POTS: This May Be Worsening Your Symptoms
Postural Orthostatic Tachycardia Syndrome (POTS) SUCKS!!!
Chances are if you are reading this you either have POTS, know someone with POTS or are just interested in learning more about it.
For those of you that don’t know POTS is a complex condition affecting blood flow, often causing dizziness, rapid heart rate, fatigue, and brain fog (+SO MUCH MORE!). It is a very complex condition with many contributing factors but one area that often goes overlooked is nutrient deficiencies—especially iron.
Now listen, this isn’t another “quick fix for POTS” blog because let’s be real, we are all sick of those! This is to highlight deficiencies in iron and other key vitamins and minerals can significantly worsen symptoms.
As someone who has battled POTS for over 10 years I know that we take those wins where we can and if addressing these can lessen any of those symptoms, take it!
For me, Iron was my saving grace, so let’s start there!
Iron & POTS: Why It Matters
Iron is a crucial mineral that plays a vital role in oxygen transport, circulation, and energy production. When our iron levels are low, it can contribute to many symptoms that overlap with POTS, including:
Chronic fatigue and weakness
Dizziness and lightheadedness
Heart palpitations
Cold intolerance
Shortness of breath
Brain fog
Sounds familiar doesn’t it?
Many POTS patients struggle with low iron levels even if they are not anemic. This is known as non-anemic iron deficiency (NAID), where iron stores are depleted but hemoglobin levels remain normal. Since POTS already causes circulation issues, adding iron deficiency to the mix can worsen symptoms significantly.
But Why Are We Deficient In Iron?
Poor Gut Absorption – Many with POTS experience digestive issues such as gastroparesis, IBS, or leaky gut, all of which can interfere with iron absorption.
Menstrual Blood Loss – Heavy periods can lead to chronic iron loss, making deficiency more common in women with POTS. But it isn’t just heavy periods, we need to be rebuilding our iron stores post menstruation and if we are not doing that we are impacting those iron levels.
Dietary Restrictions – Those following limited diets (vegetarian, vegan, or low-meat diets) may struggle to get enough iron.
Blood Volume Regulation Issues – POTS is associated with low blood volume, and iron plays a role in supporting healthy red blood cell production. By making sure we have enough iron to build up our blood volume we can see a major improvement in our symptoms.
You can drink all the water and eat all the salt you want but if we don’t have the actual “ingredients” to build the blood cells and carry that oxygen, we will all still be sitting there with our feet in the air, fighting the POTS attack.
Other Key Nutrients That Impact POTS
While iron is crucial, other nutrients also play a significant role in managing POTS symptoms. I just want to give a quick run down of some of the key players + why they matter.
B Vitamins (B12, Folate)
B12 (Methylcobalamin) is needed to prevent anemia. It works together with folic acid in regulating the creation of our red blood cells and utilising iron. It is also needed to digest our foods and get the most out of what we are eating. It also plays a massive role in our nervous system, which is crucial for POTS patients.
Why It Matters: Supports red blood cell production + iron utilisation, nerve function, and energy levels.
Deficiency Symptoms: Fatigue, neuropathy, brain fog, low blood pressure, dizziness, headaches and palpatations
Common in POTS? Yes, particularly in those with digestive issues or poor absorption.
Foods with B12: meats, eggs, milk + dairy products, poultry and seafood
Folate (Folic Acid) is our brain food and also needed for energy production and red blood cell formation (are we seeing a pattern here?) Our immune system also feeds off of folic acid.
Deficiency Symptoms: anemia, digestive issues, insomnia, weakness
Foods with Folate: lots of veggies (asparagus, avocado, green leafy veg, root vegetables), beef, brown rice, chicken, lamb, legums, lentils, liver, salmon, whole wheat
Magnesium
Magnesium is like a superstar of the body - needed for over 300 processes in the body. You hear all about electrolytes with POTS and one that we tend to not stress enough is magnesium. Magnesium is needed for the uptake of calcium and potassium. These all play a role in hydration - again, drink all the water you want but without the electrolytes, the body is going to struggle to absorb it all.
