Stop P.O.T.S. (Postural Orthostatic Tachycardia Syndrome)

Share on facebook
Share on google
Share on twitter
Share on linkedin

Stop P.O.T.S. using The Nemechek Protocol Postural Orthostatic Tachycardia Syndrome, called “POTS”, is a relatively new and growing diagnostic label.

 

Individuals with POTS experience a very rapid increase in their heart rate when they stand up which is often accompanied by orthostatic symptoms of heart palpitations, altered balance, lightheadedness or dizziness, and syncope (passing out).

They may also suffer from non-orthostatic symptoms such as fatigue, headaches, neck tightness, impaired concentration or memory, gastrointestinal symptoms, impaired sleep quality, and anxiousness.

The rapid increase in the heart rate after standing is the unique characteristic of this condition and it predominantly occurs in young women of reproductive age, but it can also occur in young males.

 

People are not born with POTS, it often develops following an injury to the brain or to the autonomic nervous system.

The rapid heart rate symptoms typically come on quickly when the person stands up or is standing still. The injury may be a result of physical or emotional traumas, viral infections, the stress of surgery, vaccination, pregnancy, or autoimmune disorders.

The current diagnostic criteria for POTS is a heart rate increase of 30 beats per minute (bpm) or more, or over 120 bpm, within the first 10 minutes of standing, without a significant drop in measured blood pressure. Standing for 10 minutes is a very simple test for POTS but many patients are diagnosed by a cardiologist using a tilt-table test.

While POTS is diagnostically determined by an abnormal heart rate, it is also fairly common for POTS patents to have a noticeable drop in blood pressure upon standing.

But some POTS patients have no change in their blood pressure, or they may even experience an increase in their blood pressure, when they stand up. Those conflicting blood pressure readings can be confusing for people who do not understand the mechanics of what is malfunctioning with their body.

One important point to know is that POTS is not a discrete diagnosis, it is considered a “syndrome”. The medical use of the word “syndrome” implies a lack of a well-defined understanding of the disorder at hand.

In other words, there are probably a variety of issues causing the disorder. What has become clearer is that POTS is one form of autonomic nervous system dysfunction.

A second important point is that similar to all new syndromes, health professionals may tend to initially focus more on labels and sub-diagnosis than in finding practical answers in order to help the patients feel better. Fortunately for patients suffering from POTS, improvement or recovery from their underlying autonomic damage is now possible.

 

In order to understand how I begin to STOP POTS (a palindrome, as POTS spelled backwards is STOP), I will go back to the beginning to teach you about the nervous system problem and the autonomic answers.

The mechanical problems involved with POTS involve the dysfunction of the autonomic nervous system, which is the brain’s master control mechanism over the body. The autonomic nervous system is involved with the coordination and regulation of all organ function, blood pressure control, metabolism, hormone regulation, and inflammation.

Autonomic dysfunction is something that occurs when the nerves that carry the information from the brain and spinal cord to the heart, bladder, intestines, sweat glands, blood vessels, hormonal organs, and the immune system no longer work properly. Damage or disruption to autonomic function causes those bodily things to not function correctly and leads to a wide range of symptoms.

The autonomic nervous system controls our heart and adapts our blood pressure and pulse rate to changes in our posture and physical stress. Erratic heart rhythms, excessively high or low heart rates, and abnormal blood pressure readings are connected to autonomic nervous system dysfunction.

The autonomic nervous system has two main branches. We know them by the type of brain commands they carry such as the sympathetic (“fight or flight”) and the parasympathetic (“rest and digest”) branches. Both the sympathetic and parasympathetic branches feed into the heart and modulate the heart’s natural rhythm and contractility.

Our normal resting heart beat should be 60 to 70 beats per minute, and it is the parasympathetic branch that manages that rate. The parasympathetic branch makes the heartbeat go fast or slower, while the sympathetic branch is more involved with the strength of the heart’s contractions.

 

Five stages in autonomic dysfunction:

There are five stages in autonomic dysfunction and autonomic testing can reveal the subtle and progressive autonomic dysfunction as the brain becomes increasingly unable to modulate the heart. Parasympathetic dysfunction results in an increase of cardiac arrhythmias, and POTS is also related to weakening of the sympathetic branch in particular.

As parasympathetic function weakens the EKG portion of autonomic testing indicates whether the person has moved into atrial fibrillation (A-fib), atrial flutter, has low heart rate variability, or has progressed to a point where they are now at risk of sudden cardiac death (Cardiac Autonomic Neuropathy or CAN).

