How To Treat Postural Orthostatic Tachycardia Syndrome

Postural orthostatic tachycardia syndrome (POTS) is a common disorder of the circulatory system that most often affects women aged fifteen to sixty. The condition results in orthostatic intolerance, meaning too little blood is circulated back to the heart when a patient moves to a standing position after lying down. Symptoms include anxiety, a rapid heartbeat, dizziness, fainting, and nausea. Typically, most of these go away when the patient lies down again. Many patients with postural orthostatic tachycardia syndrome find exercise can trigger their symptoms, and some patients have reported diarrhea or constipation with this condition. 

Doctors often diagnose postural orthostatic tachycardia syndrome with a tilt-table test, where the patient is placed on a cardiac monitor and lies down on a special bed. For safety, the patient is strapped in to prevent falling during the procedure. The bed starts in the normal horizontal position and is gradually moved ninety degrees. As the bed moves, doctors observe the patient's heart rate for changes. Occasionally, patients may faint during the test. Having diabetes, anemia, mononucleosis, multiple sclerosis, lupus, or mitral valve prolapse may increase the risk of developing postural orthostatic tachycardia syndrome. This condition is considered chronic and may be lifelong.

Add A Little More Salt To Diet

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Higher salt intake can increase blood volume, reducing the likelihood of fainting upon standing for patients with postural orthostatic tachycardia syndrome. For this reason, doctors recommend patients add a little more salt to their diet. Patients who have a large number of symptoms may need to consume between five to ten thousand milligrams of sodium per day. For patients with moderate forms of the disorder, consuming two to four thousand milligrams each day is likely sufficient.

If possible, patients should increase their salt intake by eating saltier foods and adding salt to their meals at the table. For patients who cannot tolerate this, doctors can recommend appropriate sodium tablets. Increasing their salt intake will benefit patients with most kinds of postural orthostatic tachycardia syndrome, but it is not appropriate for patients who have kidney failure or heart disease.

Eat Smaller And More Frequent Meals


Patients with postural orthostatic tachycardia syndrome can experience a worsening of their symptoms after eating meals. This is because meals cause a significant amount of blood to be diverted to the digestive system to break down food, making this blood unavailable to the rest of the body. Large meals require more blood to be diverted than smaller meals, and it is for this reason, patients are advised to eat smaller and more frequent meals, as this places less stress on the body. Patients with postural orthostatic tachycardia syndrome may wish to experiment with the amount of carbohydrates in their meals. Some studies have shown patients who eat fewer carbohydrates can maintain higher blood pressure readings, decreasing the risk of fainting.

Wear Supportive Compression Socks


In postural orthostatic tachycardia syndrome, blood often pools in the lower body and is unable to return to the upper body and the heart as it should. Doctors recommend patients to wear supportive compression socks, which help force blood up the legs, to increase their circulation and make blood more readily available to the upper body. Compression socks are available in a range of styles, sizes, and pressure gauges. 

Patients with this syndrome will likely need compression socks that extend to just above the knee. Before purchasing and using compression socks, patients should ask their doctors what level of compression is appropriate for their needs. They should also inquire as to when the socks should be worn and for how long. These socks are not to be worn continuously, and patients need to know when they should be removed. Typically, most patients will need to wear them at night while sleeping.

Drink Lots Of Water


Studies have shown individuals with postural orthostatic tachycardia syndrome benefit when they drink lots of water. Increasing fluid intake helps these patients have improved blood pressure and heart rate readings when they stand up, reducing their risk of fainting. A higher fluid intake also increases the amount of time patients can comfortably stand for and helps them feel less dizzy. 

Generally, postural orthostatic tachycardia syndrome patients should aim to consume at least two liters of fluid per day. Water, soup, juices, and other fluids all count. If patients experience dizziness, doctors recommend drinking sixteen ounces of water within ten minutes to alleviate this symptom. Alcohol, energy drinks, and caffeinated beverages should be limited or eliminated from the diet to achieve the most effective symptom management.

Healthy Sleep Schedule

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Patients with postural orthostatic tachycardia syndrome often struggle with insomnia, waking up during the night, and night sweats, which can lead to daytime sleepiness and a feeling of mental fog. To ease these symptoms, doctors advise patients to maintain a healthy sleep schedule. Patients should try to get up and go to sleep at the same time each day, even on the weekends. In addition, use of electronics should be avoided one hour before bedtime, and patients should ideally not have electronic devices in their bedrooms. 

If possible, patients who can safely exercise may wish to try doing a light workout three hours before they go to bed to help them fall asleep more quickly. In patients with insomnia, the use of a ten thousand lumen light can reset the sleeping and waking cycle. The light should be aimed at the chest for thirty minutes each morning. Use of this light helps increase mental alertness too.


    HealthPrep Staff