How to Heal POTS and Dysautonomia: A Holistic Approach
A functional medicine approach to POTS and Dysautonomia might be the holistic approach you need to get your life back.
Postural Orthostatic Tachycardia Syndrome (POTS) is one of the most common ways dysautonomia shows up. It can feel frightening to stand up and suddenly experience a racing heart, dizziness, or even fainting (1). For many people – especially women between the ages of 13 and 50 – these episodes are dismissed as anxiety or stress (2, 3).
POTS results from a dysregulated autonomic nervous system (ANS), which regulates heart rate, blood pressure, and digestion. Misdiagnosis is common. Research suggests that a significant number of patients wait several years before receiving a proper diagnosis (5).
If you live in Marietta, GA, and are searching for functional medicine for POTS. This guide will help you understand the condition, explore potential root causes, and learn how a functional medicine approach can restore balance.
Understanding Dysautonomia as the Root-Cause of POTS
The first step to a personalized functional medicine approach to POTS is understanding the root cause of dysautonomia.
What is Dysautonomia?
Dysautonomia is an umbrella term for disorders involving dysfunction of the autonomic nervous system (ANS). The ANS controls involuntary processes such as heart rate, blood pressure, digestion, and temperature regulation — i.e., the things that happen “automatically” in our body.
When communication between the brain and the ANS is disturbed, symptoms can include:
- Dizziness or lightheadedness when standing.
- Fatigue and difficulty exercising.
- Digestive issues such as nausea, constipation, or diarrhea.
- Brain fog and headaches.
- Temperature regulation problems and heat intolerance.
Dysautonomia may be a primary disorder driven by genetic factors or secondary to conditions such as autoimmune disease, chronic infection, diabetes, or connective-tissue disorders.
What is POTS?
POTS is a specific form of dysautonomia, and the most common. It is defined by a rapid heart‑rate increase of at least 30 beats per minute (or 40 bpm for children) within 10 minutes of standing, without a significant drop in blood pressure (1). POTS often coexists with connective‑tissue disorders like Ehlers‑Danlos syndrome.
The symptoms of POTS often include (2):
- Tachycardia (rapid heart rate) when standing.
- Lightheadedness, dizziness, or fainting upon standing
- Fatigue and exercise intolerance.
- Brain fog and headaches.
- Digestive disturbances due to the gut–brain connection.
- Heat/cold intolerance
POTS is often missed by Conventional Medicine
Conventional care focuses on managing symptoms rather than identifying underlying causes; as such, conventional medicine is siloed off into system-specific specialities such as cardiology, neurology, and gastroenterology. POTS and dysautonomia are multi-system diseases that affect several different body systems that might appear unrelated to the untrained eye.
Patients are frequently told that their symptoms are psychological or simply due to stress, and they may see multiple specialists before POTS is considered, often taking an average of 2 years before receiving a proper diagnosis (5). Since most people do not connect heart palpitations with digestive problems or heat intolerance, many cases go undiagnosed.
Many individuals see multiple clinicians and undergo numerous tests before anyone considers dysautonomia (6, 7).
After the COVID‑19 pandemic, the number of people experiencing autonomic dysfunction increased by over 300%(8), but awareness is still catching up. Sadly, nearly 25% of POTS cases are so severe that patients are unable to attend work or school, and many end up bedbound (9).
My Personal Experience with POTS and Dysautonomia
One thing I want you to understand is this: your symptoms are real, even if you haven’t met the official diagnostic criteria for POTS in a doctor’s office. The autonomic nervous system can fluctuate day-to-day, which means some people don’t “hit the numbers” during a brief clinical test — yet still experience life-altering dysautonomia symptoms.
If you regularly feel dizzy, lightheaded, or your vision goes black when you stand or when walking up stairs, or notice your heart racing with simple positional changes, something in your autonomic system is absolutely dysregulated — and it deserves attention, not dismissal.
I say this not just as a practitioner, but as someone who has lived it. My own mild, lifelong POTS symptoms became significantly worse after COVID. I know healing is possible because I’ve experienced it myself. I’ve since helped many patients do the same using a functional, root-cause approach — and I want you to know: relief truly is possible. You are not “just anxious.” You are not imagining this. And you are not alone.
