Pots And The Heat Factor: Navigating The Hot-Headed Debate

Postural Orthostatic Tachycardia Syndrome (POTS) is a nervous system and cardiovascular disorder that affects circulation and could cause lightheadedness, fainting, and rapid heartbeat, especially upon standing. One of the major symptoms of POTS is heat intolerance. Many POTS patients can’t regulate their body’s core temperature, causing periods of excessive heat to induce fainting, nausea, and extreme dehydration. Warmer weather means more relaxed muscles, which causes blood vessels to widen, making the heart work harder. This can send people with POTS into a flare of symptoms.

Heat intolerance and POTS

Heat intolerance is a major symptom of Postural Orthostatic Tachycardia Syndrome (POTS). Many POTS patients have difficulty regulating their body's core temperature, which can lead to excessive heat, fainting, nausea, and extreme dehydration. Warmer weather causes blood vessels to relax or widen, which means the heart has to work harder. For people with POTS, this can trigger a flare-up of symptoms, including an increased heart rate.

Heat intolerance in POTS patients can manifest in several ways, including:

• Excessive sweating
• Feeling nauseated or throwing up
• Feeling faint or actually fainting

There are several strategies that POTS patients can use to manage heat intolerance:

• Increase salt and water intake: POTS patients are advised to consume 3-5 grams of salt per day, and this can be increased to 5 grams during warmer weather. It is also recommended to drink 2 liters of water per day, and this can be increased during hotter periods.
• Stay in air conditioning: When possible, staying in air-conditioned spaces can help POTS patients manage their symptoms.
• Use cooling gadgets: Portable fans, cooling vests, and ice packs can help prevent overheating.
• Plan outdoor activities during cooler hours: Avoiding the hottest parts of the day can help reduce the risk of heat-related issues.
• Wear light, breathable clothing: Choosing the right clothing can make a significant difference in managing body temperature.
• Increase electrolyte intake: Replenishing electrolytes is crucial for POTS patients, especially after sweating. Sports drinks or coconut water are good options.
• Take cool showers: Planning showers around the hottest parts of the day can help with temperature regulation.
• Stay in the shade: When outdoors, seek out shady spots to minimize exposure to direct sunlight.

By following these strategies, POTS patients can better manage their heat intolerance and reduce the impact of heat on their symptoms.

The autonomic nervous system and POTS

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that affects the autonomic nervous system, causing a number of symptoms when you transition from lying down to standing up. The autonomic nervous system is divided into two parts: the sympathetic nervous system and the parasympathetic nervous system.

The sympathetic nervous system is responsible for the 'fight or flight' response, releasing the neurotransmitters norepinephrine and epinephrine, which increase the heart rate, blood pressure and respiratory rate. This response is designed to prepare the body for danger by sending more blood and oxygen to the muscles.

The parasympathetic nervous system, on the other hand, helps the body to rest and digest by releasing the neurotransmitter acetylcholine, which has the opposite effect of slowing the heart rate, lowering blood pressure and reducing respiratory rate.

In people with POTS, the autonomic nervous system malfunctions, causing an imbalance between these two systems. There is an excessive release of norepinephrine and/or epinephrine from the sympathetic nervous system, resulting in a rapid heart rate, high blood pressure, increased pupil diameter, digestive problems and rapid respiratory rate. At the same time, there may be a decreased release of acetylcholine from the parasympathetic nervous system, further contributing to the imbalance.

This autonomic imbalance in POTS can lead to a range of symptoms, including tachycardia (a heart rate above 100 beats per minute at rest), rapid respiratory rate, high blood pressure, hypersensitivity to light, digestive issues, dizziness, fainting, fatigue, anxiety, and disrupted sleep.

While there is no cure for POTS, treatments aim to reduce the activity of the sympathetic nervous system or increase the activity of the parasympathetic nervous system. Medications such as beta-blockers and centrally acting sympatholytic drugs are used to block or reduce the release of norepinephrine, thereby slowing down the sympathetic response. Other medications, such as acetylcholinesterase inhibitors, increase the levels of acetylcholine in the brain, enhancing the parasympathetic response.

In addition to medication, lifestyle changes such as exercise, physical activity, dietary modifications, and compression garments can help manage POTS symptoms.

POTS and dehydration

POTS, or postural orthostatic tachycardia syndrome, is a blood circulation disorder that affects an estimated one to three million Americans. It is a form of dysautonomia, or a disorder of the autonomic nervous system, which regulates functions such as heart rate, blood pressure, sweating, and body temperature.

One of the major symptoms of POTS is heat intolerance, which can cause excessive heat and lead to fainting, nausea, and extreme dehydration. This is because people with POTS often have trouble regulating their body's core temperature. Heat intolerance can also be a result of dehydration, as the body loses water through sweating.

