Postural Orthostatic Tachycardia Syndrome (POTs) - Causes and Treatment
Dr. Miranda Hill • 24 November 2023

Postural orthostatic tachycardia syndrome (POTs) is a form of dysautonomia, meaning there is dysregulation of the autonomic nervous system. The autonomic nervous system is the part of the central nervous system that controls all of the functions of the body that we do not have to think about (e.g. breathing, digestion, etc.). 


There are many causes of POTs, none of which are genetic in origin. Certain genetic snips and suppression of detoxification pathways can make someone more susceptible to developing the symptoms of POTs, but there are always underlying causes. Postural orthostatic tachycardia syndrome is a syndrome - that is the key word. A syndrome is a cluster of symptoms grouped together to form a diagnosis, but the cause is unknown. Postural orthostatic tachycardia syndrome is unique in the fact, like fibromyalgia and chronic fatigue syndrome, that there are many different causes. The challenge is determining those causes. 


Symptoms of POTs:

Postural orthostatic tachycardia syndrome is multifactorial in nature and can present with other symptoms than those included in the syndrome of POTs. This can depend on the underlying issues the body is trying to process. The following list are possible symptoms of POTs:

  • Dizziness upon standing due to rapidly decreasing blood pressure and increased heart rate
  • Blacking out or passing out upon standing
  • Low blood pressure
  • Elevated resting heart rate
  • Chest palpitations
  • Chest pain
  • Blood pooling in extremities
  • Pale complexion 
  • Raynaud’s Syndrome
  • Temperature intolerance 
  • Shortness of breath
  • Chronic fatigue / exercise intolerance (inability to exercise)
  • Headaches / migraines 
  • Brain fog
  • Anxiety
  • Depression
  • Ringing in ears 
  • Excessive day or night sweating


POTs Diagnosis:

Postural orthostatic tachycardia syndrome is diagnosed through a tilt table test, that assesses for changes in blood pressure and heart rate upon moving from a recurrent to upright position. Additional testing for POTs, including sweat gland testing (QSART), autonomic breathing test, echocardiogram, EKG, nerve biopsy, and nerve conduction studies may also be utilized to differentiate POTs from other nervous system and cardiovascular disorders. Once POTs is suspected, patients are typically referred to conventional cardiologists and/or neurologists for diagnosis and management.


Possible Causes of POTs:

Typically POTs presents after some sort of stressor to the body or a traumatic life event. This is an example of the “Rain Barrel Effect,” when the body can no longer manage toxins, infections, and other stressors. Examples of stressors that may provoke the development and progression of POTs include, physical trauma, surgery, acute illness, activation of chronic infections, bug or animal bites, toxic exposure, pregnancy, rapid changes in hormone levels (e.g. puberty), emotional trauma, etc. 


Common examples of environmental causes of POTs:

  • Mycotoxins
  • Heavy metals
  • Chronic viral infections
  • Chronic bacterial infections
  • Parasitic infections


Conventional Treatment of POTs:
The conventional treatment of POTs includes supporting blood volume and pressure through diet, hydration, salt, recumbent exercise, and sometimes pharmaceuticals. Most treatments target the management of symptoms, while underlying causes are not addressed. This approach can only take someone so far in treatment. 


Restorative Medicine’s Approach to Managing and Treating POTs:

At Restorative Medicine, Dr. Miranda Hill treats POTs utilizing similar supports to manage symptoms, but also addresses the root causes. Underlying factors, such as stressors, toxins, infections, and other imbalances, hinder optimal function of the nervous system. By addressing the underlying root causes, recovery from POTs is possible. Dr. Miranda Hill personally was diagnosed with POTs and made a full recovery. Schedule an appointment with Dr. Miranda Hill here for POTs management and assessment.

