Why Traditional POTS Treatment Fails and What Else to Consider

If you’re dizzy, exhausted, lightheaded, and constantly brushed off by traditional medicine, this episode will feel like someone is finally connecting the dots.

What you’ll learn:

• Why “normal” labs don’t mean anything is actually normal for POTS patients—and why most people are told everything looks fine when they clearly don’t feel fine.
• The big flaw in the traditional POTS approach: it manages symptoms but ignores the nervous system dysfunction driving them.
• **The hidden neurological issues no one checks—**like eye-tracking and vestibular reflexes—that keep 75–80% of POTS patients dizzy, anxious, and fatigued.
• How advanced testing at Peak Brain & Body uncovers what cardiology and neurology miss, leading to real, lasting improvement.
• Why POTS is never “one thing,” and why treating the whole system (hormones, immune function, infections, mold, anemia, etc.) finally moves the needle.

Transcript

So you're struggling with POTS related symptoms and you are not getting better and you're trying to figure out what you should be doing. In this video, here's what we are going to cover. First, we're going to start off what the traditional approach is for POTS. And we're going to start with the diagnosis and the evaluation. Then we are going to shift into what we do here at Peak Brand and Body. and why we're able to help so many individuals who did not get the results they were looking for when they did just a traditional medical approach only. And if you're watching this on YouTube or something, great. Anywhere else, it'll still work, but you may not be able to see everything that I'm presenting. And so you're not going to get the full layout in the way. that others will. So this very first one is a new article that I'd sent to me. Okay. So I get stuff all the time and they say, I feel like I'm going to pass out every day. Could this be from POTS? So now what it does is it goes through this. What is it, right? So POTS is positional orthostatic tachycardia syndrome. They use a female. So currently at this point in time, it's believed that nearly eighty percent of those diagnosed with POTS are going to be females. And then lightheadedness past two to three months. So we are looking for things to be pretty consistent. Normally for a POTS diagnosis, you're gonna wait till someone's had it for at least three months, if not six months. and what they go through is basically a story okay they go in there blood pressure is on the low end ninety over seventy with a resting heart rate of ninety because the patient of dizziness they did orthostatic testing so they lay them down to blood pressure heart rate after five minutes and then they stood them up and then they checked it at one in five minutes to see what happened. Now, what you're gonna see in this example was blood pressure did return, you know, stay fairly similar, okay? And heart rate wasn't too bad after one minute. And then at a little bit longer, Sorry. So at one minute, her blood pressure had dropped a little bit and heart rate shot up a total of thirty beats per minute. Criteria for an adult is going to be greater than thirty. So technically not there yet. And then five minutes of standing blood pressure further dropped and then blood heart rate was one hundred and thirty. So this did go up to the forty mark. So once again, greater than thirty for an adult or greater than a forty for a child. Child or teenager meets criteria without a significant change in blood pressure. And significant change is so they were ninety over seventy baseline. So it would have had to have dropped more than seventy over sixty. And as you see, it's really, really close. So probably flirting with orthostatic hypotension. So they get the diagnosis, right? It's confirmed for them through a tilt table. And then here's what you should know, especially when you're looking at regular labs. They did a basic lab panel, okay? All the test results were normal. This happens day in, day out in the POC world. So when you get told your basic labs, and yes, I consider these basic labs, these are not in-depth labs by any stretch of the imagination. They're going to be normal. Don't be frustrated. No, that's just what it is. Okay. So what did they do for treatment? Well, increased fluid intake, start pounding sodium and salt. So four grams. And then they did compression stockings. abdominal binders all of these things to help now when this patient eventually followed up what they see well they saw a little bit of improvement but still having the lightheadedness and they eventually gave mitodrine which is something a lot of people are used to having they had them work on some stress responses and at the end They did do a little bit better. They still weren't significantly better, though. And this is the story that I see every single time I encounter POTS patients. Maybe the medications they've done have helped to an extent, but they're not noticeably better. You know, it's ten percent, twenty percent, thirty percent. And at this point in time, you know, they basically wrote the story is like high fives. This was good. You know, this is about as good as we can do. Now, when we switch over to this, so this is from U.S. Cardiology Reviews. And once again, they go through all the different symptoms that we know people are going to have because this is a multi-system and symptom issue, right? You can have gastrointestinal, you can have urinary, you can have musculoskeletal, you can have neurological, you can have anxiety and so many other things. POTS is also associated with autoimmunity, mast cell activation syndrome, diabetes, concussions, Ehlers-Danlos, chronic fatigue syndrome, and much more. Now, as we go here to the bottom where they look at management, it's what we've talked about, right? Increased fluids, go crazy with salt, compression stockings, maybe a little bit of exercise. Some people are even getting antihistamine that they're using. Some people are getting sent to allergists if they think there may be some MCAS. For some people, they're doing birth control if they think there's anything with menstrual cycle impacting stuff. Mito germ, we've already talked about. Ivermectin is another one people are given. They also are given antidepressants and anxiety, right? But you see, kind of this is the extent of what it is. which is really really unfortunate because so many people continue to struggle with pot symptoms for months and years when this is the approach they follow now i'm going to tell you the way we view pots here at peak brand and body in wesley chapel and if you'd like to work with me there's the qr code you scan it you can set up a time to have a strategy consult with me. If you're wondering who I am, I'm Dr. Spencer Zimmerman. I'm a dual licensed nurse practitioner and doctor of chiropractic with advanced training in neurology and functional medicine. Here's the way we view POTS. POTS is underneath a family of conditions known as dysautonomia. Autonomia refers to your autonomic nervous system. So it's ultimately your nervous system, right? So it's nervous system dysfunction. And POTS is a manifestation of that. So all the cardiovascular symptomatic that we talked about, right? Because pretty much Every single thing that is done in traditional medicine for POTS is all about managing cardiovascular manifestation of the autonomic