Watching someone you love stand up and brace for dizziness, a racing heart, or a fainting spell is unsettling every single time, even when it happens daily. Symptoms tend to flare with a change in temperature, a shift in position, or a stressful stretch when the nervous system most needs to feel steady instead of overloaded.
If your family has been living with POTS, you have probably been told that doctors are not entirely sure what causes it, and that the main tools available are moving slowly between positions, drinking more fluids, and adding salt to the diet. Those steps can help at the margins, but they rarely touch what is actually driving the condition underneath.
What POTS Actually Is
Postural Orthostatic Tachycardia Syndrome, or POTS, is a condition of the autonomic nervous system marked by an abnormal jump in heart rate on standing, typically a rise of at least 30 beats per minute within ten minutes of getting up, without the blood pressure drop seen in other fainting conditions. But POTS is a lot more than a fast pulse. People living with it often deal with lightheadedness, fatigue, brain fog, headaches, heart palpitations, shakiness, shortness of breath, chest discomfort, nausea or digestive trouble, blurred or tunnel vision, and disrupted sleep.
For some people these symptoms stay mild. For others they are disabling enough to make basic daily tasks, bathing, cooking, even standing at the sink, genuinely difficult. POTS affects an estimated one to three million Americans, most of them women, and research has also connected new cases to prior COVID-19 infection in people with no previous history of the condition. The toll goes beyond the physical too. Many people with POTS describe real anxiety, low mood, and a sense that their world has gotten smaller because of what their body can no longer reliably do.
The Autonomic Nervous System Behind It
To understand POTS, it helps to understand the autonomic nervous system, the part of the body running every function you do not consciously think about: heart rate, blood pressure, digestion, temperature regulation. It works through two branches. The sympathetic branch is the gas pedal, activating during stress or a perceived threat, speeding the heart and directing blood toward the muscles. The parasympathetic branch is the brake, helping the body conserve energy, digest, and recover.
In a well-regulated nervous system, these two branches hand off smoothly. Standing up triggers a quick adjustment in blood flow and heart rate so the brain keeps getting what it needs, without dizziness or fainting. In POTS, that handoff breaks down. The vagus nerve, the long nerve that runs from the brainstem down through the chest and abdomen and plays a central role in heart rate, digestion, and inflammation, often is not signaling the way it should. When the vagus nerve underperforms, it cannot properly counterbalance the sympathetic gas pedal, leaving the body stuck in a state of chronic overactivation, an imbalance often described as dysautonomia.
Where This Imbalance Tends to Build
Dysautonomia rarely comes from one single event. It tends to build from a combination of stressors layered over time. Physical strain during birth, from a long labor, forceps, vacuum extraction, or a C-section, can create lasting tension around the base of the skull and upper neck, right where the vagus nerve begins, affecting how well it regulates the body from early on. Illness and infections, including mononucleosis, Lyme disease, and COVID-19, can inflame and disrupt vagus nerve function directly. Chronic mental and emotional stress, especially when it starts young, can keep the sympathetic system engaged for so long that the parasympathetic side has trouble catching up. Even everyday posture matters here: the sustained forward head position that comes with hours of looking down at a phone or screen places real, ongoing strain on the same nerves and blood vessels running through the neck, which is one reason posture and spinal function belong in a POTS care plan alongside fluid and salt intake, not instead of them.
Supporting the Nervous System Behind POTS
Rather than focusing only on managing symptoms as they appear, our approach centers on understanding how well your nervous system is regulating itself in the first place. We use INSiGHT neurological scanning to get an objective look at autonomic function and pinpoint where tension or dysfunction may be interfering with that regulation. Tracking these measurements over time lets us tailor care to what your body is actually showing us rather than guessing.
Using Koren Specific Technique and Talsky Tonal Chiropractic, our doctors work with light, nervous system focused adjustments aimed at easing tension around the upper neck and spine where vagus nerve signaling can be disrupted. This work supports your nervous system's own capacity to regulate, alongside the medical care your physician is already providing.
What Tends to Help Day to Day
Lifestyle habits genuinely matter for POTS, and they work best paired with nervous system care rather than used alone.
- Steady fluid and electrolyte intake throughout the day, not just when symptoms flare
- Regular movement built around postural stability and gradual conditioning, at a pace your body tolerates
- Consistent sleep habits, since a tired nervous system has less capacity to regulate
- A diet built around real food, adequate protein, and healthy fats
- Mindful posture during long stretches of screen or phone use, with regular breaks to unload the neck
Where to Go From Here
Living with POTS can feel unpredictable in a way that is exhausting to explain to people who have not experienced it. Understanding the nervous system underneath it opens up more to work with than salt tablets and slow transitions alone. You can learn more about how we support POTS and dysautonomia, or download our free guide on the autonomic nervous system for a closer look at what is happening underneath. When you are ready, book online with our doctors in Royal Oak, or call us at (248) 616-0900.
