Living with POTS: Understanding Symptoms and Finding Root Causes

If you’ve ever stood up and suddenly felt dizzy, lightheaded, or like your heart was racing out of control, you know how unsettling that moment can be. For people living with Postural Orthostatic Tachycardia Syndrome (commonly known as POTS), that feeling isn’t occasional; it can be a daily struggle.

POTS is often confusing, frustrating, and deeply misunderstood. Many patients are told their test results look “normal,” or worse, that anxiety may be to blame. Yet the symptoms are very real and can be life-altering.

At Atlas Specific Upper Cervical Care, we believe that when symptoms don’t make sense on the surface, it’s time to look deeper, especially at how the nervous system is functioning and what may be interfering with the body’s ability to adapt.

What Is POTS?

POTS is a form of dysautonomia, meaning it involves dysfunction of the autonomic nervous system, the system responsible for regulating automatic processes such as heart rate, blood pressure, digestion, circulation, and temperature regulation.

In people with POTS, standing up triggers an abnormal response. Instead of smoothly adjusting blood flow to keep the brain well-supplied, the body struggles to adapt. Blood may pool in the lower body, heart rate increases rapidly, and symptoms appear.

Put simply: When blood doesn’t reach the brain efficiently after standing, the body compensates, and that compensation can feel overwhelming.

Common Symptoms of POTS

While dizziness upon standing is the hallmark symptom, POTS often affects more than just balance. Symptoms can vary widely from person to person and may include:

• Lightheadedness or fainting

• Rapid heart rate or heart palpitations

• Fatigue that doesn’t improve with rest

• Brain fog or difficulty concentrating

• Headaches or migraines

• Digestive issues such as bloating, nausea, or constipation

• Shortness of breath

• Exercise intolerance

• Cold hands and feet or color changes in the legs when standing

• Sleep disturbances

• Anxiety-like sensations that don’t respond to stress management alone

Because many of these symptoms overlap with anxiety or panic disorders, POTS is frequently misdiagnosed, leaving patients feeling dismissed or unheard.

The Role of the Autonomic Nervous System

The autonomic nervous system is responsible for helping the body adapt to change without you having to think about it. It quietly regulates essential functions such as heart rate, blood pressure, circulation, and muscle tone throughout the day.

When you stand up, your body has to respond quickly. Blood vessels tighten to prevent blood from pooling in the lower body, the heart rate adjusts to maintain circulation to the brain, muscles engage for stability, and blood pressure stabilizes to keep you upright and alert.

When the autonomic nervous system isn’t communicating efficiently, these adjustments don’t happen smoothly. As a result, symptoms may appear or worsen when standing and often improve when sitting or lying back down, a pattern known as orthostatic intolerance.

It’s important to understand that this response is not a personal failing, a lack of fitness, or “just anxiety.” It reflects a disruption in neurological regulation, which is how the nervous system coordinates and adapts to everyday physical demands.

Who Is Most Affected by POTS?

POTS can affect anyone, but it is most commonly seen in:

• Women in their teens, twenties, and thirties

• Adolescents, particularly during periods of rapid growth

• Individuals recovering from infections, surgery, trauma, pregnancy, or significant stress

Many people with POTS appear outwardly healthy, yet internally feel limited in their ability to function day to day. In more severe cases, symptoms can interfere with work, school, and basic activities of daily living.

How Is POTS Diagnosed?

POTS is diagnosed by a doctor based on how the heart rate responds to changes in posture. In adults, a diagnosis is typically considered when the heart rate increases by 30 beats per minute or more within 10 minutes of standing, without a corresponding drop in blood pressure. In adolescents and teenagers, the threshold is higher, with a 40-beat-per-minute increase used as the diagnostic threshold.

One of the most well-known diagnostic tools is the tilt table test, often considered the gold standard. During this test, the patient lies on a specialized table that gradually tilts upright while heart rate and blood pressure are closely monitored. This controlled environment allows clinicians to observe how the body responds to positional changes without the influence of movement or muscle engagement.