nervous system dysfunction. The only thing that maybe isn't is when they start co-treating some mast cell issues. But so we have to say, well, how is your nervous system functioning? Which we're going to go to in a moment. But then you have to say, what can ruin the nervous system, right? Mental cycle, chronic infections, people getting sick all the time. Do they have mold issues? What about their hormones? Every time they go through a mental cycle, things go crazy. Are they vitamin D deficient? Are they iron deficient? And the list can go on and on and on. There's a lot of things. And that's why when we treat people with POTS, we're not trying to find the one thing. But here's what some of the testing looks like. Now we do. And this first one is going to be balance testing. So when someone has POTS, ultimately they are dizzy. They fell off balance. They feel weak and everything in that arena. So when we look at balance, we should be looking at how do you do with eyes open, eyes closed on a firm surface, which would be the standard idea of the eyes open, eyes closed on a Right, so those are the first two. And then how do you do with eyes open, eyes closed on a perturbed surface? Now, an example of a perturbed surface is using a blue balance pad like this, put on top of a computerized balanced platform, and it's gonna measure. So the top numbers you see is where someone's at before they get care. We specifically see that the vestibular aspect of that testing is off. So that is what eyes closed on the blue pad is really meant to look at. It really biases your vestibular functionality. And when you look at the vestibular system, the vestibular system is super important for regulating your blood pressure, and as a result, your heart rate when you do positional changes. If your vestibular reflexes, so you have what's called vestibular autonomic reflexes, same autonomics that's involved with dysautonomia in POTS, then you now are going to have these issues but unfortunately when we look at the traditional management of pots the vestibular system it's it's ignored um it's ignored and it's honestly it's going to keep being ignored until insurance and the powers that beat aside it's important and it's something they should pay for but until then they do what they're paid to do But we see that's off. But then if we fix someone's vestibular system, they're not as dizzy. Their blood pressure does better. They can live their life. Now, on the other side of what we see in POTS is it's not just about what's happening with the vestibular system. Okay. It's about what all feeds into the vestibular system. So lots of people with POTS, they were like, oh, whoa, man, I'm dizzy, I'm off. Well, your visual system feeds in and messes with it. So let's look at, so this is pre and post results for someone who would have been tracking a target up and down, okay? So here on the left, where you see these lines are anything but smooth, that's tracking down and then up, down and up. Versus on the right, this is after a short period of care. As your visual system does better, you are going to feel more stable. Your energy is usually gonna get better. Your brain fog is gonna improve. Your anxiety is gonna improve. Now, this is only part of the data that we collect when we do this testing. So when we look at the full testing that we do, it's important to realize that the eyes are just super important. And so we're gonna review what that looks like. So this first one is just like, okay, let's say you're looking at a stationary target. Your eyes should be nice and still. People don't know how well they do on this game. Everyone's like, oh, I think I aced it. Until they don't. So looking nice and still. Are the eyes still. Or do we see the eyes shifting. When we look at this. Alright. So we see the eyes shifting. Shifting. Okay. So those are what's called square wave jerks. Those shouldn't be present. And these are not something you will detect. Now I'm going to show you. What eye tracking would look like. So I've showed you the. and result on a graph and how it looks. But what does it look like in an actual recording? so the dots moving nice and smooth we want to say okay are their eyes moving nice and smooth are the eyes changing speeds are they stuttering and it's pretty clear yes they're absolutely stuttering they're changing speeds and With most POTS patients came in our experience, it's about seventy five, eighty percent. They're going to do really poorly on this test. And this test is going to create a lot of symptoms for them. As we address this, these findings, those symptoms improve because their nervous system is improving. So this is really about going to one of the underlying causes that is present in the majority of POTS patients. And this is why. even though someone maybe has already received care from, you know, a neurologist, a cardiologist and a chronologist, and they're still not sure why they're not getting better. we can usually come in there and provide them with tremendous improvement that they didn't think was possible. And it's because we're not staying within the same box that everyone else is playing in. We're saying, no, how does this really work as a whole unit? Let's really address the nervous system, but also not only address just the nervous system. Let's make sure that anything that could mess with a nervous system, if it needs to be addressed, is addressed. And like I said, that can be anything from menstrual cycles to anemia to to thyroid, to autoimmunity, to mold, to many other things. Because what I can tell you in treating complex cases over the past ten years, and POTS really has shot up over the past three to four years, the amount I've worked with, We don't try to find the one thing because the one thing doesn't exist. We don't try to be hyper-focused. Those that are hyper-focused miss a lot because they have all these blind spots. And we really step back to identify what's going on, figure out what it is for each individual. And depending on what we find, the length of time it takes to get better is going to differ for each person. If you're a neurological heavy one with your eyes and your balance, that responds fairly fast. If you're an immune system heavy one, that one takes longer. So it just depends how much of each side is playing a role. But when it's done right, most people, when I say most, eighty plus percent are going to see significant improvement if they have the willingness to take a different approach and to be patient with themselves as they go through a different process than anything they've ever done before. Because if you're like our average patient, no one's ever talked to you about this when it comes to POTS. And it's unfortunate because there's starting to be more and more research talking about this, even though, to be fair, the research is severely lacking on the nervous system and dysfunction within the nervous system and how it drives the cardiovascular manifestations of POTS. And just like we said earlier, if you would like to work with me, you do have that QR code. You scan it and you can schedule an appointment. And until next time, I'm Dr. Z. I'm known as the Brain Guy. And I'd absolutely love to work with people here one-on-one in my clinic in Wesley Chapel, which is right outside of Tampa, as we are trying to be the leaders in complex cases such as POTS and other things in that arena.