A healthcare professional monitors a patient's vital signs during a biofeedback session for treating POTS.

Treatments for POTS: Comprehensive Guide to Managing Symptoms

Postural Orthostatic Tachycardia Syndrome (POTS) is a form of autonomic nervous system dysfunction that causes symptoms such as rapid heart rate, dizziness, fatigue, brain fog, and exercise intolerance when standing upright.

For many people, POTS can make everyday activities feel exhausting and unpredictable. But while there is currently no cure for POTS, a combination of lifestyle changes, exercise therapy, hydration, medications, and supportive treatments can significantly improve symptoms and quality of life.

Key Takeaways:

  • The best treatment for POTS often includes a combination of hydration, increased sodium intake, exercise therapy, compression garments, and symptom management strategies.
  • Medications like midodrine, beta blockers, fludrocortisone, and ivabradine may help manage symptoms for some people with POTS.
  • Identifying triggers such as dehydration, heat, stress, illness, and lack of sleep can help reduce POTS flare-ups and improve daily functioning.
  • Many people with POTS improve their quality of life with individualized treatment plans and long-term lifestyle support.

We’ll explore evidence-based treatment options for POTS, including lifestyle strategies, medications, compression therapy, exercise programs, and emerging approaches used to manage symptoms long term.

Table of Contents

What is POTS?

But first thing’s first. If you're not familiar with POTS, it stands for Postural Orthostatic Tachycardia Syndrome, a condition that affects the autonomic nervous system. When someone with POTS stands up, their heart rate increases rapidly, and they may experience a range of symptoms like dizziness, fatigue, and brain fog just to name a few.

Are you new to POTS? Find out more about this condition in our comprehensive guide to Postural Orthostatic Tachycardia Syndrome (POTS).

Types of POTS

Researchers now recognize that POTS is not a single condition but a syndrome with several possible underlying mechanisms. Understanding the subtype of POTS a person has may help guide treatment decisions.

Neuropathic POTS

Neuropathic POTS is linked to problems with the nerves that control blood vessel constriction, especially in the legs and abdomen. Blood pooling and poor circulation often contribute to dizziness and fatigue.¹

Hyperadrenergic POTS

Hyperadrenergic POTS involves increased sympathetic nervous system activity and elevated stress hormones such as norepinephrine. Symptoms may include tremors, anxiety, palpitations, and elevated blood pressure when standing.

Hypovolemic POTS

People with hypovolemic POTS tend to have low blood volume, which can worsen orthostatic intolerance and fatigue.

Post-Viral or Long COVID POTS

Some cases of POTS develop after viral infections, including COVID-19. Researchers continue to study how inflammation and autonomic nervous system dysfunction contribute to post-viral POTS symptoms.

What Is the Best Treatment for POTS?

There is no single “best” treatment for POTS because the condition affects each person differently. 

The most effective treatment plan is usually a combination of lifestyle changes, exercise therapy, hydration, compression therapy, and medications tailored to individual symptoms. For many people with POTS, treatment begins with:

  • Increasing fluid intake²
  • Adding more sodium to support blood volume²
  • Wearing compression garments²
  • Following a gradual exercise program²
  • Improving sleep quality and stress management²

Some patients may also benefit from medications such as midodrine, beta blockers, fludrocortisone, or ivabradine under the guidance of a healthcare provider.

The most effective POTS treatment plans are highly individualized and may evolve over time depending on symptoms, triggers, and coexisting conditions such as hypermobile Ehlers-Danlos syndrome (hEDS), migraines, autoimmune disorders, or long COVID.

While there is currently no cure for POTS, many people see significant improvement in symptoms and quality of life with consistent treatment and support.

What Causes POTS Flare-Ups?

Many people with POTS notice that symptoms fluctuate from day to day. Certain triggers can worsen dizziness, fatigue, tachycardia, brain fog, and fainting episodes. Common POTS flare-up triggers include:

  • Dehydration³
  • Hot weather or hot showers³
  • Standing for long periods³
  • Illness or viral infections³
  • Lack of sleep³
  • Stress and anxiety³
  • Menstrual cycle changes³
  • Intense exercise³
  • Skipping meals³ (explore POTS-friendly foods)
  • Alcohol consumption
  • Large high-carbohydrate meals

Learning to identify personal triggers is an important part of long-term symptom management. Many people find symptom-tracking apps or journals helpful for recognizing patterns and preventing flare-ups before they become severe.

