ConditionsCardiovascular / Neurological
Cardiovascular / Neurological

POTS (Postural Orthostatic Tachycardia Syndrome)

Gabriel treats POTS by addressing root cause: testing for autoimmune markers, infections, EDS, MCAS, small fiber neuropathy.

Root Causes

10 identified

Supplements

11 recommended

Lab Markers

14 to test

Treatments

3 modalities

Gabriel's Approach

Gabriel treats POTS by addressing root cause: testing for autoimmune markers, infections, EDS, MCAS, small fiber neuropathy. He optimizes blood volume with salt loading and hydration protocols, supports autonomic function with targeted supplements, addresses mitochondrial dysfunction, uses IV therapies for rapid improvement, implements graded exercise protocols carefully, and combines conventional (fludrocortisone, beta blockers when needed) with natural approaches. Recognizes POTS often has multiple contributing factors requiring comprehensive treatment.

Root Causes

Autonomic nervous system dysfunction (dysautonomia)
Hypovolemia (low blood volume)
Autoimmune triggers (post-viral, vaccine)
Small fiber neuropathy
Ehlers-Danlos Syndrome (30-50% comorbidity)
Mast cell activation syndrome
Mitochondrial dysfunction
Chronic infections (Lyme, EBV)
Vitamin deficiencies (B12, folate, iron)
Deconditioning

Why Conventional Fails

Standard Treatment

Increased salt and fluid intake, compression garments, graded exercise, fludrocortisone (increase blood volume), beta blockers (propranolol, metoprolol), midodrine (vasoconstrictor), ivabradine (lower heart rate), sometimes IVIG or plasmapheresis if autoimmune.

The Problem

Often dismisses as anxiety, doesn't investigate root causes (infections, autoimmunity, EDS, MCAS), medications have side effects and don't address underlying dysfunction, exercise recommendations too aggressive (worsens condition), inadequate nutritional support, doesn't optimize mitochondrial function, doesn't address comorbidities comprehensively, many patients dismissed before diagnosis (takes average 4-6 years).

Your Complete Protocol

A comprehensive, tiered approach combining supplements, herbs, and advanced therapies

Functional MedicinePeptide TherapyWhole Food Nutrition

Your Protocol for POTS (Postural Orthostatic Tachycardia Syndrome)

Choose the level that's right for your healing journey

Essential Protocol

Start Here
$75/mo

What's Included

  • Electrolyte solution with 6-10g sodium/day
  • Licorice root 500mg 2x/day (mineralocorticoid effect)
  • Vitamin B1 (thiamine) 100-300mg
  • Vitamin B12 1000-5000mcg
Get Essential Protocol

Available through Fullscript

Practitioner-Grade Protocol

Most Popular

Practitioner-Grade — Not Available on Amazon

$165/mo

What's Included

  • Standard Process whole food protocol
Get Practitioner Protocol

Whole food supplements by Standard Process

Complete Protocol

Best Value
$245/mo

What's Included

  • All Practitioner-Grade supplements & herbs
  • BPC-157 (tissue repair + gut healing)
  • Thymosin Alpha-1 (immune modulation)
Get Complete Protocol

Standard Process + Matter peptides

Recommended Supplements

Electrolyte solution with 6-10g sodium/day
Licorice root 500mg 2x/day (mineralocorticoid effect)
Vitamin B1 (thiamine) 100-300mg
Vitamin B12 1000-5000mcg
Coenzyme Q10 300mg
L-Carnitine 2000mg
D-Ribose 5g 3x/day
Magnesium Glycinate 400-600mg
Iron if deficient
Omega-3 4g/day
Adaptogens (Rhodiola, Ashwagandha)

Key Lab Markers

Tilt table test or poor man's POTS test (30+ bpm increase within 10 min standing)
Plasma catecholamines (standing)
Aldosterone and renin
Autoimmune panel (ANA, SSA/SSB)
Celiac panel
Vitamin B12, MMA
Folate
Iron studies
Thyroid panel
Lyme testing
EBV titers
Tryptase (MCAS)
Skin biopsy (small fiber neuropathy)
Echocardiogram

Dietary Guidance

High sodium diet (6-10g/day unless contraindicated), adequate fluid intake (2-3L/day minimum), small frequent meals (large meals worsen symptoms via blood pooling), adequate salt at each meal, avoid alcohol (vasodilator), avoid caffeine initially (some tolerate after stabilization), complex carbohydrates for sustained energy, adequate protein, electrolyte-rich foods (pickles, olives, bone broth, coconut water), some benefit from increased dietary potassium, avoid very hot foods and environments.

Lifestyle Factors

Compression garments (waist-high 30-40 mmHg), elevate head of bed 4-6 inches, graded exercise program (recumbent bike, rowing, swimming - NOT running initially), avoid prolonged standing, avoid hot showers/baths, counter-maneuvers (leg crossing, squatting), adequate sleep (dysautonomia worsens with poor sleep), pacing (avoid push-crash cycles), physical therapy specialized in POTS, avoid deconditioning but don't overdo, stay cool (heat worsens symptoms).

Mind, Body & Spirit

Evidence-based practices that complement physical treatment protocols

Mind

Biofeedback

moderate

Learning to modulate autonomic responses through real-time feedback.

Cognitive Behavioral Therapy

moderate

Coping with chronic illness, pacing strategies, managing anxiety that worsens symptoms.

Meditation and Breathwork

moderate

Parasympathetic activation to support autonomic balance.

Body

Vagal Nerve Stimulation

moderate

Techniques to improve autonomic nervous system regulation.

Graded Exercise Therapy

strong

Specialized POTS exercise protocol starting recumbent, slowly progressing to upright.

Compression Therapy

strong

Waist-high compression garments to prevent blood pooling in legs.

Spirit

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