POTS: Understanding Postural Orthostatic Tachycardia Syndrome

At Anttz Family Chiropractic, we believe understanding your body is an important part of caring for your health. This article explains what POTS is, some of the symptoms people experience, and how a supportive, individual approach to care may fit alongside appropriate medical management.

What is POTS?

POTS is a form of dysautonomia, a group of conditions involving the autonomic nervous system. This system helps regulate functions that happen automatically, such as heart rate, blood pressure, digestion and temperature control.

In people with POTS, moving from lying down to standing can cause an unusually large increase in heart rate. In adults, the diagnostic criterion commonly used is an increase of at least 30 beats per minute within 10 minutes of standing, without a significant drop in blood pressure. The threshold for adolescents is generally 40 beats per minute.

POTS is not simply a fast heartbeat. It is a complex condition involving the body’s response to being upright, and symptoms vary considerably from one person to another.

What symptoms can POTS cause?

POTS can affect several systems in the body. Common symptoms include:

• Heart and circulation: a racing heart, palpitations, dizziness and feeling faint when upright.
• Energy and concentration: fatigue, brain fog, difficulty concentrating and reduced stamina.
• Temperature regulation: feeling unusually hot or cold, changes in sweating, or difficulty regulating body temperature.
• Digestion: nausea, bloating, abdominal discomfort or changes in digestion.

Some people find symptoms worsen after standing for long periods, in warm environments, after meals or during illness. Others experience significant limits on everyday activities.

Why can POTS be difficult to diagnose?

POTS symptoms overlap with several other conditions. People may experience dizziness, fatigue, palpitations or brain fog without knowing why.

Diagnosis can therefore take time, and some people see several healthcare professionals before receiving an explanation for their symptoms. A proper assessment is important, because similar symptoms can have different causes.

If you think you may have POTS, speak to your GP or an appropriate healthcare professional. Diagnosis and treatment should be guided by a qualified medical team.

The autonomic nervous system and POTS

The autonomic nervous system is often described as having two main branches:

• The sympathetic nervous system helps the body respond to activity, stress and increased demands.
• The parasympathetic nervous system supports rest, digestion and recovery.

These systems work together to keep the body in balance. In POTS, the regulation of circulation and other automatic functions can be disrupted, particularly when a person stands up.

The vagus nerve is an important part of the parasympathetic nervous system and is involved in communication between the brain and many organs, including the heart and digestive tract. It is one part of a wider network, and POTS is a complex condition that cannot be explained by a single nerve or spinal segment.

Can chiropractic care help people with POTS?

People living with POTS may benefit from care that considers the whole person, including their nervous system, musculoskeletal health, lifestyle and individual needs.

Chiropractic care may help some people manage co-existing musculoskeletal symptoms, such as neck or back discomfort, which can matter more when fatigue, reduced activity or long periods of rest affect daily life. Gentle, individual care may also support comfort and movement where appropriate.

However, there is currently not enough high-quality evidence to conclude that chiropractic adjustments treat or cure POTS itself. Claims that adjusting a particular spinal bone can directly restore vagal tone or resolve POTS are not established by robust clinical research.

For this reason, chiropractic care should be seen as complementary support, never a replacement for medical assessment or treatment. Any approach should be adapted to your symptoms, tolerance and clinical needs.

A collaborative approach to care

Living with POTS can be frustrating, especially when symptoms are invisible or misunderstood. A supportive approach may include:

• working with your GP or specialist on a diagnosis and treatment plan
• understanding your own triggers, limits and energy levels
• pacing and gradual activity, as advised by your healthcare team
• addressing musculoskeletal discomfort with care that suits your condition
• reviewing progress regularly and adapting care as your needs change

At Anttz Family Chiropractic, we aim to listen carefully, understand your concerns and work within a collaborative model of care. If you have POTS, any chiropractic assessment takes your diagnosis, symptoms, medication and medical advice into account.

When should you seek medical advice?

If you regularly experience dizziness, fainting, a racing heart or significant fatigue when standing, seek medical advice rather than assume the symptoms are caused by POTS.

Seek urgent medical attention if you experience chest pain, severe breathlessness, fainting during exertion, or a sudden or sustained racing heartbeat with feeling seriously unwell.

References and further reading

• NHS: Postural tachycardia syndrome (PoTS) (opens in a new tab)
• PoTS UK (opens in a new tab)

This article is for education only and does not replace medical diagnosis or treatment. POTS should be assessed and managed by an appropriately qualified healthcare professional.