During symptom flares, increasing fluids and electrolytes, wearing compression garments, resting, and avoiding overheating may help reduce symptom intensity.

Lifestyle and Non-Medication Treatments for POTS

Lifestyle changes are considered one of the most effective first-line treatments for POTS. For many people, improving hydration, increasing sodium intake, exercising consistently, and reducing symptom triggers can significantly improve daily functioning and quality of life.

Hydration and Increased Sodium Intake

Many people with POTS have low blood volume, which can worsen dizziness, fatigue, rapid heart rate, and fainting symptoms. 

Healthcare providers often recommend increasing both fluids and sodium to help improve circulation and support blood pressure regulation. Helpful strategies may include:

  • Drinking electrolyte-rich fluids throughout the day.
  • Increasing sodium intake under medical supervision.
  • Avoiding dehydration, alcohol, and excessive caffeine.
  • Eating smaller, balanced meals to reduce symptom flare-ups.

Exercise and Physical Therapy

Although exercise can feel difficult with POTS, gradual physical activity is one of the most evidence-supported treatments for improving symptoms over time.

Many providers recommend starting with reclined or low-impact exercises such as:

  • Recumbent biking
  • Swimming
  • Rowing
  • Gentle yoga

Physical therapy programs focused on cardiovascular conditioning and lower-body strength may help improve circulation, exercise tolerance, and autonomic nervous system regulation.

Compression Garments

Compression stockings, abdominal binders, and compression leggings may help reduce blood pooling in the legs and improve blood flow back to the heart. Many people experience improvements in dizziness, fatigue, and standing tolerance when wearing compression garments consistently.⁶

Sleep and Daily Symptom Management

POTS symptoms often worsen with poor sleep, illness, stress, overheating, or prolonged standing. Maintaining a consistent sleep schedule, pacing activities, and identifying symptom triggers can help reduce flare-ups and support long-term symptom management.⁷

Because POTS affects each person differently, treatment plans are often individualized and may combine several lifestyle strategies together.

Medications Used to Treat POTS

Lifestyle strategies are considered the foundation of POTS treatment, but some people may also need medications to help manage symptoms. Since POTS affects the autonomic nervous system in different ways, medications are often selected based on a person’s primary symptoms and subtype.

Medications That May Help Increase Blood Volume

Some people with POTS have low blood volume (hypovolemic POTS), which can worsen dizziness, fatigue, and rapid heart rate. Healthcare providers may prescribe:

  • Fludrocortisone: Helps the body retain sodium and fluid⁴
  • Desmopressin: May temporarily increase blood volume in certain patients⁴

These medications are typically used alongside increased fluid and sodium intake.

Medications That Help Improve Blood Vessel Constriction

Blood pooling in the legs and abdomen is common in POTS. Medications that improve vascular tone may help reduce dizziness and lightheadedness when standing. These include:

  • Midodrine: A commonly prescribed medication that helps tighten blood vessels and improve circulation⁴
  • Droxidopa: Sometimes used in patients with severe orthostatic intolerance⁴

Medications That Help Slow Heart Rate

Some people experience severe tachycardia (rapid heart rate), palpitations, or exercise intolerance. Medications that help regulate heart rate may improve symptoms and quality of life. Examples include:

  • Beta blockers such as propranolol or bisoprolol⁴
  • Ivabradine, which may help reduce heart rate without lowering blood pressure⁴
  • Pyridostigmine, which can support autonomic nervous system regulation⁴

Because POTS symptoms vary widely, medication plans should always be individualized and monitored by a healthcare provider familiar with autonomic disorders.

Complementary Treatments for POTS

Some people with POTS find additional symptom relief from complementary therapies like yoga⁵, meditation, breathing exercises, and biofeedback. Electrolytes may also help support hydration and circulation. While research is still limited, these approaches may help reduce stress and support nervous system regulation when used alongside medical treatment and lifestyle changes.

Dietary supplements like electrolytes, vitamins, and minerals may help alleviate symptoms and improve overall health.