Why It Matters: Helps with muscle relaxation, nerve function, and hydration balance.
Deficiency Symptoms: Muscle cramps, rapid heart rate, heart palpitations, anxiety, and poor sleep.
Common in POTS? Yes! POTS patients tend to lose more magnesium through urine and stress-related depletion.
Foods with Magnesium: Found in most foods including dairy products, fish and meat, apples, avocados, blackstrap molasses, nuts, sesame seads, alfalfa, dandelion, raspberry leaf.
Sodium & Electrolytes (Potassium, Chloride)
If you have POTS you have definitely heard of electrolytes. Your electrolytes include sodium, potassium, chloride, calcium, magnesium, phosphate, and bicarbonates. You learned above that magnesium is needed to help these two - so keep that in mind.
Why It Matters: Helps maintain blood volume and prevent dizziness.
Deficiency Symptoms: Low blood pressure, fatigue, headaches, weakness.
Common in POTS? Yes! Many POTS patients need higher sodium intake to support circulation.
Vitamin D
The “sunshine hormone” is needed to help protect against muscle weakness and helps with heartbeat regulation.
Why It Matters: Supports immune function, energy production, and muscle function.
Deficiency Symptoms: Fatigue, muscle pain, and poor immune health.
Common in POTS? Yes, especially in those who avoid sun exposure or have absorption issues. If you have gallbladder issues you can also have issues absorbing Vitamin D.
How to get Vitamin D from the sun: expose your face and arms to the sun for 15 minutes three times per week (minimum)
How to Improve Nutrient Levels
Get tested – Work with a healthcare provider to check your iron (ferritin), B12, magnesium, and vitamin D levels. You can work with an integrative health practitioner to test your electrolyte deficiencies through an HTMA Test.
Optimise your diet – You can see all of the foods rich in the different vitamins / minerals above. You can include iron-rich foods like red meat, spinach, lentils, and pair them with vitamin C for better absorption.
Consider supplements – supplementation can help if we are not getting enough from our diet. It is not a permanent fix but to give you a boost while you need it. Work with a holistic health practitioner to understand what forms are best for you.
Improve gut health – Address any absorption issues with digestive support, probiotics, or gut-healing foods. If you need additional help, please work with a practitioner to discover the imbalances.
Monitor symptoms – Track how you feel when increasing certain nutrients and adjust accordingly. If you are worried that these are impacting you, reach out to a health practitioner.
Final Thoughts
Living life with POTS is nothing short of challenging. Addressing our deficiencies can make a huge difference on our symptoms. If we can remove barriers to feeling better and support the nervous system and blood as much as we can, we should!! You can support your body and its blood levels, nervous system function and healing capacity through digging deeper.
If you suspect nutrient deficiencies are playing a role in your symptoms, consider working with a healthcare provider to get tested and develop a personalised plan. Small changes can lead to big improvements!
I work with clients (including myself) to find their deficiencies and improve their symptoms - I would love to support you or your loved one on your journey!
Resources:
Balch, P. A. (2006). Prescription for nutritional healing. 4th ed. Avery.
Do, T., Diamond, S., Green, C., & Warren, M. (2021). Nutritional Implications of Patients with Dysautonomia and Hypermobility Syndromes. Current nutrition reports, 10(4), 324–333. https://doi.org/10.1007/s13668-021-00373-1
Jarjour, I. T., & Jarjour, L. K. (2013). Low iron storage and mild anemia in postural tachycardia syndrome in adolescents. Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 23(4), 175–179. https://doi.org/10.1007/s10286-013-0198-6
Öner, T., Guven, B., Tavli, V., Mese, T., Yilmazer, M. M., & Demirpence, S. (2014). Postural orthostatic tachycardia syndrome (POTS) and vitamin B12 deficiency in adolescents. Pediatrics, 133(1), e138–e142. https://doi.org/10.1542/peds.2012-3427
