Symptoms, Causes, and Treatments
What is Postural Orthostatic tachycardia syndrome (POTS)?
Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia, a condition where the autonomic nervous system does not regulate body functions properly. It is characterized by an excessive increase in heart rate (often 30+ beats per minute in adults, or exceeding 120 bpm) within 10 minutes of standing, without a significant drop in blood pressure. This leads to symptoms such as dizziness, lightheadedness, fatigue, palpitations, and sometimes fainting.
Common Symptoms Include
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Rapid heartbeat on standing
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Dizziness or fainting (syncope)
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Fatigue and exercise intolerance
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Brain fog and difficulty concentrating
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Nausea or gastrointestinal discomfort
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Temperature regulation issues (feeling hot/cold easily)
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Headaches and migraines
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Tremors or shakiness
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Sleep disturbances
What causes it?
The exact cause of POTS is not fully understood, but it appears to result from a combination of genetic, immune, and environmental factors that affect the autonomic nervous system.
Possible underlying mechanisms include:
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Abnormal blood vessel constriction leading to poor circulation.
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Low blood volume or impaired blood pooling in the lower body.
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Autoimmune processes affecting nerves and receptors.
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Neuropathic changes in small fiber nerves.
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Hormonal and stress-related dysregulation.
Possible contributors include:
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Viral or bacterial infections (e.g., post-viral onset)
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Autoimmune disorders (e.g., lupus, Sjögren’s, Hashimoto’s)
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Hormonal changes (e.g., puberty, pregnancy, menopause)
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Trauma or major surgery
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Prolonged physical deconditioning
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Genetic predisposition
A Neuroplasticity-Based Approach
Neuroplasticity refers to the brain and nervous system’s ability to reorganize and adapt. In POTS, the autonomic nervous system can become "stuck" in a maladaptive state of over-reactivity. By using neuroplasticity-informed strategies, patients can gradually retrain the nervous system toward regulation and resilience, reducing the intensity of symptoms over time.
At Menda, we use therapies that help retrain the brain and calm the nervous system. Approaches such as Pain Reprocessing Therapy, Cognitive Behavioral Therapy, and Acceptance and Commitment Therapy can help reduce the brain’s fatigue signals and restore balance. By teaching the nervous system new, safer patterns, people can gradually rebuild their energy, resilience, and quality of life.
You don’t have to keep living with these symptoms. Explore Menda’s evidence-based therapies designed to rewire the brain and restore balance.
Key Neuroplasticity-Informed Strategies
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Breath regulation: Slow, diaphragmatic breathing to calm the autonomic nervous system.
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Graded exposure: Gradual reintroduction of upright activity and movement to build tolerance.
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Nervous system calming techniques: Meditation, mindfulness, and grounding practices.
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Reframing symptoms: Reducing fear-based responses to physical sensations to prevent stress amplification.
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Consistency & pacing: Structured routines that prevent overexertion and promote stability.
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Body–brain retraining tools: Guided programs, somatic exercises, and cognitive-behavioral approaches focused on autonomic regulation.
Why Neuroplasticity Works
When the brain perceives standing or certain physical states as a “threat,” it activates a stress response, worsening autonomic dysfunction. Neuroplasticity techniques help “teach” the brain and body new, safe patterns of response. Over time, this can reduce symptom severity, restore balance, and improve quality of life by rewiring maladaptive pathways in the nervous system.
When to Seek Care
Seek medical evaluation if you experience:
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Frequent fainting or near-fainting spells
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Severe, unexplained rapid heart rate with standing
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Chest pain, shortness of breath, or severe fatigue
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Inability to perform daily activities due to symptoms
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Neurological or autoimmune symptoms alongside POTS
A healthcare provider (often a cardiologist, neurologist, or autonomic specialist) can confirm diagnosis, rule out other conditions, and provide treatment tailored to your needs.
