What Is POTS, And How Do I Manage It?

By Jennifer Smallridge, Exercise Physiologist Hawthorn, Exercise Physiologist Blackburn.

Being diagnosed with POTS (Postural Orthostatic Tachycardia Syndrome) can often raise more questions than it answers. Symptoms of POTS range from mild dizziness, breathlessness and nausea, to brain fog and exercise intolerance, right up to debilitating fatigue.

As an exercise physiologist with a special interest in chronic conditions, I regularly help people with POTS find a movement regime and lifestyle approach that is right for them.

I’ve created the below video to help explain POTS a little further:

In addition to the above, here are some practical, actionable tips to help you on your way with POTS:

  1.         Befriend your drink bottle

Hydration sounds simple in theory, but it’s amazing how easy it is to go through a day and not hit your water targets (around 2L for most people).

Mornings tend to be harder for people with POTS due to the dehydration that naturally occurs when we sleep. Start your day the right way with a glass of water or drink bottle on your bedside table, and aim for 250-500ml before your feet touch the ground.

This approach also means that you only have 1.5-1.75L to go to hit your water goal! Try to take big sips before other key times of the day eg: before showering, before meals (this helps to prevent crashing after eating), and during periods of prolonged sitting.

  1.         Get salty

Remember that increasing your salt intake will only work if you increase your water intake as well. Please note that sodium increases may not be appropriate for you – always check with your health practitioner.

Part of the challenge of POTS is finding a way to build up sodium levels consistently, in a way that works for you. This could include:

  • Salt tablets from the chemist: be aware that some people find these can upset their stomach, and need to be taken with lots of fluid, but they are a cost-effective option
  • SaltStick Vitassium Salts: these can be found online, seem to be friendlier on stomachs and also have added electrolytes to keep things in balance
  • Hydralyte Sport: the sports version is low sugar and is a good choice for those who like flavoured options.
  • Being aware of your personal dietary and energy requirements, salty snacks (eg: pretzels, popcorn, chips) are generally a good combination of sodium and carbohydrates, and they taste great!
  • Soups and broths can also be high sodium whilst providing nutrition through vegetables and some hydration from the water component too.
  • Sprinkling salt on EVERYTHING (to taste)! Most people build up a tolerance to the taste of salt very quickly, which is only a good thing for people with POTS.
  1.         Set up before you get up

A small change that can make a huge difference is to prime your muscles before standing up.

Simple muscle contractions such as calf pumps, quadricep squeezes and glute pulses (about 10 of each) can be done from a seated or lying position. This quick action can help counteract the drop in pressure and raise in heart rate, making those first few moments of being upright easier.

  1.         Pacing, not racing

As with any chronic, stress-sensitive condition, POTS doesn’t respond well to huge bursts of activity (whether it be mental, physical, emotional or cognitive).

Taking a well-paced approach allows the body adequate recovery time and prevents the need to ‘run on adrenaline’, which is a known trigger for people with POTS.

If you’d like to know more about managing your POTS with lifestyle and exercise, exercise physiology services at Beyond are designed to help you to move through life!

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