The unique feature of POTS, the rapid heart rate, is from the combined effects of poor regulation of the heart rate response to the inadequate generation of blood pressure and oxygen delivery upwards into the brain when the person is in the upright position.

The person suffering from the rapid heart rate symptom is having difficulty adapting their blood pressure and their pulse against the stress of gravity. The problem with the change in their posture is the letter “P” in POTS.

In other words, when someone stands up their body should compensate for gravity by delivering a perfectly timed increase of blood pressure and blood oxygen upward to their brain. When their autonomic nervous system branches work correctly, blood pressure and oxygen delivery occur normally, and there are no symptoms.

But when the autonomic nervous system is damaged and the sympathetic and parasympathetic branches no longer function correctly, the person may feel the rapid heart rates of POTS and experience swings in blood pressure.

The letter “O” (orthostatic) in POTS stands for their orthostatic intolerance, which is the development of symptoms when they move to an upright position or after sitting or standing up for an amount of time.

The other feature of POTS, the elevated heart rate, is a tachycardia response to the drop in the blood pressure upward to the brain. Tachycardia is the letter “T” in POTS. It is a hydraulic malfunction with one’s cerebral blood pressure regulation which makes their pulse go up very high.

In less severe cases of autonomic dysfunction (stages 1 -3) the person may just feel a head rush, get a little dizzy or lightheaded, or feel anxious when they stand upright or change their posture.

The functional damage to the autonomic nervous system that triggers POTS symptoms may be triggered by physical trauma to the brain (falls, concussions, bumps to the head), from emotional traumas that deeply impact the individual (death of a loved one, intense fear, bullying), or from prolonged inflammatory reactions that may result after a vaccination, surgery, or even from allergy testing or shots.

I have discovered a multifaceted formula for autonomic nervous system restoration that is so groundbreaking that I filed a patent application for The Nemechek Protocol® for Autonomic Recovery (Patent Pending). The steps in my treatment program that can help STOP POTS begins by encouraging someone’s own stem cells and repair mechanisms to once again function.

This is not accomplished by injecting stem cells into someone because high levels of metabolic (chemical) inflammation is what prevented that person from making their own stem cells and from healing their initial injury to begin with.

Instead, it is done by suppressing the chronic inflammatory state within the body and brain which allows someone’s own stem cells to turn back on and perform their job of repairing cell damage.

 

The key to restoring our natural inflammation control mechanisms is through a global reduction of inflammation throughout the brain and body by using every scientific, nutritional, and bioelectric tool available.

It is the natural process of re-activating natural stem cell production that allows a person to begin healing their underlying autonomic nervous system injury. This is possible to do without long term medications in most individuals by down-regulating metabolic (chemical) inflammation through short term medications, a limited number of omega-3 nutrients for the brain, the elimination of omega-6 vegetable oils from the diet, by controlling bacterial overgrowths in the intestinal tract, and in some people by using bioelectric Vagus nerve stimulation.

Something as simple as a core shift in the diet to more omega-3 fatty acids (most easily accessible in fish oil) and the elimination of omega-6 fatty acids (vegetable oils) helps to create a healthier inflammatory environment in the body that restores the production of stem cells.

It has been my experience that a consistent change in these dietary chemicals in someone’s daily food is absolutely mandatory for achieving or maintaining autonomic nervous system health.

I have also seen the powerful effects of bioelectric medicine to the main nerve of the autonomic nervous system, which is the Vagus (or “vagal”) nerve. The Vagus nerve carries information from the organs to the brain, and it is instrumental in the regulation of inflammation in the autonomic nervous system.

While we typically think if we stimulate something we are turning something “on”, when it comes to the autonomic Vagus nerve this stimulation actually helps turns inflammation “off”.

The stimulation of the Vagus nerve is one additional tool to calm down the inflammation that is preventing the brain and nervous system from healing the underlying injury (concussion, trauma, inflammatory trauma) that is responsible for the symptoms of POTS.

When inflammation is lowered and cells naturally function again, the body is finally allowed to heal. When the autonomic nervous system improves or repairs and the two branches work together again in balance, the symptoms with the change in posture (the “P”) are relieved because the body can once again generate enough blood pressure and oxygen upward to the brain.

This improved blood pressure and oxygen delivery to the brain further resolves the orthostatic intolerance (the “O”) and the abnormal tachycardia response from the heart (the “T”). When the symptoms are gone, the syndrome is gone.

