Reducing Flare Ups in POTS
Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia distinguished by a significant increase in heart rate following a positional change. Though if you live with POTS you know it's far more complex than just a racing heart when you stand up… People with POTS can experience full body symptoms such as lightheadedness, frequent near fainting or fainting episodes, headaches, fatigue, brain fog, GI distress, and more due to the underlying dysfunction in the autonomic nervous system.
One of the most frustrating aspects of living with POTS is the variability and unpredictability of symptoms and the disruption symptoms and flare ups cause to daily life. A key component of occupational therapy is helping my clients understand their symptom patterns and triggers and empowering them to reduce flares as much as possible so they can do the things that matter most to them. This article will discuss common POTS triggers and strategies for tracking your symptoms to identify your most significant triggers so that you can take strategic action to reduce flare ups.
What is a POTS flare up?
A POTS flare up is an increase in symptoms from your usual baseline. Flare ups looks different for each person - you might experience more significant increases in heart rate, larger fluctuations in blood pressure, or worsening of chronic symptoms overall, such as fatigue, brain fog, GI issues, etc. How long a flare up lasts varies significantly as well and might last for one day, a few days, a week, or longer.
Two of the first questions I ask a new client are:
“What makes your symptoms worse?”
“What helps you manage your symptoms?”
Knowing what impacts your body empowers you to feel more able to navigate the inevitable health ups and downs that come along with a chronic health condition.
What are some triggers which worsen POTS symptoms?
Some of the most common symptom triggers and exacerbating factors for POTS are:
Heat
Stress
Exercise
Dehydration
Caffeine
Alcohol
Valsalva maneuvers
Large meals
Moving abruptly from laying down or sitting to standing
Prolonged standing
Prolonged bed rest or inactivity
Airplane travel (altitude changes)
Infection or illness
Menstrual cycle
These are all factors that could potentially worsen POTS symptoms; however, everyone is different and triggers impact people in different ways. It's also important to remember that all of these triggers do not necessarily cause POTS symptoms on their own, but might contribute to the likelihood of a flare up in a cumulative fashion. For example, one night of poor sleep might not lead to a flare up; however, a week of not sleeping well because you are stressed out about a school or work deadline, on top of it being hotter outside, is more likely to cause a flare.
Tracking your symptoms
One of my top recommendations when I begin working with someone with POTS or another chronic condition is to keep a symptom log, especially if they are not sure what their most significant triggers are. This can help you to better understand how your lifestyle and the activities you are doing every day impact how you feel. It also can help you better advocate for your health needs with healthcare providers.
There are many different ways to track symptoms. The most important thing is to find what works for you. Do you know you’ll do better with an app because you always have your phone on you and can set up notifications? There are many symptom tracking apps out there to try - I’ve heard good things about bearable (no affiliation). Or if you are a paper and pen person, go with that.
I recommend tracking your most prominent POTS symptoms, the triggers you think could be impacting you, as well as sleep and other lifestyle areas which impact overall nervous system regulation. Try tracking your symptoms for at least 2 weeks to get a good baseline understanding of your symptom patterns.
Do you need help figuring out how best to track your symptoms? Do you want support interpreting the data you have tracked and figuring out how to use it to manage your health? I specialize in supporting people with POTS and other chronic conditions improve their health and reach their goals. Reach out to me with any questions or schedule a free consultation call to figure out how our work together can empower you on your health journey.