Diagnosis, Treatment, and Nutritional and Lifestyle Support

Picking up where my last installment of this article ended, I would like to expand upon the ways in which Postural Orthostatic Tachycardia Syndrome (POTS) is diagnosed and treated, both conventionally as well as through nutritional and lifestyle modifications.

As I had noted previously, diagnosing POTS can be challenging. In order to do so, your doctor must first detail the history of the symptoms that may indicate orthostatic (positional change) intolerance. These are symptoms which occur when standing up.

Next a comprehensive physical examination needs to be performed. Findings that would be considered positive for POTS include:

• An increased heart rate within 10 minutes of transitioning to a standing position that is equal to or above 30 beats per minute (BPM) for adults and 40 BPM for individuals 12-19 years of age.
  
  
• No decrease in the blood pressure upon standing. This means no decrease of the systolic (top number) of 20 or above and no decrease in the diastolic (bottom number) of 10 or above.
  
  
• Frequent symptoms upon transitioning position to standing that include lightheadedness, heart palpitations, trembling, weakness, blurred vision, and fatigue.
  
  
• Above symptoms that have been present for at least 3 months.
  
  
• No other conditions that may be impacting on or causing the above symptoms.
  
  

Your doctor shall then rule out other cardiovascular causes for the symptoms as well as medications that might be causing those symptoms.

Finally, there are tests that can be performed to specifically diagnose POTS as well. They include:

Title Table

The patient lies on a table, and it is tilted to an angle of 60 to 70 degrees. Then it will be elevated to a horizontal position. The table will then be tilted into the upright position, and the heart rate will be monitored for 10 minutes.

Active Stand

In this test, a patient will lie down for a minimum of 10 minutes. He or she will then stand up and remain upright for 10 minutes without assistance and his or her blood pressure will be monitored.

Valsalva Maneuver

Valsalva maneuver may also be performed to assess the activity of the autonomic nervous system on the regulation of your heart rate. In this test, the patient forcefully exhale with a closed airway while heartrate and blood pressure are monitored.

QSART

The QSART, which stands for quantitative sudomotor axon reflex test, is another test used to assess the function of the autonomic nervous system (ANS) is test. It evaluates the function of sweat glands in the skin, which are controlled by the ANS.

Additionally, the following tests should be performed during a full analysis for POTS. They include an MRI, CT scans, blood tests to assess iron levels, kidney, liver, and thyroid function, specialized urine tests to assess both sodium and adrenal hormone levels, ECG, echocardiogram, and a 24-hour Holter monitor.

TREATMENTS INCLUDE THE FOLLOWING:

• Dietary modifications which will include above all else regular hydration. The fluids in the body must be replaced, and most don’t do so on a daily basis. This is even more critical in POTS patients in light of the fact that they often have a low hydration/saturation level to begin with.
  
  
• Increase salt intake. POTS patients often require as much as three times the amount of salt on a daily basis as the general population.
  
  
• Consume frequent small meals which should be made up of carbohydrates of low sugar content.
  
  
• Avoid alcohol, caffeinated beverages and energy drinks, which typically contain both high concentrations of both sugar and caffeine.
  
  
• Incorporate Chiropractic care. In a recently published study titled “Relief of Postural Orthostatic Tachycardia Syndrome with Chiropractic Rehabilitation” the authors emphasize the relief of POTS symptoms with chiropractic care in 3 months.
  
  
• Add targeted movements such as reclined exercises, aquatic therapy, and some form of exercise therapy.
  
  
• Manage Stress. This is also an essential component of the overall treatment for POTS.
  
  
• Investigate medications. Multiple medications can be employed, which should be discussed with your medical practitioner.
  
  

CONCLUSION

As you can see from this three-part discussion, this condition is neither easily diagnosed nor simply treated. However, it is a great example of the life-altering benefits of a proper diagnosis, because diagnosis is the first step towards treatment. No one should accept repetitive dizziness as a way of life. Symptoms such as brain fog, severe fatigue, profound weakness with standing, racing heart intolerance to exertion and muscle aches should never be brushed aside as incidental. These are the ways in which your body expresses disorder. When its messages come, pay attention and seek help.