There are two other types of autonomic disorders with low brain oxygen features that a POTS patient may or may not experience. One is Vasovagal Syncope (VVS), another autonomic disorder causing low oxygen delivery to the brain but the main symptom of VVS is passing out when startled or stimulated (needle puncture from blood draw, sight of blood, a negative visual experience).

The other autonomic disorder causing low brain oxygen levels is neurogenic orthostatic hypotension. In the case of orthostatic hypotension, individuals have very low blood pressure readings at the arm and are frequently feeling faint or lightheaded.

There is no magic pill or quick fix when it comes to repairing the autonomic nervous system and individual results will always vary. The reversal of autonomic nervous system damage requires a sustained reduction in metabolic (chemical) inflammation in the patient for years.

 

Maintaining one’s recovery and healing from new autonomic injuries will require maintaining a lower, healthier inflammatory state in the body throughout their lifetime.

If you or a family member have been diagnosed with POTS or any of these other conditions causing low brain oxygen, the encouraging news is that these things are now reversible in some people. The key to recovery is to work to resolve the underlying sympathetic and parasympathetic dysfunction and to not just mask the symptoms.

At first glance POTS seems like just a cardiac issue but it actually involves the brain, the nervous system, the intestinal tract, the production of stem cells, inflammation, and the chemicals in someone’s diet.

Therefore, the reduction of brain inflammation, the reversal of intestinal bacterial overgrowth, and the electrical stimulation of the autonomic nervous system help reverses the underlying dysfunction and eliminates symptoms.

 

I am an internal medicine physician (D.O.) from UCLA and my Internal Medicine and Autonomic practice, Nemechek Autonomic Medicine, is in the greater Phoenix, Arizona area. My discovery is that autonomic nervous system improvement or repair is possible without using long term medications that only serve to stabilize symptoms.

Even when autonomic testing has identified the weakest pattern of stage 5 autonomic dysfunction (Cardiac Autonomic Neuropathy), I have facilitated improvement or recovery of this pattern in some of my patients. I have seen the recovery of CAN even in elderly patients, so the ability of the brain and body to repair throughout our lives and well into advanced age is amazing.

My wife and I recently published “The Nemechek Protocol® for Autism and Developmental Delay” further explaining my discovery and my work with brain inflammation, bacterial overgrowth, and autonomic dysfunction in children with autism and other developmental disorders such as SPD, ADD and ADHD. The Nemechek Protocol® for Autism and Developmental Delay is available at AutonomicRecovery.shop.

For additional information, you may call my office 623-208-4226.

This post is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship.

© 2017. Nemechek Consultative Medicine, Inc. All Rights Reserved.

2.3 3 votes
Article Rating
Dr. Patrick Nemechek and Jean Nemechek

Dr. Patrick Nemechek and Jean Nemechek

Subscribe
Notify of
102 Comments
Newest
Oldest
Inline Feedbacks
View all comments
Chrissy R
Chrissy R
March 28, 2019 2:21 pm

Is the protocol book for Autism the same one you would use for a adolescent patient with POTS?

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
March 28, 2019 9:25 pm
Reply to  Chrissy R

Yes

Josie
Josie
February 4, 2019 7:09 pm

Hi Dr Nemechek,
I have severe POTS and am bedridden . I’m saving up to have a skype consult with you from the UK, but wondered while I’m waiting if there’s anything I can get started with to help me get out of bed and more upright? Perhaps if I start omega 3 fish oils and eliminate all omega 6 oils? If so how much fish oil should I take? Thank you so so so much, Josie

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
February 4, 2019 8:33 pm
Reply to  Josie

The protocol I developed for adults was later adapted for autism.

Reading our autism protocol book will outline the science and gives you the doses I recommend for adults. The dosing for aults with and without autism are the same.

You can purchase a copy at https://autonomicrecovery.shop

Donna
Donna
December 26, 2018 9:11 pm

Hello Dr. Nemecheck,
My 14 year old daughter has just been diagnosed with Mast Cell Activation Syndrome and Vasovagal Syncope. I have MCAS as well. We live on the East Coast and both are unable to travel due to reactions. I started her on the oils, but she has a histamine reaction to the fish oil and the EVOO. Is there a way to have a digital visit with you without traveling across country?

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
December 27, 2018 3:51 pm
Reply to  Donna

I am sorry, we no longer provide Skype or phone sessions for U.S. residents.

I would like to add that the histamine reactions you are seeing are secondary to SIBO and not due to fish oil or olive oil per say.