Types of POTS: Tailoring Functional POTS Treatment to the Root Cause
A functional medicine approach to POTS recognizes that POTS is not a single condition, but a syndrome with multiple contributing root causes. Identifying your subtype is essential for building a personalized treatment plan that restores autonomic balance instead of merely suppressing symptoms.
Hypovolemic POTS
In hypovolemic POTS, the body doesn’t retain enough fluid, so blood volume is low (10). This reduced volume means less blood returns to the heart, forcing it to beat faster to maintain circulation.
Research suggests that about 70 % of POTS patients have a chronic fluid deficit; on average, their plasma volume is roughly 13 % below normal (11). An impaired renin‑angiotensin‑aldosterone system—the hormone network that controls sodium retention and blood pressure—may prevent the kidneys from conserving salt, further reducing blood volume (2). Comprehensive testing, including plasma renin and aldosterone levels and urinary sodium excretion, can help confirm this subtype.
- Problem: low blood volume –> reduced blood return to the heart.
- Key signs: chronic dehydration, low renin–angiotensin–aldosterone function, and low urinary sodium.
- Functional medicine approach to Hypovalemic POTS: increase salt intake, use electrolyte supplementation (sodium, potassium, magnesium), and support adrenal function through targeted nutrients and stress management (12).
Hyperadrenergic POTS
Hyperadrenergic POTS is driven by an overactive sympathetic nervous system—the fight‑or‑flight response. Some patients carry genetic variations in the norepinephrine transporter (NET) that cause poor clearance of norepinephrine, leading to high circulating levels (13). Standing plasma norepinephrine levels above 600 pg/mL often point to this subtype (11).
People with hyperadrenergic POTS have an overactive fight-or-flight response and often experience a surge of symptoms such as high systolic blood pressure, palpitations, anxiety, and tremors.
- Problem: overactive fight‑or‑flight –> Elevated norepinephrine levels –> palpitations, anxiety, tremors, and high blood pressure.
- Key signs: standing norepinephrine above 600 pg/mL, episodes of high systolic blood pressure, and anxiety.
- Functional medicine approach to hyperadrenergic POTS: address stress with meditation, breathing exercises, and adaptogenic herbs; support liver detoxification; evaluate medications that may increase norepinephrine; and consider nutrients that assist neurotransmitter metabolism (11).
Neuropathic POTS
Neuropathic POTS results from partial autonomic denervation, especially in the small fiber nerves of the legs. This nerve damage impairs the blood vessels’ ability to constrict when standing, causing blood to pool in the lower extremities and triggering tachycardia (14). Autoimmunity, viral infections, and connective‑tissue disorders may all contribute to this type of nerve damage (15).
Early studies indicate that roughly half of POTS patients show evidence of neuropathic involvement (16).
- Problem: nerve damage or dysfunction in the peripheral nerves that regulate blood‑vessel tone.
- Key signs: blood pooling in the legs, loss of sweating or temperature regulation, and signs of small‑fiber neuropathy.
- Functional medicine approach to neuropathic POTS: focus on repairing nerve integrity with B vitamins, omega‑3 fatty acids, and antioxidants; treat underlying infections; and consider graded exercise or physical therapy to improve blood return.
Genetic and Connective‑Tissue Connections: Hypermobile POTS
POTS frequently coexists with connective‑tissue disorders, particularly hypermobile Ehlers‑Danlos syndrome (hEDS). POTS research has found that 31 % of POTS patients met diagnostic criteria for hEDS, and 55 % exhibited generalized joint hypermobility (17).
Connective‑tissue laxity may cause veins and arteries to stretch more easily, leading to excessive blood pooling in the legs when standing. (18). h-EDS is also associated with small fiber neuropathy, which may exacerbate autonomic dysfunction (19).
Identifying joint hypermobility and genetic factors allows practitioners to tailor interventions—
- Problem: Stretchy/weak connective tissue –> lax blood vessel walls –> blood pooling
- Key signs: blood pooling in the legs, hypermobile joints, reduced skin elasticity
- Functional medicine approach to Hypermobile POTS: highlights the importance of joint stability with interventions like physical therapy and proprioceptive training, collagen‑supporting nutrition, vitamin C, and careful monitoring of cardiovascular response.
