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

Stop P.O.T.S. (Postural Orthostatic Tachycardia Syndrome)
November 6, 2017 Dr. Patrick Nemechek and Jean Nemechek

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.

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Chrissy R
Chrissy R

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

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Yes

Josie
Josie

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.
Patrick Nemechek, D.O.

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

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.
Patrick Nemechek, D.O.

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

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.
Patrick Nemechek, D.O.

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

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.
Patrick Nemechek, D.O.

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

Anonymous
Anonymous

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

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

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

Will
Will

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.
Patrick Nemechek, D.O.

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

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.
Patrick Nemechek, D.O.

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

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

Laurelle
Laurelle

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.
Patrick Nemechek, D.O.

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

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.
Patrick Nemechek, D.O.

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

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.
Patrick Nemechek, D.O.

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

Anonymous
Anonymous

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.
Patrick Nemechek, D.O.

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

I understand.. Thank you!!

Gypsy Garner
Gypsy Garner

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.
Patrick Nemechek, D.O.

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

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.
Patrick Nemechek, D.O.

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

Gypsy Garner
Gypsy Garner

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.
Patrick Nemechek, D.O.

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

Lanise
Lanise

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.
Patrick Nemechek, D.O.

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

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.
Patrick Nemechek, D.O.

Yes, you are correct

Lanise
Lanise

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

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

Lanise
Lanise

Once you begin the Nemechek Protocol will things get worse before they get better? If you stop the protocol will symptoms return?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Generally not. In children with autism they can undergo what we refer to as the awakening which sometimes temporarily worsens symptoms but adults do not experience this.

Yes, symptoms will return if you stop the protocol.

Lanise
Lanise

What is the relationship between eating and dysautomic failure? I know if I don’t eat a bad day becomes a worse day.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Autonomic dysfunction makes it difficult to get the proper delivery of blood and oxygen into the brain when you are upright. Foods with salt and carbs as well as fluids help boost pressure into the brain.

Lanise
Lanise

Every doctor treating Dysautonomic disorders prescribes : Increase fluid, increase salt, compression garment, and exercise. Will these things treating the dysfunction or just masking symptoms?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

These recommendations will temporarily increase delivery of blood and oxygen to the brain, thereby reducing the symptoms. They do not help the nervous system to recover.

My protocol actually helps restore autonomic function. We presented the success of our protocol at the Brain Stimulation conference in Scotland last June in Edinburgh and are presently working on a peer-reviewed paper for publication this year.

gypsy garner
gypsy garner

Thank you for your response. That’s very interesting. I’m also on bioidentical progesterone cream which I feel has been making my POTS symptoms worse. I have stopped it only for 4 days now and I don’t know if I should of because of my estrogen dominance but I dont know what to do. Have you heard of this correlation?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

No I haven’t.

gypsy garner
gypsy garner

I have recently been diagnosed with POTS. I just came across your website. I’m curious what your opinion is on Lyme disease and POTS? I don’t know if I have Lyme but do have some of the symptoms. If I were to go to your office do you check for things like this or underlying infections as well? I’ve read about secondary POTS and all the things listed and Lyme being one of them. In live in Ohio and looking for someone who can check all things related to POTS.

Thank you!

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

While acute Lyme Disease is not that uncommon especially in endemic areas, I believe chronic Lyme’s disease if frequently misdiagnosed.

The primary problem with persons misdiagnosed with chronic Lyme disease is a chronic neuroinflammatory disorder that leads to fatigue, dizziness, poor cognition, depression, and generalized anxiety. MAny of these symptoms are due to chronic autonomic dysfunction.

I am able to reduce the underlying neuroinflammation and induce recovery with the assistance of vagus nerve stimulation.

Anonymous
Anonymous

Is there a physician in Brisbane Australia that understands and can assist with my recovery?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Sorry, not that I’m aware of.

Lanise Sanders
Lanise Sanders

Is exercise beneficial to those with autonomic disorders?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Exercise is beneficial to everyone but is not potent enough to reverse underlying autonomic dysfunction

Lanise
Lanise

Any wise words for someone suffering from an autonomic disorder who is facing surgery?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Fish oil, olive oil and inulin.

Lanise
Lanise

Good answer. I started the fish oil (up to 3 capsules daily) and my INR went to 4 (2-3 desired). My hematologist physician assistant thinks it was the fish oil. I have since backed down to 1 capsules. We know many things can impact INR. I will watch it.

Lanise
Lanise

What do you do with patients who take blood thinners and high dose fish oil is contraindicated?

Lanise
Lanise

Can exposure to toxins (mold, exhaust, bad air,etc) trigger an autonomic dysfunction?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I believe common exposure to mold, chemical odors, etc. do not damage the nervous system per say but stress the nervous system enough to reveal pre-existent neurological damage.

Lanise
Lanise

What is the difference between the vagus nerve stimulation you perform and the vagal vagus stimulation people get when they bear down?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Bearing down, cold plunges, etc triggers a response from a healthy vagus nerve. They are ineffective if the parasympathetic signaling through the vagus nerve is damaged.

