Postural Orthostatic Tachycardia Syndrome (POTS)

Q Can herbal medicine and rehabilitation really get me back to living normally like before? Please be honest.

A. Symptoms won't vanish overnight, but building the force that supports circulation while consistently doing rehabilitation often leads to recovery to a level where daily life is possible. This is especially true for cases that develop after infection, which tend to improve over time.

Q Tests show no clear disease, so how can Korean Medicine treat these symptoms of unknown cause?

A. Rather than looking for a specific disease name, Korean Medicine examines where the autonomic balance that evenly regulates circulation and heart rate during postural changes has broken down. This allows an approach tailored to the body's condition even in POTS, where tests show no clear disease.

Q Along with POTS, I also have chronic fatigue, indigestion, and cold hands and feet. Can these improve together too?

A. These symptoms often arise together from the same root — disrupted autonomic regulation and depleted energy/fluids — so treating the root cause often relieves them together. Rather than suppressing each one separately, an approach that balances circulation and autonomic regulation tends to be effective.

Q What should I do to manage POTS at home? I keep lying down because the symptoms scare me.

A. Getting enough fluids and salt, wearing compression stockings, and avoiding sudden standing are the basics, but constantly lying down actually worsens the condition, so it is important to gradually increase lower-body exercise. Avoiding sudden standing and gradual activity are the two pillars of management.

Q They tell me to exercise, but even standing is hard. How am I supposed to exercise?

A. Start with exercises done lying or sitting down (swimming, recumbent cycling, lower-body strength training) to reduce cardiac strain, then gradually increase intensity over several weeks. Gradual exercise rehabilitation is a key part of POTS treatment.

Q My heart is already in a sensitive state — will taking herbal medicine long-term put strain on my heart?

A. Herbal medicine prescribed according to your constitution and condition is not medication that forcibly stimulates the heart rate, and it does not build tolerance. However, since your heart rate and blood pressure are sensitive, it is safest to adjust the prescription through regular visits based on how you respond.

Q My palpitations and dizziness are severe — in what cases should I urgently get a cardiology evaluation?

A. If you experience fainting (loss of consciousness), chest pain, severe persistent arrhythmia or irregular pulse even at rest, or shortness of breath, you should get a cardiology evaluation without delay. These may signal something beyond simple POTS, such as arrhythmia or heart disease.

Q I'm taking a heart rate medication (beta-blocker). Is it okay to take herbal medicine alongside it?

A. In most cases, herbal medicine can be taken alongside your current medications, but you must always disclose any medication affecting heart rate or blood pressure so it can be prescribed safely alongside it. Do not stop such medications on your own — any overlap is adjusted during treatment.

Q How long after starting treatment and rehabilitation before I can return to daily life?

A. POTS that develops after infection often improves gradually over several months, while cases with a constitutional or autonomic nervous system background usually require consistent management for several months or longer. Recovery is faster and more stable when combined with fluid intake and exercise rehabilitation.

Q I can't even go to school properly because of my symptoms, and my head is too foggy to concentrate. Will I be able to study like before?

A. The brain fog and fatigue of POTS are very difficult, but they often recover together as circulation stabilizes. Building the force that supports circulation while managing activity without overexertion can gradually restore concentration and daily function.

Q The moment I stand up my heart races, I feel dizzy, and my head goes foggy. What is Postural Orthostatic Tachycardia Syndrome (POTS)?

A. Postural Orthostatic Tachycardia Syndrome (POTS) is a condition where blood pressure stays stable when you stand up from lying down, but your heart rate rises abnormally fast (30+ beats per minute in adults, or over 120 bpm), along with dizziness, palpitations, a faint feeling, fatigue, and brain fog. It is common in young women.

Q I'm a 20-year-old university student and these symptoms started after having COVID. Why does this happen so often in young women?

A. POTS is most common in young women, and often begins after a viral infection or major stress disrupts the balance of the autonomic nervous system. It also tends to appear in people with relatively low blood volume or after prolonged bed rest.

Q I've been told to eat lots of water and salt, but cut down on coffee. Does diet really matter this much for POTS?

A. Increasing fluid and salt intake is a key management step that expands blood volume and reduces POTS symptoms, while excessive caffeine can further stimulate the heart and worsen palpitations. Dietary management is a major pillar of POTS treatment.

Q My symptoms get much worse on hot days, when standing for a long time, and around my period. Why is that?

A. Heat, prolonged standing, menstruation, and overeating all worsen POTS by pooling blood in the lower body or digestive system, or by causing dehydration. Knowing these triggers in advance and preparing with hydration and posture management can reduce symptoms.

Q I want to manage my POTS while attending school/work in Incheon Dong-gu, but it's hard to find time during the day.

A. POTS treatment is generally managed through regular visits every 2-4 weeks to monitor progress. Appointment times and herbal medicine dosing can be coordinated around your school or work schedule, so we recommend booking ahead to be seen without waiting.

Q What stages does POTS treatment go through?

A. First, pulse diagnosis and consultation, along with ruling out dangerous causes, set the direction. Then treatment proceeds by replenishing depleted energy and fluids → balancing the organs → evenly restoring disrupted circulation and autonomic regulation → consolidating recovery. Emphasis on circulatory and autonomic balance varies by individual condition.

Q Can herbal medicine really help with POTS? I heard it's an autonomic nervous system problem — can Korean Medicine actually help?

A. Herbal treatment is an approach that replenishes depleted energy and fluids and rebalances circulation so autonomic regulation becomes less disrupted. However, it is most effective when combined with standard management such as increased fluid and salt intake and exercise rehabilitation.

Q My heart tests and thyroid are all normal, but my heart races and I feel dizzy just from standing up. It doesn't show up on tests — can Korean Medicine still help?

A. Normal test results are a good sign that dangerous causes like arrhythmia or thyroid disease have been ruled out. POTS, where circulation regulation by the autonomic nervous system is disrupted without any structural abnormality, is an area where Korean Medicine treatment, which regulates the body's overall circulatory balance, tends to show its strengths.