Heart & Circulation
Postural Orthostatic Tachycardia Syndrome (POTS)
Postural Orthostatic Tachycardia Syndrome (POTS) is a form of orthostatic intolerance where your heart rate rises more than expected when you move from sitting or lying down to standing.
Common Symptoms
- Fast heart rate when standing, pounding heart, or palpitations
- Dizziness or lightheadedness, especially on standing or long walks
- Near-fainting or fainting
- Severe fatigue and feeling wiped out after simple tasks
- Brain fog, trouble focusing, forgetfulness
- Shortness of breath with standing or mild activity
- Shakiness and sweating changes (too much or too little)
- Headaches, often worse upright and better lying down
- Nausea and bloating or IBS-like gut upset
- Anxiety-like surges, often tied to feeling “keyed up” or overstimulated
Likely Root Causes and Contributors
- Autonomic nervous system dysfunction (dysautonomia): Impaired regulation of heart rate and blood vessel tone when moving to an upright position.
- Low blood volume (hypovolemia): Reduced circulating blood volume can worsen heart rate increases upon standing.
- Blood pooling in the lower body: Poor blood vessel constriction in the legs and abdomen allows blood to pool when standing.
- Hyperadrenergic response: Excess sympathetic nervous system activity with elevated norepinephrine levels.
- Post-viral onset: POTS may develop after viral illness or infection that disrupts autonomic regulation.
- Autoimmune involvement: Immune system dysregulation may contribute to autonomic dysfunction in some patients.
Patient Pain Points We Often Hear
“I get dizzy when I stand up.”
“My heart races just from standing.”
“I can’t stand in line for long.”
Our Approach to Healing
How We Map, Treat, and Sustain Real Recovery from POTS with the LAM Method™
POTS can make your body feel unreliable. You stand up, and your heart rate spikes. You try to push through, and you crash. At Lam Clinic, our approach to healing uses the three phases of LAM Method™: Learn the Why, Address the Root, Maximize Longevity. Here’s how we use the LAM Method™ to address POTS:
Phase 1 of LAM Method™
Learn the Why of POTS
At Lam Clinic, the first step is identifying what is driving your orthostatic intolerance. With POTS, the Cardionomic Circuit is most directly affected.
Most useful tests for POTS:
Core evaluation for POTS
- Orthostatic vitals or active stand assessment
- Heart Rate Variability (HRV) analysis
- Autonomic or nervous system testing (when indicated)
For more information about specific tests and labs used in POTS evaluation, you can explore our full service page.
Phase 2 of LAM Method™
Address the Root of POTS
Once the orthostatic pattern is defined, we build a slow, structured plan focused on improving circulation stability and autonomic balance.
Lifestyle Foundations
- Increase fluids and sodium intake (when appropriate): Higher fluid intake and physician-guided sodium support can help expand blood volume and reduce heart rate spikes when standing.
- Use compression to reduce blood pooling: Waist-high compression stockings or abdominal compression can help improve circulation and limit blood pooling in the lower body.
- Use recumbent or seated exercise: Start with rowing, recumbent biking, or swimming to build circulation and autonomic tolerance without prolonged upright strain.
- Break up prolonged standing: Sit, elevate the legs, or perform calf muscle contractions when symptoms begin to reduce pooling and improve blood return.
- Use smaller, balanced meals: Smaller meals with protein, fiber, and healthy fats can help reduce post-meal blood pooling and prevent symptom flare-ups.
Targeted Supplement Support
Only a few supplements are prioritized, introduced one at a time and adjusted carefully.
- Electrolyte Support (including sodium and potassium when appropriate): Foundational for many POTS patients, especially those with low blood volume or dizziness upon standing.
- Magnesium: Supports autonomic balance and helps reduce nervous system overactivation and palpitations.
- Taurine: Supports cardiovascular tone and may help regulate heart rate variability and sympathetic overactivity.
IV Therapies
For patients who require additional support, we may incorporate:
- IV Nutrient Therapy
- IV Ozone Autohemotherapy
These therapies may help support circulation, improve oxygen delivery, and replenish nutrients involved in autonomic nervous system and vascular function, which can help support blood volume regulation and cardiovascular stability in patients with POTS.
This information is educational, not a prescription. Your actual plan is always individualized, adjusted slowly, and refined based on how your body responds.
Phase 3 of LAM Method™
Maximize Longevity
As symptoms become more predictable, we shift toward long-term support:
- Simple plans for heat, travel, illness, and hormonal changes
- Early signs to watch for so flares don’t spiral
- Routines you can maintain in real life
NEM Response Circuits
How Your Body Regulate Stress
Your body handles stress through six interconnected circuits. When even one is out of balance, symptoms can show up in your heart, hormones, energy, and more.
Top Articles
Expert Insights on POTS
Ready to Start Feeling Better? Let’s figure this out—together.
Take the QuizFrequently Asked Questions
Can Lam Clinic help with POTS?
Yes. We first learn the “why,” such as low blood volume, poor vessel tone, autonomic imbalance, hormone shifts, nutrient or electrolyte gaps, inflammation, or gut issues. Then we create a personalized, step-by-step plan to restore stability, improve daily function, and support long-term resilience.
What triggers POTS flare-ups?
Heat, hot showers, long periods of standing, illness, dehydration, stress, and menstruation are common triggers. Large meals and pushing too hard with exercise can also worsen symptoms for some people.
Can postural orthostatic tachycardia syndrome be prevented?
There is no guaranteed way to prevent developing POTS. Many people can reduce flare-ups by learning triggers and building steady routines around hydration, meals, sleep, and paced movement.
Does POTS go away?
Some people improve over time, and symptoms can come and go for years. The goal is to lower flare-ups and improve function by supporting what is driving your specific pattern.
Do you offer virtual visits and where are you located?
Yes. We offer secure telehealth visits worldwide and in-person care at our clinic in Tustin, California. We proudly serve patients across Orange County including Irvine, Santa Ana, Orange, Costa Mesa, and Anaheim, as well as individuals throughout the United States and internationally who want personalized POTS and NEM stress response care from the comfort of home.
The Lam Family has helped thousands recover from fatigue and stress for years.
Using advanced diagnostics and whole-body care, the Lam family looks beyond routine labs to uncover the real reasons behind fatigue—like adrenal stress, hormone imbalance, and nutrient depletion. Then, they create a personalized plan to help you heal fully and feel like yourself again.
The Pioneer of Root-Cause Healing & Whole Person Care
Before adrenal fatigue was widely understood, Dr. Michael Lam, M.D. led the way—developing one of the first clinical approaches to diagnose and treat it. His bestselling book, Adrenal Fatigue Syndrome, became a lifeline for patients around the world. Today, his children—Dr. Carrie Lam and Dr. Jeremy Lam—carry that legacy forward, building on his foundation with advanced diagnostics and whole-person care for lasting recovery.
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