by Dr. Miranda Hill 28 May 2024
What Is SIBO: SIBO stands for small intestinal bacterial overgrowth and occurs when bacteria, both friendly and unfriendly strains, overgrow in the small intestine. Overgrowth of bacteria in the small intestine can lead to many adverse gastrointestinal symptoms. Symptoms of SIBO: Abdominal bloating, especially after eating Burping Gas Indigestion Reflux / GERD Nausea Abdominal pain Constipation and/or diarrhea Undigested food in stool Food intolerances / sensitivities Environmental allergies Anemia - iron deficiency anemia, vitamin B12 deficiency anemia, or anemia of unknown origin Fatigue Brain fog Poor concentration Anxiety Depression Joint pain, usually in combination with gastrointestinal symptoms Muscle pain, usually in combination with gastrointestinal symptoms ADD / ADHD Skin conditions - rashes, eczema, psoriasis, rosacea Itching Changes in weight - weight loss or weight gain May be asymptomatic Causes of SIBO: It is commonly believed that SIBO occurs when bacterial species in the colon overgrow in the small intestine; however, this is not always the case. Other factors that may contribute to the formation of SIBO, some of which include the following: Oral antibiotics Other acute or chronic microbial imbalances in the gastrointestinal tract (bacteria, viruses, parasites) Food poisoning Low gastrointestinal immune function Poor drainage of the intestines Delayed gastrointestinal motility Constipation Gastric bypass surgery Drinking chlorinated water Long-term use of antacids or proton pump inhibitors Certain medications Smoking Pesticides Types of SIBO: Small intestinal overgrowth is differentiated into methane, hydrogen, and/or hydrogen sulfide positive SIBO based on the types of gases produced during SIBO diagnostic tests. Conventional SIBO Diagnosis: The gold standard for diagnosing SIBO is a jejunal aspirate, which is highly invasive, expensive, and has limited ability to assess the entire small intestine. Breath tests are the most common conventional method used to diagnose SIBO. Patients must follow a specific bland diet for multiple days leading up to the breath test and fast the day of the test. The morning of the breath test, a single dose of liquid lactose, fructose, or glucose is ingested. A series of breath samples are taken throughout the day and then sent to a lab for gas analysis. Positive SIBO breath tests occur when bacteria ferment the ingested sugar solution and produce methane, hydrogen, and/or hydrogen sulfide gas. The accuracy of SIBO breath tests is highly limited and prone to user error. False-positive tests may result in certain cases of large intestine bacterial overgrowth, rather than bacterial overgrowth occurring in the small intestine. In many cases, SIBO extends beyond the parameters of conventional testing. It is possible for species other than those that give off methane, hydrogen, or hydrogen sulfide gas to be overpopulated in the small intestine and produce the symptoms of SIBO. Conventional SIBO Treatment: The conventional approach to SIBO treatment includes oral antibiotics with or without a low-FODMAP diet. A low-FODMAP diet involves eliminating foods high in certain fermentable sugars that feed many types of bacteria. Many individuals with SIBO experience adverse symptoms, such as abdominal bloating, pain, brain fog, etc. after eating foods high in FODMAPs. Eliminating or minimizing foods containing FODMAPs can help reduce the severity of symptoms while treating SIBO. Antibiotics that may be used to treat SIBO include, rifaximin, neomycin, metronidazole, and others. The use of antimicrobial herbs to treat SIBO has become more popular due to the ineffectiveness of oral antibiotics to completely eradicate SIBO. SIBO Testing & Treatment at Restorative Medicine: Dr. Miranda Hill utilizes a form of applied kinesiology known as Cellular Photonics to test and formulate treatment plans for SIBO. Dr. Miranda Hill utilizes various forms of therapies to treat SIBO, including herbs, supplements, enzymes, binders, homeopathics, PEMF therapy, and/or medications. Dietary modifications are individualized based on each patient’s case. Following a low-FODMAP diet is not required in every case of SIBO. Dr. Miranda Hill specializes in supporting the immune system and other areas of the body while treating SIBO. Treatment plans are comprehensive and inclusive to the whole person. Contact our office for more information about scheduling an appointment with Dr. Miranda Hill. References: Simrén M, Stotzer PO. Use and abuse of hydrogen breath tests. Gut. 2006;55(3):297-303. doi:10.1136/gut.2005.075127 Lim J, Rezaie A. Pros and Cons of Breath Testing for Small Intestinal Bacterial Overgrowth and Intestinal Methanogen Overgrowth. Gastroenterol Hepatol (N Y). 2023;19(3):140-146.
by Dr. Miranda Hill 16 April 2024