Immune‑Related POTS: Post‑Infectious and Post‑COVID POTS
Many patients first develop POTS following a viral or bacterial illness. Influenza, Epstein–Barr virus, Lyme disease, and pneumonia can injure autonomic nerves or trigger autoimmunity (15). Since the emergence of COVID‑19, clinicians have observed a surge in new POTS cases; some individuals develop symptoms months after recovering from SARS‑CoV‑2 (20).
Theories to explain post‑COVID POTS include:
- Autoimmune responses targeting autonomic receptors
- Direct damage to autonomic nerves from viral invasion
- Persistent inflammation affecting the central nervous system
- Mast Cell Activation Syndrome and Histamine Imbalance
Functional‑medicine treatment for immune‑related POTS often integrates immune‑modulating nutrients (e.g., vitamin C, quercetin, zinc), antiviral botanicals, stress management, and careful evaluation for mast‑cell activation.
- Problem: Viral-activated autoimmunity or nerve cell infiltration –> inflammatory cascade/histamine response –> dyrautonomia
- Key signs: High ANA antibodies, high inflammation markers, histamine intolerance/MCAS symptoms, chronic fatigue.
- Functional medicine approach to Post-COVID POTS: evaluate immune markers, look for lingering infections, address histamine intolerance/MCAS, support gut health (70 % of the immune system resides in the gut), and use anti‑inflammatory nutrition strategies.
Functional Medicine Approach to Healing POTS
A functional medicine approach to POTS focuses on identifying and treating the root causes of dysautonomia, rather than simply managing symptoms like rapid heart rate, dizziness, and fatigue. Because POTS affects multiple systems — cardiovascular, neurological, immune, and metabolic — it requires a holistic and personalized strategy, not a one-size-fits-all protocol.
Comprehensive History and Root‑Cause Analysis
Functional medicine begins with an in-depth health history to map triggers, underlying drivers, and symptom patterns. Conventional medicine often struggles with POTS because specialists treat body systems in isolation, but POTS is inherently multi-system. The heart-rate changes are the symptom, not the cause.
Functional Medicine Practitioners who specialize in POTS want to identify underlying factors such as:
- Chronic or recent infections.
- Nutrient deficiencies (iron, vitamin B12, vitamin D, magnesium, etc.).
- Hormonal imbalances (thyroid or adrenal dysfunction).
- Gut dysbiosis and leaky gut.
- Chemical or mould toxin exposure.
- Chronic stress and trauma.
By understanding why the autonomic nervous system is dysregulated, we can build a targeted plan that supports long-term healing and nervous system resiliency.
Determining POTS Subtype Reveals the Root Cause:
The most important first step in a functional medicine treatment plan for POTS is identifying your subtype (Hypovolemic, Hyperadrenergic, Neuropathic, or post-viral/immune-related). Subtype-specific findings may come from:
- 24-hour urine sodium test
- Standing and lying epinephrine levels
- Autonomic function testing and imaging
- Genetic and flexibility assessments
- A functional approach to MCAS when relevant
Knowing your POTS subtype helps match the treatment to the mechanism — not just the symptoms.
Strategic Functional Medicine Testing for POTS
Root-cause labs for POTS focus on metabolic health, inflammation, nutrient status, and immune function, including:
- Basic labs: complete blood count (CBC), comprehensive metabolic panel (CMP), lipid panel, iron studies, thyroid panel, and vitamin D levels.
- Inflammation markers: C‑reactive protein (CRP), Insulin, and homocysteine.
- Hormone and adrenal function tests when indicated.
- Specialty tests (stool analysis, organic acids, mold, heavy metals) only when symptoms or history suggest they will guide treatment.
If budget is a concern, a good functional medicine practitioner will prioritize testing based on budget and clinical impact, not overwhelm you with thousands of dollars in labs on day one.
Why This Matters
Many POTS patients see improvement simply by addressing the foundational pillars of autonomic healing — nutrition, sleep, electrolytes, hydration, nervous system repair, and stress modulation — before advanced testing is ever needed. Specialty testing can be helpful, but it should guide treatment, not replace clinical reasoning.
