Postural Orthostatic Tachycardia Syndrome
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How We Treat POTS

At POTS Care, instead of treating POTS symptomatically, we treat POTS by looking for (and treating) the underlying medical issues causing POTS. This dramatic paradigm shift in treatment is often essential for reversing Idiopathic POTS.

During your week-long evaluation, we will perform the following:

Complete evaluation of all symptoms and signs of illness.

When patients do not respond to traditional treatments for POTS (such as salt, blood volume expanding medications, beta-blockers and SSRI’s), there are often underlying conditions that have been overlooked. When these conditions are correctly identified and treated, patients can recover. Some of these conditions cannot currently be diagnosed based on routine blood work or imaging (we call these “invisible illnesses”). We will start your evaluation by looking at every symptom and sign of your illness, searching for clues as to the underlying cause of your POTS. We then utilize proprietary software to help us identify conditions which may have been missed in your case.

We do not assume your illness is a psychological illness.

Blood work

Based on your individual case, blood work will likely be performed to help identify undiagnosed conditions contributing to POTS. 

Genetic studies

If you have results of genetic testing (or “23andme” genetic data), we will include these studies in our evaluation.

Unless you have Familial Dysautonomia, we never assume your condition is genetic, and therefore nothing can be done.

Review of all medical records

In many recalcitrant cases of POTS, patients have visited many specialists and have a thick stack of medical records. Rarely is someone reviewing the entire patient history to locate undiagnosed medical problems that may have been missed. We will examine all medical records to look for issues that may only be apparent when all systems of the body are considered simultaneously.

Response to treatment

For many conditions, the patient response to treatment can help confirm (or reject) the suspected diagnosis. Always beginning with the lowest risk medications first, the doctors at POTS Care will carefully evaluate your response to treatment as part of the diagnostic protocol.

We reevaluate everything you have been told about your condition.

Ocular studies

Ocular studies extending far beyond traditionaleye examinations can help locate many systemic disorders that can remain hidden in traditional testing. The eye is the only place in the body, for example, where blood vessels can be observed without a biopsy. The eyes are especially sensitive to some neurological conditions, inflammatory disorders and abnormalities of intracranial pressure. We will conduct extensive ocular studies to help us locate underlying problems contributing to POTS.

Team workshops

Much of the work in your case will be done behind the scenes. Extensive review of your case and group consultations contribute to the team effort needed to find answers in difficult cases of POTS. We find that a team approach, in conjunction with extensive diagnostic algorithms, can be the most efficient and effective method to get answers as quickly as possible. The results of extensive studies by Genetic Disease Investigators, LLC (including their findings concerning intracranial pressure, vascular abnormalities, vagus nerve problems, mast cell disorders, inflammatory conditions and abnormal immunity in POTS) are a critical component to your evaluation. The combination of this new information, when combined with the extensive experience of physicians involved in idiopathic POTS, is a powerful one.

Treatment Plans

When you leave POTS Care, you will be provided with a written treatment plan.

We do not resort to symptomatic treatment unless we have first exhausted all other attempts to treat POTS at its cause.

We will investigate conditions that fall outside the scope of traditional POTS, including the evaluation of hidden abnormalities such as:
– Intracranial pressure problems
– Vagus nerve problems
– Some inflammatory conditions
– Mast cell activation (MCAS) — and the conditions that mimic MCAS
– The activation of other histamine-producing cells
– Immune dysfunction
– Joint hypermobility – genetic and acquired


Not all POTS patients are alike and custom evaluation and treatment is essential for recovery in most cases. At POTS Care, you will receive this customized approach to care.