What is Homeopathy? Homeopathy is a form of medicine that uses very dilute substances at low and ultra low doses to stimulate healing within the body. Homeopathic medicine has been used for hundreds of years. National health systems of Brazil, Chile, Cuba, India, Mexico, Nigeria, Pakistan, South Africa, and Switzerland regularly use homeopathy as part of healthcare. Traditional homeopathic remedies contain nanoparticles (very small particles) of the original substance from which the medicine is derived from. In the body, homeopathic nanoparticles can treat acute and chronic infections, support optimal organ and immune function, correct dysfunctional cellular patterns, and promote drainage. Homeopathy can also be prepared through electromagnetic imprinting of alcohol or water. This form of homeopathy works by shifting the positive and negative charges lining cells throughout the body, supports detoxification, increases drainage, improves immune function, and can directly treat acute and chronic infections. Homeopathics may be prepared from plants, minerals, vitamins, microorganisms, animal derivatives, root canals post extraction, hormones, peptides, etc. Dr. Miranda utilizes homeopathy with patients to address underlying causes and to treat many conditions. Homeopathy is a very gentle form of medicine that is dosed based on the condition and the state of the body. Dr. Miranda Hill personalizes each homeopathic blend and sources homeopathics from around the world. Homeopathy May Be Used For The Following Indications: Detoxification Optimizing digestion - treating constipation, diarrhea, abdominal pain, bloating, etc. Regulating organ function Drainage of body systems - lymphatics/spleen, liver, gastrointestinal tract, cardiovascular system, etc. Treatment of acute or chronic infections - bacteria, viruses, and parasites Balancing of the immune system Regulating hormones Alleviating acute or chronic pain Treatment of many dental conditions Aid healing of tissues - post surgery, wounds, cuts, lacerations, trauma, bites, etc. Supporting emotional health Improving sleep Traditional Homeopathic Dosages: Dr. Miranda Hill utilizes a variety of homeopathic dosages as a part of a comprehensive treatment plan. Homeopathics vary in dilution and strength. The following is a key to the numeric homeopathic dosage system: A homeopathic remedy with a number followed by “X” or “D” is diluted based on a 1:10 ratio A homeopathic remedy with a number followed by “C” or “cK” is diluted based on a 1:100 ratio A homeopathic remedy with a number followed by “M” is diluted based on a 1:1,000 ratio A homeopathic remedy with a number followed by “LM” is diluted based on a 1:50,000 ratio The first number in the ratio refers to the original substance, while the second number refers to the alcohol or water base used to prepare the homeopathic remedy. Homeopathics are made by preparing a mother tincture out of the raw material (e.g. plant material) and then taking one drop of the mother tincture and combining it with alcohol or water - nine drops for a X remedy, 99 drops for a C remedy, 999 drops for a M remedy, or 49,999 drops for a LM remedy. This would produce a 1X, 1C, 1M, or 1LM homeopathic depending on the relative amount of alcohol or water used. The dilution process continues until the number of dilutions coincides with the respective number on the homeopathic. For example, five more dilutions would occur from a 1X preparation to produce a 6X remedy. Some homeopaths believe that beyond a potency of 12C, such as 30C, 200C, 1M, or higher dilutions, molecules of the original substance are no longer present in the homeopathic. Studies have shown nanoparticles of the original substance to persist in homeopathic medicines of high dilution. A commonly held belief in homeopathy is that highly dilute homeopathics, such as 1M, are stronger than less dilute homeopathics, such as 6X. The strength of a homeopathic remedy does not always depend on the number of dilutions. Homeopathic potency depends on multiple variables within the body, the quality of the remedy, and how the remedy is prepared. Factors That Alter How Homeopathics Work In The Body: Genetics The state of liver detoxification and total body burden The state of the immune system at the time of taking a homeopathic Allergies Hormonal fluctuations Cellular membrane integrity The amount of inflammation in the body (acute vs. chronic inflammation) Specific toxins in the body, such as environmental chemicals, heavy metals, mycotoxins, biotoxins, etc. Chronic infections Quality of the homeopathic remedy Alcohol vs water base of the homeopathic (alcohol preserves homeopathics better than water) The source and quality of the original substance used to prepare the homeopathic Form of homeopathic used - liquid vs. pellets / dissolvable tablets Individualized Homeopathy At Restorative Medicine: Dr. Miranda Hill utilizes many homeopathics as part of a comprehensive treatment plan with patients. Dr. Miranda Hill sources homeopathics from around the world. Homeopathics help condense the number of therapies in a treatment plan since they are diverse and broad in action. Homeopathic medicine can expedite treatment and reduce the severity of symptoms. Inquire about homeopathic medicine by contacting Restorative Medicine’s office. References: Vassighi N. Homeopathy Basics. 2020. Chikramane PS, Suresh AK, Bellare JR, Kane SG. Extreme homeopathic dilutions retain starting materials: A nanoparticulate perspective. Homeopathy. 2010;99(4):231-242. doi:10.1016/j.homp.2010.05.006 
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