Personalized Functional Medicine Treatment Plan for POTS
True healing requires personalization. Because every POTS case is driven by different root causes, the most effective path forward is a functional medicine plan tailored to your specific POTS subtype, symptoms, labs, and tolerance level. Working with a qualified Functional Medicine POTS specialist ensures you receive a plan that is both safe and effective — not a one-size-fits-all protocol.
A comprehensive, root-cause functional medicine approach to POTS commonly includes the pillars below:
Hydration & Electrolytes for Holistic POTS Support
For many patients, expanding blood volume is a key step in stabilizing symptoms. This requires more than “drinking extra water.” POTS-focused electrolyte repletion helps maintain proper sodium, potassium, and magnesium balance — supporting circulation, nervous system signaling, and autonomic regulation.
Research shows some patients may require 8–12 grams of salt per day to maintain adequate blood volume (21). This should always be guided by a practitioner who understands functional medicine for POTS, as electrolyte needs vary based on subtype and labs.
Dietary Strategies for a Functional Medicine Approach to POTS
Nutrition is foundational in reducing inflammation, repairing tissue, and stabilizing autonomic function. For some individuals — especially those with histamine intolerance or MCAS-driven POTS — a low-histamine phase can reduce symptom flares while deeper healing takes place. If you’re constantly ‘overflowing your histamine bucket,’ this can slow POTS healing. A low-histamine approach helps to calm the histamine reaction.
Focus on:
- High-protein, nutrient-dense meals (for tissue repair and blood sugar stability)
- Colorful vegetables, organic fruits, and anti-inflammatory fats
- Identifying and eliminating inflammatory triggers
- Balancing blood sugar, which is essential for nervous system stability
- Fresh, whole foods; avoiding preserved or aged foods if histamine issues are a concern
Because many gut-healing “superfoods” are also high in histamine, it’s important to work with someone who understands the POTS–histamine–gut connection and can time interventions appropriately. Healing the gut is a key pillar in addressing dysautonomia, but this must be done strategically to avoid worsening POTS symptoms.
Gut Repair for Root-Cause POTS Healing
Up to 70% of the immune system lives in the gut, which is why dysautonomia and gastrointestinal dysfunction so often coexist. Dysbiosis, leaky gut, and mast-cell activation frequently amplify POTS symptoms — and restoring gut integrity can dramatically improve resilience, inflammation, and autonomic balance.
Correct sequencing matters here. When and how you heal the gut depends on your subtype and histamine tolerance — which is why guided functional POTS care is essential.
Stress Reduction & Nervous System Rehabilitation
Research shows that improving nervous system signalling can reduce POTS flares. This can be acheived by improving Heart rate variability (HRV), and calm MCAS-related symptoms (22, 23, 24). Because dysautonomia is ultimately a nervous system disorder, incorporating daily nervous system-strengthening strategies is a must for holistic POTS healing
Support vagal tone and autonomic balance with practices such as:
- Resonance or slow diaphragmatic breathing
- Meditation or prayer
- Humming or gargling to stimulate the vagus nerve
- EFT (tapping) for limbic system calming
- Gentle somatic work
Targeted Supplementation for POTS (Personalized to Your Root Cause)
Supplement plans must be personalized — and should be guided by functional lab interpretation. Common supportive nutrients include:
- Methylated B-complex, magnesium glycinate, vitamins A, D, and K to restore nutritional foundations
- Omega-3 fatty acids, choline, antioxidants, and anti-inflammatory nutrients to enhance nerve health and function
- Antiviral, immune-modulating, or antihistamine botanicals, when appropriate, to address the underlying root cause and mediators of POTS
Because POTS is highly individual, your personalized strategy will depend on your particular POTS subtype. Supplements should never be taken blindly. Working with a practitioner trained in functional medicine treatment for POTS will help you avoid wasting money or worsening symptoms.
Movement & Physical Therapy to Rebuild Autonomic Strength in POTS
Movement is one of the most effective — and most overlooked — POTS therapies. While this might feel impossible given the dizziness and lightheadedness, starting small and increasing gradually will drastically improve POTS symptoms, graded exercise retrains autonomic pathways, strengthens connective tissue, and improves cardiovascular function and muscle tone to reduce blood pooling.