Paula Barrows
Paula Barrows
October 22, 2018 12:49 pm

Hello Dr Nemechek My seven year old granddaughter has been recently diagnosed with POTS using the tilt table test at the Great Ormond Street Hospital in London. She was diagnosed with Ehlers Danlos a number of years ago and has high functioning autsm. The cardiologist has prescribed a beta blocker, salt and fluids. She has not started the beta blocker yet, but we have been told that this drug will only take the edge off of the symptoms. She has a severe case of POTS and we have been warned that she could end up in a wheelchair. Since birth,… Read more »

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
November 2, 2018 2:54 am
Reply to  Paula Barrows

Yes we can help.

She is crawling around the house because standing causes too much unpleasant lightheadedness when fully upright.

The propranolol might make this worse.

Start my protocol and set up a Skype visit.

Katia
Katia
October 19, 2018 9:10 am

I was tested positive for SIBO (methane dominant) 2 years ago and was treated with Rifaximin and Neomycin (they often substitute if with Flagyl). It is believed in Australia that only the combo of both can treat it properly. Now I am facing full-on POTS syndrome and going to follow your protocol. Would you say Rifaximin still works for methane SIBO? Thank you for your time and all the work you are doing.

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
October 30, 2018 2:29 pm
Reply to  Katia

The test is extremely inaccurate and I don’t use it.

Anonymous
Anonymous
October 4, 2018 12:40 pm

What’s your opinion on the drug Fludrocortisone for someone with POTS suffering dizzy spells, fatigue, palpitations etc?

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
October 5, 2018 2:14 pm
Reply to  Anonymous

It’s helpful sometimes. Increases intravascular volume and can reduce some of the orthostasis.

Will
Will
September 28, 2018 11:01 am

Hello,

Have you ever had any of your patients with POTS have stem cell treatment? What’s your thoughts on this, are there any proven benefits?

Thanks

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
September 28, 2018 2:40 pm
Reply to  Will

I do not recommend stem cell therapy because in their present form they are ineffective, costly and potentially dangerous. There is a growing chronic inflammatory condition believed to be affecting most everyone worldwide. It is often referred to as inflamm-aging or chronic metabolic inflammation, and is manifest as the chronic and highly abnormal secretion of pro-inflammatory cytokines. Humans make stem cells throughout their lives and some research suggest the rate of production even increases as we age. Unfortunately the inflammatory cytokines released from inflamm-aging prevents our natural stems cells from working. They also prevent infused stem cells from working. In… Read more »

Katie Dunlap
Katie Dunlap
September 21, 2018 5:52 pm

If POTS started from a bad case of mono and I’m still testing positive years later for chronic reactivated EBV is that something you would address specifically or does following the protocol allow your body to take care of the virus itself once it’s restored function?

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
September 22, 2018 6:44 pm
Reply to  Katie Dunlap

Chronic re-activated EBV is really a misunderstanding of the EBV tiers. Any source of inflammation can falsely make make some antibody titers look like re-activation (+ IgM).

If you were under my care, I would ignore the testing and just reverse the autonomic dysfunction.

Katie Dunlap
Katie Dunlap
September 22, 2018 10:18 pm
Reply to  Katie Dunlap

Thanks so much for responding! That makes sense! I’m flying out to see you in December!

Laurelle
Laurelle
July 31, 2018 8:18 pm

Find your work very interesting. My daughter has Genetic type 1 von willie brand, and they suggest no fish oil. What are your thoughts on this. She suffers with low blood pressure normally and what I would say is vasovagel syncope a few times a year. noticed syncope when it occurs is after urination. Have you heard of Emrys Goldsworthy in Australia re vagus nerve stimulation and red light therapy

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
August 1, 2018 1:54 am
Reply to  Laurelle

You’ll have to discuss this with your specialists. My question to them would be do they tell their patients not to consume fish as well as fish oil? Are there reported causes of more bleeding from those with high fish intakes (eskimo’s for instance)

Blake
Blake
July 21, 2018 10:26 pm

Hello D.O. I am very interested in starting your protocol. I am in the US Army, and I believe my issues may stem from injuries and inflammation and a horrible diet. I am getting out soon, and my desire is to become a Fire Fighter however I don’t want to cut my life short because of going into such a stressful job again without treating my medical issues. The symptoms have only appeared in the last few months and its caused me so much grief until I found your website. My question is how long is the protocol? Is it… Read more »

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
July 22, 2018 2:28 pm
Reply to  Blake

The principles are life-long but hopefully some things will improve (less omega-6 in food and a method to permanently control microglia) with time

Kimberly Proctor
Kimberly Proctor
July 19, 2018 4:26 pm

Hello Dr. Namechek, I think P.O.T.S. is something I’ve been suffering from most of my life. I had fainting spells upon standing as a teenager and young adult. I am one who gets anxiety sitting at a stoplight like you mentioned in your video, and my doctor just smiles when I tell him this. Now that I’m probably perimenopausal and had a spinal leak/headache from an epidural nerve block in my back, I’ve been sick for over a month with rise in temperature and blood pressure. They thought it could be meningitis, so I had a spinal tap where they… Read more »

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
July 19, 2018 8:01 pm

Sorry, I am not aware of anyone in the region using my protocol.

