Top 11 Lifestyle Changes for POTS

A diagnosis of POTS may feel like a life sentence. Hearing your life will change in so many different ways can be alarming to many, and cause a sense of hopelessness. 

However, once the initial shock passes, the next step is figuring out how to live with your new diagnosis. POTS is more common than people think and affects anywhere between one and three million Americans^[1]. While there is, as of now, no definitive cure to this condition, there are treatment and management options available for people living with POTS. 

While some of these treatment options are pharmacological, not all require medications. There are a number of lifestyle changes you can implement to help manage your POTS symptoms without consuming medicines. 

That said, keep in mind each person’s POTS treatment plan is different. What works for you may not work for another person, and it’s always essential to consult your doctor before you make any changes to your treatment plan or lifestyle habits. 

1. Increase Salt Intake

Increasing your salt intake has been shown^[2] to help reduce and manage common POTS symptoms, including helping increase your blood volume and slow down your heart rate. Patients are recommended to consume anywhere between 2-8g of salt^[3] daily, depending on the severity of their symptoms. 

Before increasing your salt intake, consult your doctor first. They will advise you on an effective strategy, and what you should increase your salt intake to. 

Some people find increasing their salt consumption to be challenging due to a dislike of salty foods. One solution is to get your additional salt from salt pills like Klaralyte. One Klaralyte tablet contains 250 mg of sodium and 50 mg of potassium, and you can consume 2 tablets with water, 2-5 times a day. This can help you get to the recommended sodium intake without having to oversalt your meals.

2. Increase Fluid Intake 

Aside from Salt, POTS patients are also asked to increase their fluid intake. Studies indicate that increased water consumption can help people stand longer and increase the levels of the neurotransmitter norepinephrine in your body^[4]. Ideally, if you are living with POTS, you should consume about 3L of water daily^[5].

In fact, POTS and water are so interconnected that one study demonstrated that children who drank under 800 ml of water per day were significantly more likely to develop POTS – almost 4 times as those who drank an adequate amount of water.

3. Eat Smaller Meals

Your blood plays an important role in digestion, and the redirection of blood from other areas of the body to the digestive systems can worsen symptoms for POTS patients. This is especially true following a large meal, as more blood is redirected for digestion. Instead, POTS patients are recommended to eat smaller meals throughout the day^[6] instead of dividing their meals into the traditional three-meal, breakfast-lunch-dinner pattern.

4. Avoid Alcohol

Alcohol can dehydrate a person, causing hypotension and worsening your symptoms^[7]. Additionally, if you are on medications, alcohol can interact with your medicines, making it a bad idea to consume any. 

Some POTS patients are unable to handle alcohol at all, while others have better tolerance. If you’re worried about your ability to drink alcohol while living with POTS, contact your doctor for help. They’ll let you know if avoiding alcohol should mean giving it up altogether or having it in moderation while staying hydrated simultaneously.

5. Avoid Caffeine

This is generally one of the most challenging lifestyle adaptations to make, especially if you depend on caffeine daily. However, like alcohol, caffeine is a diuretic and can dehydrate you. Additionally, some people with POTS note caffeine can worsen their symptoms by raising their heart rate and causing insomnia. 

At the same time, some find caffeine can actually help reduce symptoms^[8] by raising their blood pressure. However, others cannot handle the slightest amount of caffeine, while still others find caffeine is okay for them as long as it’s consumed in moderation. 

Each person has a different reaction to caffeine, and it’s best to avoid it until you can consult your doctor about whether you can continue to drink coffee and how much of it you should drink. It’s always best to be safe over sorry!

6. Build a Go Bag

A go-bag doesn’t need to be one for emergencies – it can be as simple as packing a purse in advance of an outing. 

Having everything ready in a single space means you don’t have to run around looking for your medications or snacks when out, and it also means you don’t have to waste time rummaging through your bag if you need a sodium boost. Once you’ve prepared and packed everything, you can rest easy knowing your bag is ready to go whenever you are.