A bioelectrical VNS will mimic parasympathetic signals and transmit them through the vagus nerve. Very effective when the parasympathetics are damaged

Lanise
Lanise

My symptoms seem to be cyclical. Upon awakening I am usually at my best. As the day progresses symptoms worsen. Late at night the symptoms (lightheaded, dizziness etc.). Like right now…..it is 2am and I feel great. I have read on blogs that other people have a cyclical experience. Do you know of any rhyme, reason or rational?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

It a factor of how your autonomics break.

Lanise
Lanise

Whereas I cannot afford to come to Pheonix in the very near future are there any physicians in the Chicagoland area that are working with your protocol. I currently see Alexandru Barboi (he is not familiar with your protocol. Until such time that I can come to you will it be helpful to begin taking Olive Oil, Omega and Inulin now?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Yes it will. Be sure to use the proper doses and brands I recommend in the protocol guide.

Julie Gerhardt
Julie Gerhardt

My son has been sick for almost 6 years. Diagnosed with Lyme, Rocky Mtn Spotted Fever, POTS, CIRS, mold toxicity, MTHFR and chronic fatigue. Have you helped patients like him? He has seen 30+ doctors. We started the protocol about a month ago and haven’t been any improvements. He is almost 16 but adult size. Perhaps he needs riflaxin. He has been on MANY antibiotics and supplements. You name it, we have tried it. Considering coming to see you but want to make sure you have successfully treated people with his issues. As you can imagine, this long road has… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

We have successfully treated many children and adults with these diagnoses.

Read through our protocol for autism, it is the same protocol I’ve used previously in children with similar diagnoses.

It’ll also explain why rifaximin is very helpful for older kids. I also have aYouTube video on this topic.

Scott Daniska
Scott Daniska

Is anyone doing any research in the mechanism for POTS or how to distinguish between different subtypes?

And POTS isn’t automatically a nervous system issue it could be vascular or even anatomical if you have too much blood pooling in a certain part of your body in theory though right?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

In the vast majority of patients it’s an autonomic issue.

The blood pooling is due to dilated bloods because of poor autonomic control.

Romina
Romina

Dear D.O Nemchek, Thanks so much for the reply, but again bothering with the VNS, we are considering an appointment with you via skype, I would like to know first if its necessary that she takes or does some analysis beforehand so she would have some things to prove her condition, and if afterwards are you able to prescribe her the settings for the VNS ( I consider we would buy on like the one you promote on this website), but I just want to be sure if this is how it could work, or if it may be compulsory… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

My office staff can answer all your questions.

Lanise Sanders
Lanise Sanders

Brain fog ……….I am receiving acupuncture and she does stimulate vagus through the ear. Is that helpful or similar to the stimulation you refer to?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Similar if the points used and the current is correct.

Lanise Sanders
Lanise Sanders

I am suffering daily with autonomic dysfunction/Orthostatic Intolorence which has worsened after colon resection in November 2017. I am very interested in your protocol. I have read where some people take Inulin and others take Rifaximin. What is the difference? Are they interchangable? Are there side effects?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I’ve posted some youtube videos on this topic.

Romina
Romina

Hello, I would like to know regarding the VNS, if it is possible for any POTS specialist to prescribe it to a patient, or is it maybe needed to get an appointment for you to prescribe the right settings. I honestly do not know how to do so. I actually came around your website by doing some research about the vagal nerve stimulation, after reading an article on Nature, which speaks about the shock tactics, in which they mention SetPoint Medical wants to implement an implantable stimulator that would deliver shocks to the vagus nerve, to help with all symptoms… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Very few physicians are considering VNS for anything but depression and epilepsy.

I’m sorry but I do not know of anyone in France you can go to obtain a VNS.

Elizabeth Woods
Elizabeth Woods

Hi there, I have an appointment booked for April, I can’t wait! I just have one question… I want to start the protocol, but I am taking raniditine for acid reflux. I’ve only been taking it 3 weeks, and two days ago I went down to once a day 75mg. I’m not sure if raniditine could interfere with the protocol, but I need to try it out. What do you think? My esophagus muscles don’t want to push food down to my stomach anymore and every single day along with multiple other extremely scary symptoms are getting worse.. now on… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Ranitidine does not interfere with the protocol.

Anonymous
Anonymous

Do you have an opinion on the GAPS diet? Your protocol helps kids with Autism, and your similar protocol helps teens/adults with Autonomic Dysfunction. Do you think the GAPS diet would be safe to try in conjunction with the Nemechek Protocol when trying to repair the gut issues (specifically Autonomic Dysfunction/inflammation in this case)?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The gut is repairs within 2-3 weeks after starting inulin or using rifaximin.

GAPS doesn’t really repair the gut, it just reduces the bacterial load within the small intestine by reducing a main food source, carbohydrate.

Edward Morea
Edward Morea

Excellent write up on POTS and autonomic dysfunction with the reasons, symptoms, all beautiful explained in easy to understand language.

