Understanding the Syndrome, Causes & Treatment Considerations
What is POTS?
POTS (Postural Orthostatic Tachycardia Syndrome) is a condition where standing up causes a sudden increase in heart rate, often leading to dizziness, fatigue, and brain fog. It’s classified as a syndrome, meaning it’s a collection of symptoms with multiple possible causes rather than a single disease with one clear cause.
POTS can develop after viral infections (such as COVID or Epstein-Barr), adrenal fatigue, thyroid dysfunction, inflammation, toxic metal exposure, or even as an adverse reaction to certain vaccines. It can also follow a concussion or traumatic brain injury (TBI), making recovery difficult.
Signs and Symptoms of POTS
Symptoms vary from person to person but often include:
Dizziness or fainting (especially when standing up)
Racing heart (tachycardia) upon standing
Fatigue and exhaustion that isn’t relieved by rest
Brain fog (difficulty concentrating, memory issues)
Exercise intolerance (feeling worse after activity)
Cold hands and feet (poor circulation)
Digestive issues (bloating, nausea, IBS-like symptoms)
Excessive or reduced sweating
Many people with POTS feel like their body isn’t regulating itself properly, with symptoms shifting unpredictably.
How is POTS Diagnosed?
Doctors diagnose POTS using:
Tilt-Table Test – The patient is tilted upright while their heart rate and blood pressure are monitored.
Active Stand Test – The patient lies down, then stands up while their vitals are recorded.
POTS Criteria – A heart rate increase of 30+ beats per minute (bpm) within 10 minutes of standing (or 40+ bpm in teenagers) without a significant drop in blood pressure.
POTS is often misdiagnosed as anxiety, panic attacks, or chronic fatigue syndrome (CFS/ME).
Why Do Doctors Use Overcomplicated Terminology?
(This is a brief, but important digression)
If you had a racing heart and dizziness upon standing, why not just call it that? Instead, we get Postural Orthostatic Tachycardia Syndrome (POTS)—a term that sounds like something out of a medical textbook.
So, why the complicated language?
Prestige & Professionalism – Medical jargon can make doctors sound more knowledgeable and authoritative.
Dependency on the System – If a condition sounds too complex, patients may feel they need medical intervention rather than seeking simpler, natural solutions.
Billing & Insurance – In some healthcare systems, using a complicated diagnostic term allows for higher billing rates and insurance claims.
Avoiding Simplicity – If medical conditions were described in plain English, patients might start thinking for themselves—and that’s bad for business.
Just saying!
The Key Players: What Contributes to POTS?
POTS is often linked to autonomic nervous system dysfunction, inflammation, mitochondrial energy failure, and mineral imbalances. Some contributing factors include:
1. Post-Concussion Syndrome (PCS) & Traumatic Brain Injury (TBI)
Poor recovery from a head injury can lead to POTS-like symptoms—racing heart, dizziness, fatigue, and brain fog.
A concussion or mild TBI can damage the autonomic nervous system (ANS), which controls blood pressure, heart rate, and circulation.
The symptoms of PCS closely mimic adrenal fatigue because both conditions involve dysregulated stress hormones and blood flow problems.
Many undiagnosed concussion sufferers actually have autonomic dysfunction similar to POTS.
2. Adrenal Fatigue & Dysregulation
The adrenal glands make cortisol (stress hormone) and aldosterone (which regulates blood pressure and fluid balance).
If the adrenals are weak, the body struggles to regulate blood pressure, causing dizziness, salt cravings, and exhaustion.
3. Thyroid Dysfunction
Many POTS patients have low thyroid function (hypothyroidism).
The thyroid regulates energy, circulation, and metabolism, so a sluggish thyroid can worsen fatigue, poor circulation, and brain fog.
Some cases involve autoimmune thyroid disorders (Hashimoto’s), which drive systemic inflammation.
4. Post-Viral Fatigue (EBV, COVID, etc.)
Viruses like Epstein-Barr (EBV) and COVID-19 can damage the autonomic nervous system, leading to POTS.
Many Long COVID patients develop POTS-like symptoms, showing a strong viral connection.
5. Systemic Inflammation
Chronic inflammation disrupts nerves, blood vessels, and mitochondria, worsening symptoms.
High levels of oxidative stress impair energy production, leading to fatigue, brain fog, and circulation issues.
6. Mineral Imbalances (Especially Copper)
Copper is crucial for the nervous system, blood vessels, immune function, and energy production.
Copper Deficiency: Can cause neurological issues, dizziness, and fatigue.
Copper Excess or Biounavailability: Unbound copper (not properly used by the body) can drive oxidative stress and mitochondrial dysfunction.
Zinc & Copper Balance: High zinc intake lowers copper, affecting nerve and blood vessel function.
To learn more about copper and health:
7. COVID Vaccine Adverse Reactions
Many people develop POTS-like symptoms after COVID-19 vaccination.
The spike protein or immune response may trigger autonomic dysfunction, inflammation, or clotting issues.
Some cases involve autoimmune activation or microclots, affecting blood flow regulation.
Hormonal Contraceptives, Copper IUDs
For decades, women have been told that hormonal contraceptives and IUDs are safe, effective, and relatively free of serious side effects. However, a growing number of women are developing postural orthostatic tachycardia syndrome (POTS)-like symptoms—racing heart, dizziness, chronic fatigue, and brain fog—weeks or months after starting or stopping birth control.
I will write a separate article about this issue of copper and contraceptives.
The Role of HTMA in Understanding POTS
What is HTMA?
Hair Tissue Mineral Analysis (HTMA) is a non-invasive test that measures mineral levels and toxic elements in hair.
Unlike blood tests (which show short-term changes), HTMA provides a long-term view of mineral balance, toxic elements, and organ function.
How HTMA Helps Assess POTS-Related Issues
Adrenal Function – Low sodium and potassium may indicate adrenal insufficiency.
Thyroid Function – Mineral imbalances (low selenium or iodine) can impact thyroid health.
Liver Detoxification – Copper dysregulation or high toxic metals (aluminium, arsenic) can burden the liver.
Mitochondrial Function – Magnesium, manganese, and copper levels give clues about energy production.
Inflammation & Oxidative Stress – High iron, calcium, or toxic metals drive oxidative damage.
HTMA & Toxic Metals: How They Affect POTS
HTMA can also detect toxic elements like aluminium and arsenic, which may worsen POTS symptoms. For example:
Aluminium Toxicity
Found in vaccines, cookware, deodorants, and processed foods.
Interferes with nervous system function, causing brain fog and poor circulation.
Disrupts mitochondrial energy production, leading to fatigue.
Arsenic Toxicity
Found in contaminated water, rice, and pesticides.
Damages the nervous system, thyroid, and mitochondria, leading to dizziness, fatigue, and blood flow issues.
Contributes to copper dysregulation, worsening symptoms.
Addressing POTS Naturally
Because POTS is a syndrome with multiple causes, treatment must be personalised.
HTMA testing to establish nutrient, organ health, and toxic elements baselines.
Support Mitochondria – Magnesium, CoQ10, B vitamins.
Red-light therapy (contact me if you want to learn more about this form of therapy).
Use HTMA to Assess Mineral Balance & Toxic Load.
Balance Copper & Zinc – Avoid excess/unavailable copper.
Reduce Inflammation – Address gut health and oxidative stress.
Support Thyroid & Adrenal Function – Optimise selenium, iodine, and adaptogens.
By focusing on mitochondrial health, mineral balance, and detoxification, POTS recovery is possible.
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