INTEGRATIVE POTS DIAGNOSIS & TREATMENT

Integrative POTS Treatment in San Diego

POTS treatment can vary because no single set of criteria is universally accepted.

From an integrative rheumatology perspective, Postural Orthostatic Tachycardia Syndrome (POTS) is a systemic autoimmune illness that affects multiple organs and tissues.

From a clinical standpoint, we follow the recommendations developed by the Heart Rhythm Society (HRS).

These criteria include:

  • A heart rate increase ≥30 bpm (≥40 bpm those aged 12–19) when standing for several minutes.
  • No significant orthostatic drop of systolic blood pressure (BP) (>20 mm Hg).
  • The HRS does not require tilt table testing for diagnosis but rather recommends the use of findings derived by moving from recumbent to standing positions.
 
 


The presentation of POTS is not limited to only cardiovascular symptoms. The following table outlines various clinical symptoms observed in POTS patients.

Cardiovascular SymptomsMain SymptomsOther Symptoms
Cardiovascular systemOrthostatic intolerance, orthostatic tachycardia, palpitations, dizziness,
lightheadedness, (pre)-syncope, exercise intolerance
Dyspnea, chest pain/discomfort, acrocyanosis, Raynaud’s, venous pooling, limb edema
Non-Cardiovascular SymptomsMain Symptoms
General symptomsGeneral deconditioning, chronic fatigue, exhaustion, heat intolerance,
fever, debility, bedriddenness.
Nervous systemHeadache/migraine, mental clouding (“brain fog”), cognitive impairment,
concentration problems, anxiety, tremulousness, light and sound sensitivity,
blurred/tunnel vision, neuropathic pain (regional), sleeping disorders, involuntary movements
Musculoskeletal systemMuscle fatigue, weakness, muscle pain
Gastrointestinal systemNausea, dysmotility, gastroparesis, constipation, diarrhea, abdominal pain, weight loss.
Respiratory systemHyperventilation, bronchial asthma, shortness of breath.
Urogenital systemBladder dysfunction, nocturia, polyuria.
SkinPetechiae, rashes, erythema, telangiectasias, abnormal sudomotor regulation, diaphoresis, pallor, flushing.

From: Fedorowski A. Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management. J Int Med 2019; 285: 352–66

Our diagnosis and POTS treatment centers on four cornerstones:

  1. Integrative diagnostic module
  2. Integrative therapeutic module
  3. Rehabilitation module
  4. Maintenance module
 

 

Integrative diagnostic module presumes that POTS originates from a chronic infection affecting genetically susceptible individuals. This triggers an infection-driven autoimmune response frequently associated with the hyperactivation of mast cells (also known as Mast Cell Activation Syndrome or MCAS) and eventually causes the malfunction of the autonomic nervous system.

Typically, the diagnostic module includes:
Physical examination
Whole body thermography
Assessment of autonomic nervous system imbalance with ANS/QSART test
Assessment of autoantibodies associated with POTS and autoimmune dysautonomia
Assessment of mast cell activation processes
Comprehensive diagnostic search for chronic infections

Integrative therapeutic module is highly customizable and based on specific results generated during the diagnostic tests.

In general, it includes:
Individualized drug therapy
Individualized food supplements and herbal therapy
Various, highly individualized forms of biofeedback therapy
Individualized drug and nutritional intravenous therapy
French-style ear acupuncture
Laser-based ear acupuncture
Human mesenchymal stem cell (MSC) exosome therapy

Rehabilitation module includes highly successful POTS program performed in our physical therapy department.

The typical duration of the above modules is 3 months.

Maintenance module involves ongoing supplement and herbal therapies after completion of the integrative therapeutic and rehabilitation modules.

If you are interested in receiving more information regarding our integrative POTS treatment program in San Diego, please do not hesitate to contact us at 858-794-9192 or info@ifsmed.com