Supportive Therapies for Postural Orthostatic Tachycardia Syndrome

Managing POTS often requires a multi-faceted approach that goes beyond medication. For many patients, postural orthostatic tachycardia syndrome supportive therapy can play an important role in alleviating symptoms, enhancing quality of life, and reducing the impact of POTS on daily activities.

Since POTS symptoms can be different for everyone, non-pharmacological therapies can be personalized to address the unique challenges of each individual, giving you the tools you need for better symptom control and overall well-being.

Essential Takeaways:

• Supportive Therapies Can Improve Quality of Life with POTS: Managing POTS requires a comprehensive approach, and supportive therapies play a key role in improving quality of life. These non-pharmacological therapies target symptoms holistically, helping patients better cope with daily challenges and reduce the impact of POTS on their overall well-being.

 

• Consistency is Key in Non-Pharmacological POTS Management: For effective POTS symptom relief, consistency in supportive therapies like staying hydrated, wearing compression garments, and engaging in gentle exercises is crucial. Regularly practicing these lifestyle adjustments can lead to gradual, long-term improvements in blood flow, energy levels, and symptom management, empowering patients to take proactive control of their health.

In this guide, we’ll explore the most effective non-pharmacological POTS treatment approaches, from physical and cognitive therapies to lifestyle changes that can help stabilize blood pressure, improve circulation, and ease symptoms like dizziness, fatigue, and anxiety.

• What Are Supportive Therapies for POTS?
• Physical Therapy and Exercise for POTS Management
• Hydration and Nutrition as Supportive Therapies
• Compression Garments for Blood Flow
• Cognitive Behavioral Therapy (CBT) for POTS Patients
• Breathing Exercises and Relaxation Techniques
• Enhancing POTS Management with Supportive Therapies

What Are Supportive Therapies for POTS?

Supportive therapies for POTS include a range of non-medication strategies designed to alleviate symptoms and improve physical and mental health.

While medication can help manage certain aspects of POTS, supportive therapies provide additional tools that address the syndrome’s underlying challenges, such as blood flow, nervous system balance, and stress management.¹

Understanding Non-Pharmacological Approaches

Managing POTS with therapy goes beyond traditional medical treatments. POTS supportive therapies can include physical conditioning, hydration strategies, compression therapy, and mental health support.

These evidence-based approaches help address both the physical and emotional aspects of living with POTS.

How Supportive Therapies Are Used to Treat POTS

These therapies are often used in conjunction with medical treatment, forming a comprehensive approach that empowers patients to take an active role in their symptom management.

Here’s what supportive therapies can do:

• Improve physical endurance and circulation.

• Reduce orthostatic intolerance symptoms.

• Manage stress and emotional well-being.

• Stabilize blood pressure and heart rate.

• Increase overall quality of life.¹ ²

Let’s take a look at specific supportive therapies and how they can be added to your POTS management plan.

Physical Therapy and Exercise for POTS Management

Physical therapy is one of the most commonly recommended non-pharmacological POTS treatments, offering a way to gradually build strength and stamina, helping you feel more resilient over time.

A structured, gradual exercise regimen can help strengthen the heart, improve circulation, and increase muscle tone—all of which are beneficial for POTS patients who struggle with blood pooling and low blood volume when standing.² ³ ⁴

Benefits of Physical Therapy for POTS

Some benefits of physical therapy for treating POTS symptoms include:

• Improved Circulation: Strong leg muscles help pump blood back to the heart, reducing pooling in the legs.

• Enhanced Stamina: A gradual increase in exercise intensity over time can build endurance and reduce fatigue.

• Increased Muscle Tone: Strengthening muscles helps support blood flow and maintains stability during position changes, such as from sitting to standing.

With consistent physical therapy and tailored exercise, POTS patients can experience significant improvements in circulation, muscle strength, and stamina, making it easier to manage daily activities.² ³

These physical benefits go beyond symptom relief, often contributing to a greater sense of control and empowerment while managing POTS, supporting a healthier, more resilient lifestyle.

Learn how to exercise safely with this condition in our guide to Exercise and Physical Therapy with POTS.

Hydration and Nutrition as Supportive Therapies

Maintaining hydration is crucial for people with POTS, as dehydration can worsen symptoms like dizziness, fatigue, and tachycardia. Consistent hydration supports blood volume and stabilizes blood pressure, making it easier for the body to adapt to standing.²

How to Stay Hydrated with POTS

Here are some tips for staying hydrated with POTS:

• Drink Water Throughout the Day: Aim for at least 8-12 cups of water and other fluids per day. Drink more in hot weather or during physical activity.