In many cases, POTS can also be identified using a simpler active stand test, which is commonly performed in a clinical setting. This test involves measuring heart rate and blood pressure while lying down and then again after standing. Although less formal than a tilt table test, it can still provide valuable insight into how the autonomic nervous system responds.

Because POTS symptoms can overlap with other conditions, doctors often perform additional rule-out testing to ensure there are no underlying causes contributing to symptoms. This may include blood or urine tests, an electrocardiogram (ECG), or an echocardiogram to evaluate heart structure and function.

To avoid misdiagnosis, symptoms generally need to be present for three to six months or longer before a formal POTS diagnosis is made. This timeframe helps distinguish chronic autonomic dysfunction from temporary responses related to illness, dehydration, or acute stress.

Why Symptoms Can Feel “Stuck”

Many people with POTS are told to focus on hydration, salt intake, and exercise, and while these strategies can help, they don’t always address why the nervous system is struggling in the first place. POTS is often associated with underlying stressors such as:

• Previous infections or inflammation

• Autoimmune activity

• Hormonal or metabolic imbalance

• Chronic stress or trauma

• Poor circulation or neurological signaling

• Toxin buildup from chemotherapy, environmental sources, and heavy metals

• Mold infection

When the body remains in a state of imbalance, symptoms may persist despite best efforts. This is where a root-cause approach becomes essential.

The Overlooked Connection: The Upper Cervical Spine

One area that is often overlooked in POTS care is the upper cervical spine, the top two vertebrae of the neck that surround and protect the brainstem. The brainstem plays a critical role in regulating:

• Heart rate

• Blood pressure

• Balance

• Breathing

• Autonomic nervous system function

If the upper cervical spine is misaligned, whether from injury, poor posture, or accumulated stress, it can interfere with the brain-body communication needed for proper autonomic regulation. Standard imaging may not always detect this type of misalignment, yet its effects can be significant.

How Upper Cervical Chiropractic Care May Help

At Atlas Specific, our Upper Cervical Care focuses exclusively on the upper cervical spine using precise, gentle corrections designed to restore proper alignment and reduce interference to the nervous system. This approach does not treat POTS directly. Instead, it supports the body by:

• Reducing stress on the brainstem

• Improving nervous system communication

• Supporting better balance, circulation, and adaptability

For some patients, this can help the nervous system respond more efficiently to positional changes, especially when symptoms have been resistant to other approaches.

If you’re searching for a Durango chiropractor who looks beyond symptom management and considers how structure, neurology, and regulation work together, upper cervical care may be an important piece of the puzzle.

Supporting the Body Along the Way

Managing POTS often requires a multifaceted approach. Many patients benefit from:

• Consistent hydration and electrolyte balance

• Thoughtful movement and gradual reconditioning

• Nervous system regulation and rest

• Identifying and reducing underlying stressors

Healing rarely happens all at once. Progress is often measured in small, meaningful improvements.

You’re Not Alone, and You’re Not Imagining This

Living with POTS can be overwhelming, especially when answers are slow to come. But persistent symptoms are not a personal failure; they’re a sign that the body needs support, not dismissal.

At Atlas Specific, as your trusted Durango chiropractor, we strive to help patients explore potential root causes behind chronic, unresolved symptoms and support the body’s natural ability to heal and regulate.

If you’ve been told “everything looks fine,” but you don’t feel fine, it may be time to look deeper. Schedule a free consultation with the link below, stop by our Durango Office, or call us at 970.259.6803

Notice of Disclaimer:

We are doctors of upper cervical chiropractic, but we are NOT necessarily YOUR doctors. All content and information on this website is for informational and educational purposes only, does not constitute medical advice, and reading or interacting with this site does not establish any form of patient-doctor relationship. Although we strive to provide accurate information, the information presented here is not intended as a substitute for any kind of professional advice and you should not rely solely on this information. Always consult a professional in your particular area of need before making medical decisions.