The upright posture presents the circulatory system with physiological challenges, figuring out how to move blood from the legs against gravity all the way up to the all-important brain. How can the body move blood up the legs against gravity when standing and walking? Returning blood from the legs back to the heart and brain is an even greater challenge, especially among those with POTS.

When upright, POTS patients experience reduced oxygenation of the brain.  This brain anoxia (reduced oxygenation) can be associated with an assortment of clinical symptoms including headaches, visual disturbances, confusion, dizziness, weakness and fatigue.  Those with more severe brain anoxia when upright experience difficulty concentrating or “brain fog” and even short-term memory loss. “Brain fog” consists of difficulty thinking, focusing, communicating, confusion and being forgetful.

As a result of the cognitive impairment or brain fog, POTS patients experience significant functional limitations. Activities associated with daily living may become severely limited. Thus, schoolwork, productivity, shopping and quality of life deteriorate. Academic, vocational and economic advancements suffer. Social activities like dating, attending theater, concerts and sporting events become unworkable.

Normal complex biologic processes (automatic bodily functions) have the responsibility to return blood from the lower body to critical organs like the heart and brain. When not functioning properly, as occurs in POTS patients, excessive blood accumulates in the lower abdomen and lower limbs rather than immediately returning to the heart to recirculate.

For most POTS patients, treatment consists of behavioral changes: increasing salt, fluids, muscular strength and exercise. POWER over POTS provides guidance for designing a personalized program to “Take Back Your Life.”

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