• Balance Your Electrolytes: Adding a squeeze of Buoy electrolytes can help you retain fluids and prevent “water flushing,” where you quickly pee out fluids and electrolytes before your body can properly absorb them.

• Enjoy Hydrating Foods: Foods like watermelon, cucumber, oranges, and strawberries add fluids and nutrients.

Hydration is a continuous process, and it’s more important to be consistent rather than drinking occasional large amounts of fluids. By drinking regularly and balancing electrolytes, you can maintain steady hydration levels throughout the day, supporting better blood volume and stability in managing your POTS symptoms.² ⁵ ⁶

Staying hydrated can be a daily challenge with POTS, but with a few adjustments, you can keep your fluid levels steady and feel more in control.

Dietary Tips to Support POTS Management

Getting a balanced diet with adequate salt intake is also essential for managing POTS symptoms. Why is salt so beneficial for those with POTS? Salt helps retain fluids and increases blood volume, which can alleviate dizziness and other symptoms.

Some nutrient-dense, POTS-friendly foods include:

• Salt Snacks: Tasty foods like pickles, pretzels, salted nuts, and other sodium-rich snacks make it easier to get enough salt.

• Complex Carbohydrates: Whole grains and vegetables help you stay energized and prevent blood sugar crashes.

• High-Protein Foods: Protein-rich foods also support sustained energy and muscle health.

Incorporating sodium, complex carbs, and protein into your diet can give you steady energy, improved blood volume, and symptom relief. While some patients find relief with higher sodium intake, it’s best to consult with a healthcare provider before making dietary changes.¹ ² ⁶

For more guidance on what to eat with POTS, check out our POTS Diet and Nutrition Guide.

Compression Garments for Blood Flow

Compression garments, such as compression socks or abdominal binders, can be valuable tools for managing POTS symptoms.

These garments work by gently compressing the veins in the legs or abdomen, which helps maintain blood flow to the heart and upper body, helping to prevent blood from pooling in the lower body when standing, which can reduce dizziness and fatigue.

Types of Compression Garments

Compression garments come in various styles and strengths, allowing POTS patients to choose the best option for their needs and comfort:

• Compression Socks: These are designed to apply pressure to the calves and ankles, encouraging blood flow back to the heart.
  
  
• Abdominal Binders: These garments apply pressure around the abdomen, helping maintain blood volume in the upper body and reduce symptoms of lightheadedness.
  
  
• Full-Length Compression Wear: For some people with POTS, full-length compression stockings may provide the most effective symptom relief.

Compression garments are particularly useful in the morning when POTS symptoms tend to be more severe due to lower blood volume from overnight fasting. Different types of compression wear can be tailored to your daily routine or symptom severity, providing support when you need it most.² ⁸

Cognitive Behavioral Therapy (CBT) can help POTS patients manage anxiety, depression, and other emotional challenges by providing tools for mental resilience.

Cognitive Behavioral Therapy (CBT) for POTS Patients

Living with POTS can be emotionally challenging, as the syndrome often comes with anxiety, depression, and a reduced quality of life.

Cognitive Behavioral Therapy (CBT) can be an effective supportive therapy to help patients cope with these emotional challenges, improve mental resilience, and even alleviate some physical symptoms.² ⁹

Benefits of CBT for POTS Patients

Here are some of the benefits of CBT for people with POTS:

• Managing Anxiety and Depression: CBT teaches strategies to identify and manage negative thoughts, which can improve your mental health.

• Improving Quality of Life: Learning coping techniques can make daily life with POTS less overwhelming.

• Reducing Somatic Hypervigilance: CBT helps patients manage “somatic hypervigilance,” or a heightened awareness of physical symptoms, which can reduce the frequency or intensity of symptoms.

A therapist trained in CBT can guide you in building a stronger mental framework for coping with POTS-related challenges. Therapy sessions may focus on managing the limitations posed by POTS and helping you adapt to your condition with less mental strain.⁹

Breathing Exercises and Relaxation Techniques

Breathing exercises and relaxation techniques can be beneficial for POTS patients, especially those who experience rapid heart rate, anxiety, and lightheadedness. These practices help regulate the autonomic nervous system, which is often overactive in POTS patients.² ¹⁰

Types of Exercises and Relaxation Techniques

Try these techniques to help manage your POTS symptoms:

• Deep Breathing Exercises: Practicing slow, deep breaths can activate the parasympathetic nervous system, helping reduce heart rate and anxiety.