Anonymous
Anonymous
June 25, 2018 3:50 pm

Hello Dr.Nemechek!
Thanks for taking your time. I am a longterm CFS/ME and POTS patient aged 29 and am still in search for improvement within my illness. Is there already a book for Chronic fatigue/POTS patients you are offering as I have not found any in your shop? (I have only discovered the ones for autism).

Thanks in advance,
K.Neis

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
June 25, 2018 4:48 pm
Reply to  Anonymous

Sorry, because of the overwhelming response to the effectiveness of our protocol in children, we are running behind on getting the adult book out.

The kids book will give you plenty of insight on how your condition and how I would approach it.

Gypsy Garner
Gypsy Garner
June 20, 2018 6:40 pm

I understand.. Thank you!!

Gypsy Garner
Gypsy Garner
June 19, 2018 10:14 pm

Ok thank you! I’m wanting to make sure I could get treated by you. But confused, if I can’t take EVOO because of LES muscle how can I take your protocol? I don’t have any signs of SIBO? I’m sorry I live in Ohio so it’s a big decision to make. Are you saying if my POTS is reversed it will fix everything else? Thank you for your time! I really do appreciate it.

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
June 20, 2018 1:36 am
Reply to  Gypsy Garner

All I can say is that there is a manner to move you forward through this.

I understand the concerns about travel, very legitimate.

Once you fix the gut bacteria, much of the food intolerance improves.

Gypsy Garner
Gypsy Garner
June 19, 2018 4:36 pm

I also know medications can cause weakened LES muscle. I do take Immitrex for migraines and have been on amitriptyline for three years and stopped last year. So I don’t know if this is what I have but can this be reversed?

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
June 19, 2018 9:11 pm
Reply to  Gypsy Garner

If you have POTS, then it can almost always be reversed.

Gypsy Garner
Gypsy Garner
June 19, 2018 1:33 pm

I started just taking the Olive oil you recommend without the fish oil or inulin for POTS. I thought it was helping my migraines but I started getting a feeling of something stuck in my throat but it’s not. Like I’m having some silent reflux because I do experience alot of belching as well but no heartburn. I read that olive oil can cause your LES muscle to weaken which could cause this. Is this true? I went from having migraines to fibromyalgia than POTS and now this type of reflux. Just seems like everything is going down hill. I… Read more »

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
June 19, 2018 2:33 pm
Reply to  Gypsy Garner

EVOO and fish oil can sometimes cause silent reflux especially if SIBO is still present (i.e., no prior treatment with rifaximin).

Lanise
Lanise
June 10, 2018 6:17 am

Can you please explain the role of Low Acetylcholine in autonomic function/dysfunction? Is mestion the miracle some would like to believe?

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
June 10, 2018 1:55 pm
Reply to  Lanise

I don’t find mestinon useful in autonomic recovery. It can alter some symptoms but it does not help in true restoration of autonomic function.

Many times patients who try it are intolerant to it.

Lanise
Lanise
June 4, 2018 9:33 pm

Dr. Nemechek,I think I just answered my own question by reading this paper……..http://www.jvr-web.org/images/ICVD-PPPD-Dx-Crit-18Oct16(003).pdf. If I understood correctly it is the autonomic that triggers PPPD.

Patrick Nemechek, D.O.
Admin
Patrick Nemechek, D.O.
June 4, 2018 11:25 pm
Reply to  Lanise

Yes, you are correct

Lanise
Lanise
June 4, 2018 8:57 pm

I think I can speak for the entire community in saying Thank You for your time and attention to this blog. It speaks volumes about your concern for people.

Lanise
Lanise
June 4, 2018 8:55 pm

How do you differentiate between n autonomic disorder and Persistent postural-perceptual dizziness? The symptoms seem similar.

Recent Articles

Follow Us

Subscribe to Dr. Nemechek's YouTube Channel

Is Autonomic Dysfunction Affecting Your Health?

Take the Autonomic Health Quiz

102
0
Would love your thoughts, please comment.x
()
x
Send this to a friend