What is POTS?
Postural Orthostatic Tachycardia Syndrome (POTS) is a chronic blood circulation disorder characterized by an excessive increase in heart rate–without the typical corresponding drop in blood pressure–that occurs during the transition from lying down to standing. POTS predominantly affects girls and young women and brings on a range of frustrating symptoms such as lightheadedness, blurred vision, difficulty concentrating, and chest pain.
POTS can be rooted in issues with neuropathy, or nerve damage affecting the autonomic nervous system, which can be thought of as the ‘automatic’ nervous system since it controls unconscious functions like digestion, breathing, and heart rate. It can also be rooted in what’s called a ‘hyperadrenic state,’ meaning the sympathetic branch of the autonomic nervous system is in overdrive. The sympathetic nervous system controls reactionary mechanisms associated with ‘fight or flight’ responses. This is opposed to its counterpart, the parasympathetic nervous system, which controls ‘rest and digest’ responses. In POTS, both issues with neuropathy and being in a state of sympathetic overdrive can make everyday activities feel like a massive challenge.
Gastrointestinal Concerns and Nutritional Implications
GI symptoms are a common struggle for those with POTS. Symptoms including nausea, bloating, heartburn, and irregular bowel movements are common due to disturbances in GI motility. These issues can decrease your appetite, reduce fluid intake, and interfere with nutrient absorption, making staying hydrated and well-nourished a constant battle.
This can result in unintended weight loss, dehydration, and nutrient deficiencies—especially in iron, folate, B12, and fat-soluble vitamins. These deficiencies are often “clinically silent” (meaning they don’t always present obvious symptoms), but still have a significant impact on how you feel day-to-day. This is where monitoring your intake and symptoms can be a game-changer in ensuring these deficiencies don’t go undetected.
How to Differentiate Nutritional Symptoms from POTS
Living with POTS often means playing detective with your own body. It can be tricky to figure out what’s directly related to POTS, what might be making it worse, or what's unrelated. Here’s a quick guide to help make sense of it all:
- POTS-Related GI Symptoms: Nausea, bloating, and constipation can often be traced back to dysautonomia in POTS, where the autonomic nervous system struggles to regulate digestion.
- What Can Make It Worse: Dehydration and low sodium intake can worsen POTS symptoms like dizziness and fatigue. High-sugar foods or large meals can cause rapid shifts in blood volume, potentially triggering symptoms. Alcohol and caffeine-containing energy drinks may also contribute to heart rate increases.
- What Might Be Separate: Certain nutrient intolerances or conditions like irritable bowel syndrome (IBS) may present similar symptoms but require different management. A dietitian can help distinguish between these by analyzing symptom patterns and dietary habits.
Nutritional Management Strategies for POTS
Managing POTS with nutrition isn’t about a one-size-fits-all diet—it’s about finding what helps you feel your best. Here are some POTS diet strategies that can make a real difference:
Stay Hydrated and Up Your Salt Intake: Drinking 2-3 liters of fluids daily and boosting your sodium intake (aiming for 10-12 grams daily) can help keep your blood volume up and minimize those dizzy spells. Start with around 6 grams of salt and gradually increase—this is something you’ll want to coordinate with your doctor to get just right. Lemon water and salt or sugar-free electrolyte supplements designed for POTS and dysautonomia, such as Vitassium, offer excellent alternatives that won't exacerbate symptoms in those with blood sugar sensitivities or migraines.
Think Small (Meals, That Is): Eating smaller, more frequent meals can keep GI symptoms in check and prevent those big swings in blood sugar that can worsen POTS. Lower-glycemic, complex carbs can help provide steady energy without the highs and lows.
Focus on Nutrient-Dense Foods: Since absorption issues can lead to deficiencies, it’s important to include foods rich in iron, folate, and B12. For those with absorption challenges, fortified foods or supplements may be necessary under the guidance of a registered dietitian.
Keep an Eye on Deficiencies: Regular blood tests to check for nutrient levels are important, especially since deficiencies might not be obvious until they’re already taking a toll on your energy and overall well-being. Certain nutrient deficiencies can take longer than others to improve, so don’t be disheartened if your diet changes aren’t immediately reflected in your blood work.
Be Smart About Alcohol and Caffeine: A glass of wine here and there might be okay, but heavy drinking can mess with your heart rate and fluid levels. Likewise, swapping out energy drinks for caffeine-free options can help keep your heart rate more stable.
Watch for Disordered Eating Patterns: Given that POTS often affects young, underweight women, there’s a risk of overlapping symptoms between restricted eating behaviors and POTS. A registered dietitian can provide guidance to ensure patients are meeting their energy needs without exacerbating symptoms.
How Guava Can Support POTS Management
Managing POTS requires a personalized approach and regular tracking of symptoms, dietary changes, and lab results. Guava provides a platform for tracking symptoms like lightheadedness, heart rate fluctuations, and GI distress. By logging meals, hydration levels, and salt intake, patients and dietitians can better identify what triggers symptoms and which strategies are most effective.
Guava's ability to track lab results helps dietitians monitor nutrient levels over time, making it easier to adjust dietary recommendations and identify the need for supplements. With all this data centralized, registered dietitians can develop a more tailored plan, allowing for a collaborative and proactive approach to managing POTS symptoms.
The Bottom Line
While POTS presents unique challenges, a thoughtful nutritional approach can make a significant difference in symptom management. Through hydration, balanced eating, and careful monitoring, patients can improve their quality of life. With tools like Guava, patients and dietitians can work together more effectively to identify patterns, address deficiencies, and ensure a more stable and balanced journey with POTS.