To manage POTS symptoms during the summer or in hot weather, it is important to stay properly hydrated. Drinking plenty of water and maintaining proper hydration can help ease symptoms and make day-to-day tasks more manageable for people with POTS. This is because many people with POTS have a low blood volume, and proper hydration helps to increase that volume. It is recommended that those with POTS drink between 2 to 3 liters of fluid each day and consume more salt and water than usual. However, it is important to note that drinking too much water all at once can inundate the renal system, so it is best to sip water throughout the day.

In addition to water, sports drinks, coconut water, and electrolyte powders or tablets can also help with hydration. Consuming enough salt is also important, as sodium is the most important electrolyte for retaining water in the body. The type of salt is important, as table salt is refined and stripped of its natural minerals and electrolytes. Therefore, Himalayan and Celtic sea salts are preferable.

There are also certain drinks that should be avoided, as they can be dehydrating. These include alcohol, sugary drinks, and caffeine. Alcohol is a diuretic, which increases urine production and leads to dehydration. Sugary drinks can increase the likelihood of symptoms due to a rise in blood sugar levels. Caffeine is a mild diuretic and can also increase heart rate, although some people with POTS find that small amounts can help alleviate symptoms.

Overall, staying properly hydrated is crucial for managing POTS symptoms, especially during hot weather. By increasing fluid intake, consuming electrolytes, and avoiding dehydrating drinks, people with POTS can help reduce the impact of their symptoms.

Managing POTS in the summer

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that affects the body's ability to regulate heart rate and blood pressure. It is characterised by a heart rate of over 100 beats per minute and symptoms such as dizziness, fainting and fatigue. POTS can be difficult to manage at the best of times, but the heat of summer can significantly worsen these symptoms. Here are some tips to help manage POTS during the hotter months:

Stay Cool

• Seek shade whenever possible. The temperature is always lower in the shade, so spend as much time as you can in shaded areas.
• Use a small black umbrella to keep yourself out of direct sunlight.
• Invest in a cool vest or cooling products such as ice packs, a facial mist or a Chillow pillow.
• Use a portable fan.
• Wear sandals to keep your feet cool and avoid blood pooling.
• Wear compression socks to lessen venous pooling and hypotension.

Stay Hydrated

• Drink plenty of water. It is recommended that individuals with POTS drink 2-3 litres of water, milk or electrolyte drinks per day.
• Eat ice lollies to increase your water consumption.
• Drink a bottle of water before getting out of bed in the morning.

Manage Your Diet

• Increase your salt intake. POTS patients are advised to consume 3-5 grams of salt per day, but in hotter weather, this can be increased to 6-10 grams.
• Eat small and frequent meals. Large meals can worsen POTS symptoms as the body redirects blood to aid digestion.
• Try a low histamine diet or eliminate gluten, dairy and/or eggs from your diet.

Exercise

• Exercise is key to managing POTS. Try swimming, rowing, recumbent biking or weight training.
• Practice isometric exercises, such as contracting your muscles without moving your body, to squeeze blood back towards your heart.
• Avoid strenuous exercise, especially in warm environments.

POTS and blood vessels

Postural Orthostatic Tachycardia Syndrome (POTS) is a blood circulation disorder characterised by an unusual jump in heart rate when moving from a seated to a standing position. This is caused by a dysfunction of the autonomic nervous system, which controls involuntary bodily functions such as heart rate, blood pressure, and breathing. In healthy individuals, the autonomic nervous system constricts blood vessels and increases heart rate in response to standing, to ensure blood continues to flow to the brain. In people with POTS, the blood vessels do not constrict as they should, and blood pools in the lower body. This results in an exaggerated increase in heart rate as the body tries to compensate.

The symptoms of POTS include lightheadedness, dizziness, fainting, difficulty concentrating, shortness of breath, and cold or pain in the hands and feet. These symptoms are often relieved by lying down. POTS can be diagnosed using a tilt table test, which measures heart rate and blood pressure as the patient moves from lying down to standing up.

There are several types of POTS, including:

• Hypovolemic POTS, caused by low circulating blood levels.
• Neuropathic POTS, caused by damage to the peripheral nerves that manage how certain blood vessels expand and contract.
• Hyperadrenergic POTS, caused by elevated levels of the stress hormone norepinephrine.

Treatment for POTS typically involves a combination of diet, medication, and physical therapy. It is recommended that people with POTS increase their fluid and salt intake, wear compression stockings, and engage in reclined exercises such as swimming or recumbent biking. Medications may also be prescribed to slow heart rate, increase fluid volume, or improve blood vessel constriction.

Frequently asked questions