ysautonomia-POTS and Mandarin Wellness Center

Neurally Mediated Hypotension Postural Orthostatic Tachycardia Syndrome


In POTS, you cannot retain water without taking in electrolytes because of posterior pituitary dysfunction and insufficient antidiuretic hormone (ADH).  Dehydration occurs.

Hyper-reactive Sympathetic nervous system (fight-or-flight) fires off a very rapid heart rate of 120 – 200.  Sometimes just taking a shower will leave you exhausted as if you’d run a marathon.

The key to treatment is to take in massive quantities of salt and baking soda:

Along with high fluid intake, essential to increase electrolytes:

  • Salt (Hain Iodized Sea Salt +/- Celtic or Himalayan) 1 tsp 2 – 4x/d
  • Baking Soda ½ – 1 tsp 2 – 4x/d or Propel or Smart Water
  • +/- Alka Selzer Gold 1 fizzy 1 – 3 x/d         

If Anti-diuretic Hormone (Arginine Vasopressin) is low, add

   Desmopressin (DDAVP)  0.1 – 0.2 mg bedtime +/- in am   


  • Beta-Blockers
  • Cymbalta, Effexor, Savella
  • If ADH (anti-diuretic hormone) levels are low, can replace with Desmopressin DDAVP
  • Midodrine
  • Fludrocortisone (Florinef)

For more information:  http://www.potsuk.org/what_is_pots2

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