Stacey Stauffer
Stacey Stauffer

Haven’t got to that yet thanks so much!

Stacey Stauffer
Stacey Stauffer

Thank you Dr. Nemechek, for all your hard word and time. You are truly a miracle! I find your research incredibly fascinating. My daughter has been struggling with POTS and Aspergers. I am reading your book, and “A Simplified Guide to Autotomic Dysfunction, your website and blog. Thank you for all your incredible information. We have already started your protocol. I am unclear as to how much dosage of inulin, omega 3 and Cal. olive oil she is to consume each day. I am going to schedule a phone call appt. with you as soon as I finish your amazing… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The dosing I used for my patients is listed in the book.

Anonymous
Anonymous

Hello Dr. Nemechek,

In your opinion, is it possible for POTS (autonomic dysfunction) and lack of cerebral blood flow to cause issues with ability to control eye muscles and/or optic neuritis? What about other types of sensory nerve damage?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

All of these including the POTS can be cause by inflammation

christi a fieselman
christi a fieselman

My 17 year old daughter has been diagnosed with pots, and one of her biggest issues is emotional, she has rages meltdowns , headaches brain fog all over pain etc.. serious gastric issues as well.. I have taken her to so many doctors, nobody has been able to help.. I fear for her sanity and her life, she has talked about suicide and been bed ridden at times for days, she is unable to attend school without stimulants. I am in desperate need of help for her.

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

We can help these issues. You should call 623-208-4226 and discuss the possibility of seeing us for a consult.

Lurenda Richter
Lurenda Richter

Can you be diagnosed with POTS at any age?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Yes

Anonymous
Anonymous

Why do they call this a “young persons syndrome”?

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Most commonly but not exclusively diagnosed in younger adolescents, female in particular.

Happens quit frequently in adults of all ages.

Sara Moroza-James
Sara Moroza-James

I’m delighted to hear that 🙂 Thank you so much for your time xxx

Sara Moroza-James
Sara Moroza-James

Hello, A recent blood test for my son (who has autism & epilepsy) showed that his intake of fructose exceeded his metabolic capacity and the doctor advised me to cut virtually all fructose out of his diet. It is my (possibly wrong) understanding that inulin is in part fructose. Do you think inulin will be suitable for him. By the way he’s 15 and we are just about to start the protocol.
Thanks,
Sara

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Inulin and fructose are completely different. The inulin is not metabolized into fructose or in a similar fashion.

Rita
Rita

Hello Dr. Nemechek. I’m scheduled to see you in late January and that appointment can’t come fast enough. Thankfully, my GERD symptoms are not as severe and the constipation somewhat better now that I’m on the fish oil and EVOO so I sincerely appreciate you sharing your protocol on-line with all of us!!! Thank-you!! But the POTS symptoms are still occurring daily off and on— occiptital pain & pressure headaches, poor sleep, severe dry eyes/mouth and sudden palpitations accompanied with cognitive decline. I’m wearing compression socks to aid my blood from pooling in my legs with hopes of getting oxygen… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

I’m sorry but medical licensing regulations prohibit me from giving precise medical advice without seeing a patient face-to-face first.

Rita
Rita

oh, I should add that my dr was not concerned that my 2015 blood work flagged my AST and ALT as HI with GGT LO. She said since I’m thin, I don’t have to worry. The ultrasound for accompanying pain showed “mild infiltration of fatty deposits to pancreas and liver” but she had no suggestions or comments opposite that. After reading your articles, I think it’s also related to the Dysautonomia! I am starting your protocol today as I’m now wondering if I’m at a dangerous stage of autonomic dysfunction. Would I benefit even more with having the VNS and… Read more »

Rita
Rita

I’ve been dealing with severe reflux for over 2 yrs following a 3 yr hell with POTS. Other lifelong dysautonomia issues are chronic constipation, low blood pressure, fainting, IBS, sleep issues, constant hunger (yet thin and tall) . The neurologist and endocrinologist diagnosed me with POTS (tilt table) in 2012 and did their best to help with symptom relief but to no avail. I believe it was the deliberate, paced exercise that I put myself on that allowed me to get out of the wheelchair and back to walking again.Since late 2015 I’ve been feeling healthier than even prior to… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

Dysautonomia is the cumulative dysfunction of the autonomic nervous system from a variety of sources. Autonomic damage per say is does not worsen but the external stressors placed on our body that generally require the autonomic nervous system to respond and compensate cannot do so. As such, symptoms such as fatigue, brain fog, anxiety, palpitations and anxiety can fluctuate up and and down. In addition, bacterial overgrowth in the small intestine can change the function of the autonomics as well as be another almost invisible source of stress which again cannot be compensated for with a damaged nervous system. Foods,… Read more »

Patrick Nemechek, D.O.
Patrick Nemechek, D.O.

The important aspect of VNS is the settings used. The wrong settings can harm soemone, and vary from person to person depending on the issues being addressed.

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