What to Do When You Have POTS (Postural Orthostatic Tachycardia Syndrome)?

Postural Orthostatic Tachycardia Syndrome (POTS) is a complex condition that affects the autonomic nervous system, causing a range of symptoms when a person moves from lying down to an upright position. While the exact cause of POTS remains unclear, research suggests that it can be linked to various triggers, including viral infections, autoimmune diseases, and trauma. For those living with POTS, holistic management strategies that encompass dietary changes and mindfulness meditation can play a crucial role in alleviating symptoms and addressing underlying issues such as trauma.

What is Postural Orthostatic Tachycardia Syndrome (POTS)?

POTS is a type of dysautonomia, a disorder of the autonomic nervous system that controls involuntary bodily functions such as heart rate, blood pressure, and digestion. The hallmark of POTS is an excessive heart rate increase of 30 beats per minute (bpm) or more (40 bpm in teenagers) within 10 minutes of standing, often accompanied by dizziness, lightheadedness, fatigue, and palpitations.

Additional symptoms can include:

• Chronic fatigue

• Brain fog

• Gastrointestinal disturbances

• Sleep issues

• Exercise intolerance

• Anxiety and depression

The Role of Dietary Management in POTS

Dietary management is a cornerstone of POTS treatment. Since many POTS patients have gastrointestinal issues and experience symptoms that worsen after eating, it is important to adopt a diet that stabilizes blood sugar levels and supports overall health. Key dietary strategies include:

1. High MInerals and Fluid Intake: Increasing minerals, such as sodium, chloride, potassium, and magnesium and fluid intake can help expand blood volume, which is often reduced in POTS patients. This helps improve blood pressure and reduces symptoms of lightheadedness. You can increase mineral intake by adding electrolyte supplements or using unrefined sea salt or Himalayan Pink salt liberally with foods and water, or eating salty foods.

2. Frequent, Small Meals: Eating small, frequent meals helps prevent large shifts in blood pressure that can occur with larger meals, which might exacerbate symptoms.

3. Balanced Macronutrients: A diet rich in complex carbohydrates, healthy fats, and protein-rich foods can help maintain and stabilize blood sugar levels, preventing the exacerbation of POTS symptoms.

4. Anti-inflammatory Foods: Incorporating anti-inflammatory foods, such as leafy greens, berries, nuts, seeds and fatty fish, can help reduce systemic inflammation, which is often elevated in POTS patients.

5. Avoiding Triggers: Some foods and beverages, such as those high in sugar, caffeine, or alcohol, may trigger symptoms in some individuals and should be consumed with caution or avoided.

Foods to Eat More for POTS

Vegetables

1. Leafy greens - Spinach, kale, and Swiss chard are packed with vitamins and minerals that reduce inflammation.

2. Broccoli & cauliflower - Rich in sulforaphane, a potent anti-inflammatory compound.

3. Brussels sprouts - Contain antioxidants that can reduce inflammation.

4. Bell peppers are high in vitamin C and antioxidants.

5. Carrots - Rich in beta-carotene, which has anti-inflammatory effects.

Healthy Fats

1. Olive oil - Extra virgin olive oil is rich in monounsaturated fats and oleocanthal, a natural anti-inflammatory compound.

2. Avocados - Contain healthy fats and fiber that help reduce inflammation.

3. Nuts - Almonds, walnuts, and hazelnuts are rich in healthy fats and antioxidants.

4. Seeds - Chia seeds, flaxseeds, and hemp seeds are high in omega-3 fatty acids.

5. Fatty fish - Salmon, mackerel, sardines, and trout are high in omega-3 fatty acids, which have strong anti-inflammatory properties.

Whole Grains

1. Oats - High in fiber, which can help reduce inflammation.

2. Brown rice - A good source of fiber and nutrients that combat inflammation.

3. Quinoa - Contains antioxidants and is a good source of plant-based protein.

Legumes

1. Lentils - High in fiber and antioxidants that help fight inflammation.

2. Black beans - Rich in antioxidants and fiber.

3. Chickpeas - Provide fiber and nutrients that reduce inflammation.

Fruits

1. Berries - Blueberries, strawberries, raspberries, and blackberries are rich in antioxidants like anthocyanins.

2. Cherries - Especially tart cherries, which contain anti-inflammatory compounds.

3. Oranges - High in vitamin C and antioxidants.

4. Pineapple - Contains bromelain, an enzyme with anti-inflammatory properties.

5. Apples - High in fiber and antioxidants.

Spices and Herbs

1. Turmeric - Contains curcumin, a powerful anti-inflammatory compound.

2. Ginger - Has anti-inflammatory and antioxidant properties.

3. Garlic - Known for its anti-inflammatory effects.

4. Cinnamon - Contains antioxidants that have anti-inflammatory benefits.

5. Rosemary - Has compounds that help reduce inflammation.

Beverages

1. Green tea - Rich in polyphenols, particularly EGCG, which has strong anti-inflammatory effects.

2. Herbal teas - Chamomile, ginger, and turmeric teas are particularly anti-inflammatory.

3. Bone broth - Contains amino acids and minerals that support gut health and reduce inflammation.

   Others

1. Dark chocolate - Contains flavonoids that have anti-inflammatory effects.

2. Fermented foods - Yogurt, kefir, sauerkraut, and kimchi support gut health and reduce inflammation.

3. Mushrooms - Especially varieties like shiitake and maitake, which contain anti-inflammatory compounds.

Incorporating these foods into your diet can help manage inflammation and support overall health.