Buoy wellness supplements and skincare products

Managing Coexisting Conditions

Many people with POTS also have related conditions such as autoimmune disorders, hypermobile Ehlers-Danlos syndrome (hEDS), migraines, anxiety, or chronic fatigue.⁸ 

Managing these conditions alongside POTS is often an important part of improving symptoms and quality of life. Working with a healthcare team that understands autonomic disorders⁹, physical health, and mental health can help support a more comprehensive treatment plan.

Building a Comprehensive Treatment Plan

Managing POTS effectively requires a multidisciplinary approach. Building a team of healthcare providers who understand your condition and work collaboratively is essential. Your team may include a primary care physician, cardiologist, neurologist, physical therapist, occupational therapist, and mental health professional.

Finding the Right Treatment Plan for You

Remember, there is no one-size-fits-all approach to treating POTS. The most effective treatments for POTS will vary from person to person, depending on the severity of their symptoms, underlying causes, and coexisting conditions.

That's why it's so important to work closely with your healthcare team to develop a personalized treatment plan that addresses your unique needs

Working with Your Healthcare Team

Together, you and your healthcare team can create a personalized treatment plan that addresses your unique needs and goals. Regularly assess your progress and make adjustments as needed. Remember, managing POTS is a journey, and it's okay to take it one step at a time.

Can You Live a Normal Life With POTS?

Although POTS can significantly impact daily life, many people improve over time with consistent treatment and symptom management strategies.

Recovery often involves learning how to balance activity, hydration, nutrition, stress management, and rest. Some people experience periods of remission, while others continue to manage symptoms long term.

Working with healthcare providers who understand autonomic disorders can make a major difference. Physical therapists, cardiologists, neurologists, dietitians, and mental health professionals may all play a role in comprehensive POTS care.

Support groups, symptom tracking, and individualized treatment plans can also help people regain independence and improve quality of life.

How Buoy Rescue Drops Can Support Treatment for POTS

Staying properly hydrated is an important part of managing POTS symptoms. Buoy Rescue Drops provide electrolytes and trace minerals that can help support hydration, circulation, and daily fluid balance.

Buoy Rescue Drops

Just one squeeze of Buoy Rescue Drops provides more electrolytes than a sports drink, making it an effective solution for managing POTS symptoms. Use 4-7 times daily for best results.

References:

¹ Bryarly, M., Phillips, L. T., Fu, Q., et al. (2019). Postural Orthostatic Tachycardia Syndrome: JACC Focus Seminar.Journal of the American College of Cardiology, 73(10), 1207–1228. Retrieved from https://www.jacc.org/doi/10.1016/j.jacc.2018.11.059

² Raj, S. R., Guzman, J. C., Harvey, P., et al. (2020). Canadian Cardiovascular Society Position Statement on Postural Orthostatic Tachycardia Syndrome (POTS) and Related Disorders. Canadian Journal of Cardiology, 36(3), 357–372. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8920526/

³ Garland, E. M., Celedonio, J. E., & Raj, S. R. (2015). Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance.Current Neurology and Neuroscience Reports, 15(9), 60. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC1501099/

⁴ Wells, R., Spurrier, A. J., Linz, D., et al. (2018). Postural Tachycardia Syndrome: Current Perspectives. Vascular Health and Risk Management, 14, 1–11. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC11472415/

⁵ Fu, Q., & Levine, B. D. (2018). Exercise and Non-Pharmacological Treatment of POTS. Autonomic Neuroscience: Basic & Clinical, 215, 20–27. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289756/

⁶ Bourne, K. M., Sheldon, R. S., Hall, J., et al. (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/

⁷ Bagai, K., Song, Y., Ling, J. F., et al. (2011). Sleep Disturbances and Diminished Quality of Life in Postural Tachycardia Syndrome. Journal of Clinical Sleep Medicine, 7(2), 204–210. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3077350/

⁸ Grigoriou, E., Boris, J. R., & Dormans, J. P. (2015). Postural Orthostatic Tachycardia Syndrome (POTS): Association with Ehlers-Danlos Syndrome and Orthopaedic Considerations. Clinical Orthopaedics and Related Research, 473(2), 722–728. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4294907/

⁹ Li, H., Yu, X., Liles, C., et al. (2014). Autoimmune Basis for Postural Tachycardia Syndrome. Journal of the American Heart Association, 3(1), e000755. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24572257/

Back to blog