from the completed 74 page paper.
Note that this is not a post for beginners. This is really intended for those who are already aware of POTS. However, the complete paper does go into the basics: definitions, diagnostic criteria, symptoms, etc.
POTS is a syndrome, meaning it is a "collection of symptoms." It is not a "root cause" disease. In my opinion, the scientific community has not yet been able to "see the forest for the trees." The current perspectives are all too disjointed, attempting to study POTS and Dysautonomia via individual bodily systems, instead of looking and treating the body (and mind) as one whole system. Therefore, current traditional medicine is sorely lacking in its available or effective treatments for POTS patients.
One of the biggest issues with POTS is that the patients have dysregulation of norepinephrine (NE). Norepinephrine is the main neurotransmitter in the sympathetic branch of the nervous system (the "fight or flight" system). The patients have too much NE, while also having not enough NE.
In POTS patients, NET protein (NE Transporter Protein) becomes downregulated. This NET protein recycles NE from the bloodstream and into the synapse. This appears to be one of the main mechanical issues causing POTS. POTS patients have issues with NE via three insults: 1) They have too much NE to start with, due to an overactive Sympathetic nervous system. 2) The NET Protein is essentially busted. Therefore, not enough NE is recycled and taken up into the cells for use with normal NE functions, such as constriction of blood vessels upon standing, energy, and alertness. Since this NE is not taken up via NET Protein, there is then too much leftover and circulating in the bloodstream ("NE spillover"). The heart and other organs are then "innocent bystanders" of this excessive circulating NE, causing the symptoms of postural tachycardia, nausea, anxiety, and so on. 3) POTS patients have autoimmune auto-antibodies against NE receptors. So, the body is attacking these receptors for some reason. This attack blocks the uptake of NE as well as potentially damages the receptors.
Many POTS patients also have auto antibodies against Acetylcholine receptors. Acetylcholine is the main neurotransmitter in the Parasympathetic (calming) nervous system branch. Therefore, POTS patients have issues with both an overactive sympathic nervous system as well as an underactive parasympathetic system, which results in autonomic nervous system (ANS) chaos.
In my paper, I also attempt to find possible reasons for these breakdowns, using only scientific literature. First, increased and chronic stress and trauma will result in increased NE and sympathetic nervous system tone.
Second, there are various reasons and/or theories as to why NET Protein would downregulate. Studies have shown that cytokines (inflammation), insulin, and oxidative stress can all downregulate NET. Theories also state that NET may be downregulated when there is too much NE, overall, in the body (which bring us back to point one -- stress and trauma).
Third, the body is attacking its own receptors. Now, the traditional medical community currently accepts that autoimmunity results from a body that is "confused" or "misguided." They basically believe the body doesn't know what it's doing. That is where I disagree. I believe that the body is much more intelligent than we give it credit for. It is working for us, not against us. I believe (and provide documentation for the theories) that the immune system is dysregulated, and the body is attempting to attack pathogens that are becoming unruly. I believe the pathogens may be "docked" on our own receptor sites, and therefore, the body creates auto-antibodies in the process of attempting to remove the pathogens. Another theory, which may work in conjunction with the docking theory, is that pathogens release certain chemicals that are similar in structure to our own chemicals or proteins. Therefore, as our bodies attempt to attack the pathogen, our own receptors get attacked as collateral damage, due to "molecular mimicry." I go further into Microbial Endocrinology in the paper, which I find is a fascinating subject.
Lastly, I summarize research on various nutrients that have been found to be deficient or dysregulated in POTS patients.
In my own experience, I have seen a significant correlation between POTS patients and stealth infections (including Lyme and co-infections, particularly Bartonella and Babesia), as well as mold exposure. I also provide links for this in my paper.
Treating POTS should be done on a "whole body" level, or holistically. Treatment should vary based on each patient's individual imbalances. As with myself and other POTS patients that I've seen, POTS often resolves as the body comes back into a certain level of balance.
Regarding what helped me specifically with POTS:
-Electrolyes and hydration. Doctors push salt, salt, salt. However, potassium has been king for me, as it helps to decrease sympathetic tone and also increase aldosterone. Finding the right balance of potassium, sodium, and magnesium is often step one in helping with POTS symptoms (from a natural perspective).
-Diet, of course. This is foundational. I love the Wahl's Paleo diet, however, each patient's way of eating will vary based on their individual tolerances and their gut microbiome.
-Finding and addressing stealth pathogens. Getting ~4g of potassium daily (via foods and drinks) was when I first started noticing significant improvement with POTS. But, once I started targeting Babesia and Bartonella infections, that is when POTS really resolved for me.
-Cleaning up the environment. Mold exposure is a huge issue. It decreases the immune system and sets the stage for dysregulation in levels of electrolytes and tissue hydration, and unruly pathogens.
-Stress and Trauma. This area cannot be overstated. While some stressors cannot be avoided in today's environment, we can both mitigate what we can control, as well as work on changing our reactions to stress. For me, this has included working on past emotional traumas with the help of a counselor, as well as daily working to retrain and rewire my brain and limbic system (DNRS, or Dynamic Neural Retraining System is my favorite easily accessible program. You can read or hear many POTS DNRS success stories by searching online). Deep breathing practices (individualized) has also been key for helping to calm my autonomic nervous system.
In summary, it's my experience that POTS can be put into remission, by viewing the body as one whole system and treating accordingly. The goal of my paper was to deep dive into the subject of POTS from a holistic perspective, while using scientific data, in order to help current POTS patients as well potentially inspire new ideas for further research.