Foods to Avoid for POTS

1. High-Sugar Foods

• Sugary snacks: Candy, pastries, and desserts can cause rapid spikes and drops in blood sugar, which may worsen symptoms like dizziness and fatigue.

• Sugary drinks: Sodas, sweetened teas, and energy drinks can lead to similar blood sugar fluctuations and dehydration.

2. Refined Carbohydrates

• White bread, pasta, and rice: These can cause rapid changes in blood sugar levels, potentially leading to a worsening of POTS symptoms.

• Processed cereals: Many breakfast cereals are high in refined carbs and sugars.

3. Caffeine

• Coffee and caffeinated teas: While caffeine can help some people, it can also cause dehydration and trigger palpitations or anxiety, exacerbating POTS symptoms in others.

• Energy drinks: High in both caffeine and sugar, these can increase heart rate and dehydration.

4. Alcohol

• Beer, wine, and spirits: Alcohol is a vasodilator, meaning it can cause blood vessels to widen, leading to lower blood pressure. This can exacerbate symptoms like dizziness and lightheadedness in POTS patients.

5. High-Carbohydrate Meals

• Large meals rich in carbs: Eating large amounts of carbohydrates at once can cause a drop in blood pressure after eating (postprandial hypotension), which can be problematic for POTS patients.

6. Processed High-Sodium Foods (in excess)

• Processed meats: While some salt is beneficial for POTS patients, processed meats like bacon and sausages often contain unhealthy fats and preservatives.

• Packaged snacks: Chips, pretzels, and other packaged snacks may have high sodium levels but also contain unhealthy fats and additives.

Note: While salt is generally recommended for POTS, processed foods that also contain unhealthy food additives or excessive refined sodium without proper hydration should be limited.

7. Dairy Products (for some)

• Whole milk and high-fat cheeses: High-fat dairy products can be difficult to digest and may worsen gastrointestinal symptoms, such as bloating or discomfort, which are common in POTS.

• Cream-based sauces: These can be rich and heavy, leading to digestive discomfort.

8. Artificial Sweeteners

• Diet sodas and sugar-free products: Artificial sweeteners like aspartame can cause bloating, gastrointestinal discomfort, and potentially trigger symptoms in sensitive individuals.

9. Fried and Fatty Foods

• Fast food: Burgers, fries, and other deep-fried items can be difficult to digest and may exacerbate gastrointestinal symptoms associated with POTS.

• Heavy, greasy meals: These can slow digestion and lead to postprandial hypotension, making POTS symptoms worse.

10. Certain Vegetables (for those with GI symptoms)

• Broccoli, cabbage, and Brussels sprouts: These can cause bloating and gas, which may exacerbate gastrointestinal discomfort in POTS patients.

• Onions and garlic: While healthy for many, these can cause digestive distress for some, worsening symptoms.

11. Gluten (for those sensitive)

• Wheat-based products: If gluten sensitivity is an issue, avoiding gluten-containing foods like bread, pasta, and baked goods may help manage symptoms.

Everyone's experience with POTS is unique, so keeping a food diary to track what triggers your symptoms can help you personalize your diet.

The Link Between POTS and Trauma

There is growing evidence that trauma, particularly chronic or severe psychological trauma, may contribute to the development or exacerbation of POTS. Trauma can lead to prolonged activation of the body's stress response, affecting the autonomic nervous system and potentially leading to dysregulation. This dysregulation might manifest as POTS in susceptible individuals. In addition, the physical and emotional stress from trauma can worsen the symptoms of POTS, creating a challenging cycle for patients.

Mindfulness Meditation for Releasing Stored Trauma Emotions

Mindfulness meditation is an effective tool for managing the emotional and psychological aspects of POTS, particularly for those whose condition is linked to trauma. The practice of mindfulness involves focusing on the present moment, acknowledging thoughts and emotions without judgment, and fostering a sense of calmness and awareness, reminding your body that you’re no longer in the unsafe space and that you are now safe.

Benefits of Mindfulness Meditation in POTS Management:

• Regulates the Autonomic Nervous System: Mindfulness can help balance the autonomic nervous system, reducing the overactivity that contributes to POTS symptoms.

• Reduces Stress and Anxiety: By promoting relaxation and reducing stress, mindfulness meditation can help alleviate some of the psychological symptoms associated with POTS, such as anxiety and depression.

• Helps Process Trauma: Mindfulness provides a safe space for individuals to explore and process trauma-related emotions, helping to release stored trauma that might be contributing to the physical symptoms of POTS.

• Improves Emotional Resilience: Regular mindfulness practice can enhance emotional resilience, making it easier to cope with the chronic nature of POTS and its impact on daily life.

Integrating Holistic Approaches for POTS Management

The integration of dietary management and mindfulness meditation offers a comprehensive approach to managing POTS, particularly for those with a history of trauma. By addressing both the physical and emotional aspects of the condition, patients can achieve a better quality of life and potentially reduce the severity of their symptoms.

If you are living with POTS, consider consulting with a healthcare professional who can help you tailor a dietary plan and mindfulness practice to your unique needs. With the right combination of strategies, it is possible to manage POTS effectively and live a fuller, healthier life.