• Diaphragmatic Breathing: Breathing deeply into the diaphragm, rather than shallow chest breathing, promotes relaxation and improves the flow of oxygen throughout your body, potentially reducing pain and fatigue.

• Yoga and Gentle Stretching: Gentle yoga postures, especially those performed seated or lying down, can improve flexibility, relieve muscle tension, and support blood flow.

• Meditation and Mindfulness: These techniques help cultivate a calm mind and reduce stress, which is essential for overall nervous system health.

• Biofeedback: Biofeedback helps POTS patients observe their body’s response to stress and relaxation techniques in real-time. Sensors connected to the body monitor physiological markers, such as heart rate, muscle tension, and respiration, displayed on the screen. Patients can then practice regulating these responses, reinforcing relaxation and nervous system balance over time.¹⁰

Practicing these techniques consistently can reduce autonomic instability and improve symptoms over time. Apps like Calm or Headspace can be useful resources for beginners.

Enhancing POTS Management with Supportive Therapies

Supportive therapies offer POTS patients an opportunity to manage their symptoms more holistically. Building a supportive routine around these therapies may take time, but every small effort contributes to a healthier, more empowered life with POTS

Finding the Right Supportive Therapies for You

The right postural orthostatic tachycardia syndrome supportive therapy isn’t a one-size-fits-all approach.

If you’ve been struggling to find symptom relief, non-pharmacological POTS treatment options like physical therapy, hydration strategies, and cognitive techniques can give you personalized options to better support your health.

Creating a Supportive Routine for POTS

When developing your POTS treatment options, consider how different supportive therapies can work together. Managing POTS with therapy often requires a personalized combination of approaches, as each person’s experience with POTS is unique.

Discover More About POTS

Want to learn more ways to manage your POTS symptoms? Check out our POTS resource guides to get expert tips, hydration strategies, and comprehensive support for your wellness journey.

References:

1. Cleveland Clinic. (2022). Postural Orthostatic Tachycardia Syndrome (POTS). Retrieved from https://my.clevelandclinic.org/health/diseases/16560-postural-orthostatic-tachycardia-syndrome-pots
   
   
2. Fu, Q. & Levine, B. D. (2018). Exercise and Non-Pharmacological Treatment of POTS. Autonomic Neuroscience: Basic & Clinical, 215, 20–27. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC6289756/

1. Brain & Life. (2023). Why Exercise Is Important for People with POTS. Retrieved from https://www.brainandlife.org/articles/why-exercise-is-important-for-people-with-pots
   
   
2. Johns Hopkins Medicine. (n.d.). Postural Orthostatic Tachycardia Syndrome (POTS). Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/postural-orthostatic-tachycardia-syndrome-pots
   
   
3. Healthline. (2024). 5 Diet Tips for People with POTS. Retrieved from https://www.healthline.com/health/pots-diet#reduce-carbs
   
   
4. EDS Nutrition. Electrolytes for POTS and Dysautonomia: A Comprehensive Guide. Retrieved from https://edsnutrition.com/electrolytes-for-pots-guide/
   
   
5. Bourne, K. M., Sheldon, R. S., Hall, J., Lloyd, M., Kogut, K., Sheikh, N., Jorge, J., Ng, J., Exner, D. V., Tyberg, J. V. & Raj, S. R. (2021). Compression Garment Reduces Orthostatic Tachycardia and Symptoms in Patients With Postural Orthostatic Tachycardia Syndrome. Journal of the American College of Cardiology, 77(3), 285–296. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33478652/
   
   
6. Ralston, T. E. & Kanzler, K. E. (2016). Symptom Discrimination and Habituation: A Case Study of Behavioral Treatment for Postural Orthostatic Tachycardia Syndrome (POTS). Behavioral Medicine (Washington, D.C.), 42(1), 57–62. https://pubmed.ncbi.nlm.nih.gov/25337949/
   
   
7. Raj, V., Opie, M. & Arnold, A. C. (2018). Cognitive and Psychological Issues in Postural Tachycardia Syndrome. Autonomic Neuroscience: Basic & Clinical, 215, 46–55. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC6160364/