7. Maintain Your Temperature

People with POTS have difficulty regulating their body temperature^[9] due to issues with their autonomic nervous system. However, the heat can also exacerbate your POTS symptoms, making it a vicious cycle difficult to escape. 

As far as possible, you should try to maintain an even temperature and avoid extremely hot areas. Install an air conditioning unit in your home if you don’t already have one, and avoid going out on extremely sunny days if possible. You can also wear body-cooling vests to maintain your temperature if you do have to venture out in the heat.

8. Use a Shower Chair and Shower at Night

Showers inherently require you to stand for an extended period of time, which can exacerbate symptoms in some people with POTS. Instead, invest in a shower chair that you can sit in and shower.  

Furthermore, showering can often leave POTS patients feeling extremely tired. Because of this, patients are recommended to shower at night, just before bed.

9. Elevate Your Head When You Sleep

Raising the head of your bed between 6-10 inches^[10] when you sleep can help reduce common POTS symptoms (including acid reflux and GERD) and boost your circulation. It helps recondition your body to orthostatic stress and can make it easier to get out of bed in the morning. 

The best way to elevate your head is to use bricks or large books under your pillow. Wedge pillows do not change the position of your hips and lower legs sufficiently, and, to benefit from sleeping with your head elevated, your hip needs to be slightly elevated and higher than your feet. 

10. Wear Compression Garments

Compression clothes, including abdominal binders, have been shown to decrease venous pooling^[11] (blood pooling in the legs) and hypotension. They can help blood flow back to the heart^[12] and help your blood vessels work better. 

There are several types of compression clothes available, including tights and socks. The popularity of these clothes for exercise-related reasons has resulted in a wide range of options available on the market, which means you no longer have to worry about compromising on style for practicality. 

11. Exercise if Possible

Exercising can be a critical part of managing your POTS symptoms. It is recommended that patients start with recumbent or semi-recumbent training in the period following their diagnosis^[13]. This allows them to exercise without causing POTS symptoms to flare up due to standing upright. 

Once you become adjusted to the exercise, you may then be able to gradually move on to a more intense activity. Some exercise options to try include swimming, recumbent biking, and rowing. 

At the same time, it’s essential not to overdo things and overexert your body, as this can also cause a flare-up of symptoms. For best results, consult a doctor or experienced trainer about your workout plan, and work with them to develop an option that works best for you. Many POTS patients report success using the Levine Protocol^[14], so you can also check if this is an option for you.

Final Thoughts

Adjusting to living with POTS can be challenging, especially when you consider the range of lifestyle changes it can demand. However, by pushing forward, you’ll be able to return to your regular life sooner than expected. 

Additionally, it’s essential to remember that you may not have to make every adjustment listed above. Lifestyle adjustments are a highly individualized process, and what works for one person may not work for another. Always consult a doctor before making a significant change to your lifestyle, and don’t be afraid to end the adjustment if you find it is not helping you manage your symptoms.

Cited Sources:

[1] https://www.hopkinsmedicine.org/health/conditions-and-diseases/postural-orthostatic-tachycardia-syndrome-pots 
[2] https://www.sciencedirect.com/science/article/pii/S0735109721006306 
[3] https://myheart.net/pots-syndrome/diet/ 
[4] https://myheart.net/pots-syndrome/importance-of-water/ 
[5] https://drsanjayguptacardiologist.com/blog/12-lifesyle-modifications-which-work-in-pots/ 
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390096/?
[7] https://betterbythebeat.com/my-top-ten-pots-triggers-to-avoid/ 
[8] http://www.dysautonomiainternational.org/page.php?ID=44 
[9] https://www.potsuk.org/managingpots/temperature-regulation-2/ 
[10] https://my.clevelandclinic.org/health/diseases/16560-postural-orthostatic-tachycardia-syndrome-pots 
[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2888469/ 
[12] https://www.potsuk.org/managingpots/compression-clothing/ 
[13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289756 
[14] https://betterbythebeat.com/the-levine-protocol-for-exercising-with-pots/