Programs like the Levine Protocol and CHOP Protocol were developed specifically for POTS and can significantly improve tolerance and stamina (21). Compression garments, recumbent exercise, and slow, consistent progress are key.
Making Functional Medicine for POTS Accessible
Functional medicine requires an investment, but it should not break the bank. Many insurance plans do not cover comprehensive root‑cause care, so practitioners often operate on a cash‑based model. Many people living with POTS are unable to work full-time, which makes it challenging to receive appropriate functional care for POTS and dysautonomia.
Functional Medicine for POTS: Fair Pricing and Transparency
I’ve put together a guide to help make choosing a functional medicine practitioner to help guide your POTS-healing journey easy, ethical, and affordable.
Ethical Testing Practices
Beware of providers who insist on $1,000+ in specialty labs before your first appointment or claim they need “every test” to be thorough. An ethical practitioner should clearly explain what each test will reveal, how it will change your plan, and be able to help you make meaningful progress without advanced testing if your budget is tight.
Likewise, it’s important to understand that there is no single diagnostic biomarker or specialty functional test that can diagnose POTS. The validated criteria for POTS are the ones listed above (heart rate response, autonomic testing, and subtype-specific markers). While functional medicine labs can uncover underlying contributors—such as mold toxicity, gut dysbiosis, mitochondrial dysfunction, or histamine intolerance/MCAS—these tests are not diagnostic for POTS itself.
Instead, functional labs should be used strategically, only when:
- A patient specifically requests a deeper investigation, or
- Foundational interventions (hydration, electrolytes, gut repair, nervous system regulation, nutrient optimization, etc.) do not result in significant improvement.
Functional tests can be incredibly helpful for uncovering root-cause mediators, but they should never be the first step or used as a financial gateway to care. The goal of ethical, root-cause functional medicine for POTS is to start with the basics, stabilize the body, and then test with intention — not overwhelm you or your wallet.
Bottom Line for Choosing the Right Functional Medicine Practitioner for POTS
Many POTS patients experience real improvement using foundational strategies — hydration, electrolytes, nervous system support, nutrition, gut repair, and targeted supplements — before specialty testing is ever needed. If a practitioner cannot help you make progress with basic labs and symptom-focused care, they likely do not fully understand the complex overlap between POTS, MCAS, gut dysfunction, inflammation, and autonomic imbalance.
The Path Forward: Healing POTS with a Root-Cause Functional Medicine Approach
Recovering from POTS is not a quick or one-size-fits-all journey — it requires a comprehensive evaluation and a personalized plan that addresses the underlying drivers of autonomic dysfunction. A functional medicine approach to POTS offers a path toward meaningful symptom improvement and a better quality of life by identifying your specific POTS subtype and supporting the nervous system, immune system, circulation, and metabolic health.
With rising awareness of post-COVID POTS and growing research linking dysautonomia to connective-tissue disorders and mast cell activation, we now have clearer avenues for treatment than ever before. A root-cause approach to POTS allows us to move beyond symptom suppression and work toward true healing.
If you are experiencing dizziness, rapid heart rate upon standing, chronic fatigue, or other symptoms that align with dysautonomia, now is the time to take action. With the proper support, many individuals can regain stability, rebuild resilience, and reclaim their vitality. Functional medicine for POTS can help you move from managing day-to-day survival to restoring long-term wellness — especially when you have a practitioner who understands how to connect the dots.
Book a Free Consultation To Outline Your Holistic POTS Protocol
If you’re experiencing unexplained dizziness, rapid heartbeat, fatigue, or brain fog – or you’ve been diagnosed with POTS or dysautonomia – functional medicine offers a holistic path to healing. Working with a practitioner who understands root‑cause medicine can help you uncover underlying triggers and restore balance.
Schedule your free 15‑minute consultation today to learn how we can tailor care to your unique needs. We’ll discuss your health history, explore potential underlying causes, and outline a plan to get you feeling better. We can meet in person in Marietta, GA, or virtually to get started. Click the button below to book a call and take the first step toward reclaiming your health.
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