Finding effective care for postural orthostatic tachycardia syndrome (POTS) can be more challenging than you would expect. Most healthcare providers approach POTS as a cardiovascular issue — focusing on heart rate, blood pressure, and blood flow — without asking why those systems became unstable in the first place.
The reality is that POTS isn’t just a cardio problem. It’s a form of dysautonomia, or dysfunction of the autonomic nervous system (ANS) — the part of the brain and body that automatically regulates heart rate, breathing, and blood flow.
When that system isn’t working properly, it can lead to what’s called orthostatic intolerance and the symptoms that we associate with POTS: lightheadedness, syncope (fainting) episodes, palpitations, chest pain, fatigue, and more.
Choosing a POTS clinic that understands and treats this neurological root cause can make a significant difference for patients. This article focuses on what to look for when you’re evaluating POTS treatment options or searching for the right medical center.
1. Clinics That Treat the Neurological Root Causes of POTS
Most POTS programs are designed through the lens of cardiology and focus on symptom management. They seek to stabilize blood pressure and heart rate, but they rarely address the underlying dysfunction of your autonomic nervous system.
In contrast, there is a small but growing number of clinics that focus on treating your autonomic dysfunction directly, which can help restore balance within the nervous system, providing long-term regulation gains that reduce symptoms in daily life.
Because there are relatively few of these clinics, you may need to travel to receive this type of care. If you have the resources, it is worth considering. Below, we’ll share a list of questions to ask any POTS clinic. That way, if you’re confined to local options, you can try to find the best possible one.
Note: Our clinic, Cognitive FX, in Provo, Utah, offers this type of neurologic-focused POTS treatment. If you’re interested in learning more, fill out this form to see if you’re a good fit for our program or call our patient care coordinator at: 385-334-6093.
2. Clinics That Use Innovative Treatment Tools
Conventional POTS treatments try to build tolerance around a broken system. Compression socks, salt tablets, medications, and slow cardio reconditioning help you cope with dysregulation, but they don't fix the autonomic nervous system that's creating the problem.
Ideally, look for a clinic whose approach targets the brainstem and autonomic centers that are causing the exaggerated heart rate and blood pressure responses. This might include:
Interval-Based Cardio to Recalibrate the Autonomic Nervous System (ANS)
Because POTS patients experience ANS dysfunction, treatment should help retrain communication between the sympathetic (“fight or flight”) and parasympathetic (“rest and recover”) branches.
Programs that use interval-based physical therapy — brief, guided bursts of exercise followed by recovery — can help the body learn how to regulate heart rate and blood pressure better than conventional methods of steady-state cardio.
This method does more than improve endurance: it helps patients relearn how to switch between activity and rest without extreme fatigue or fast heart rate spikes.
Integration of Vestibular and Cranial Nerve Work
Many people don’t realize that the inner ear and cranial nerves send vital information to the brainstem centers that control heart rate, blood pressure, and blood vessels.
If these systems send inaccurate signals, the brain may overreact to position changes, causing dizziness, palpitations, or syncope when standing up from lying down.
Clinics that include vestibular rehabilitation and cranial nerve activation (such as taste, smell, and eye movement exercises) can correct that sensory mismatch — a key step in stabilizing daily symptoms for POTS patients.
Breathing Mechanics and CO₂ Regulation
Breathing patterns directly influence autonomic nervous system tone. Shallow or chest-based breathing can trap the body in a constant state of orthostatic intolerance, while deep nasal, diaphragmatic breathing helps balance oxygen and carbon dioxide (CO₂) levels and improve blood flow.
Advanced clinics teach proper breathing mechanics and may even use CO₂ therapy to retrain your system’s chemistry. Balanced breathing exercises can reduce lightheadedness, improve cardiovascular function, and ease symptoms like chest pain and fatigue.
3. Clinics That Offer Individualized, Multimodal Care
No two POTS patients are alike. Some develop symptoms after a brain injury, concussion, or viral illness; others experience them after hormonal shifts or pregnancy.
The best clinics tailor a treatment plan to your specific medical conditions. That plan should combine neurology, cardiology, physical therapy, and breathing work, often with oversight from a nurse practitioner or multidisciplinary team.
In pediatric cases, collaboration with a pediatric cardiologist or pediatric autonomic specialist is often essential for safe, effective care.
4. Clinics That Provide Education and Self-Management Skills
A great POTS clinic does more than provide therapy — it teaches patients how to manage their condition in daily life. That includes understanding symptoms of POTS, tracking triggers, and learning recovery tools like breathing exercises, hydration strategies, and pacing techniques.
Clinics that encourage follow-up, connect patients with support groups, and review medical records to personalize care help ensure long-term improvements.
Empowerment is the goal: giving patients the confidence to self-regulate and maintain progress over time.
Questions to Ask When Evaluating POTS Clinics
Before committing to a clinic, consider calling around to a few treatment centers to learn about their approaches. Here are some examples of questions to ask clinics when you’re exploring options:
- Does your clinic treat POTS as a cardiovascular condition or a neurological one?
- Do you offer POTS diagnosis, treatment, or both?
- Is your program primarily exercise-based, or does it include other types of therapies?
- What role does medication play in your treatment?
- How do you adapt treatment for patients with other conditions (such as concussion, long COVID, etc.)?
- Will I receive education and a post-treatment patient care plan for continuing therapy at home?
Clinics that express an understanding of the neurological aspect of POTS, and include innovative therapies beyond steady-state cardio, are likely to be better options.
Treating the Neurological Root Causes of POTS at Cognitive FX
Our 4-day program targets the root causes of POTS by retraining autonomic function. The goal is long-term regulation and sustainable quality-of-life improvements, not just short-term symptom relief.
This program grew out of the success we’ve had treating concussion patients who commonly experience POTS symptoms. As we consistently saw their autonomic function improve through neurological rehabilitation, we refined and formalized those methods into a dedicated POTS program.
The Four-Day POTS Treatment Program
Our intensive program lasts four days and includes:
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Comprehensive medical and neurophysiological assessment: Functional testing of orthostatic response, vestibular function, cranial‑nerve inputs, and breathing mechanics to create a customized treatment plan.
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Neuro Cardio Training: Brief high‑intensity bursts (≈8/10 RPE) → full recovery with cooling, positioning, and diaphragmatic breathing to teach the ANS to switch gears.
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Vestibular Recalibration: Exercises that improve vertical‑change sensing and reduce orthostatic overreactions.
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Breathing Mechanics & Chemistry: Nasal/diaphragmatic technique; longer exhales; CO₂ support as indicated.
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Cranial‑Nerve Stacking: Taste/scent inputs (e.g., salt intake pre‑interval, calming scents during recovery) to steer autonomic tone.
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CO₂‑Based Recovery: End‑of‑day CO₂ suit for relaxation and tissue perfusion.
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Planned Rest Blocks to protect tolerance.
Each therapy targets a different aspect of dysautonomia, teaching the brain how to self-regulate more effectively. Each patient is provided with education about what POTS is and how neuro training helps.
If you’ve been diagnosed with POTS and you live in the Utah Valley area — or can travel to Provo —our clinic offers one of the few neurologically focused POTS treatment programs in the country. Fill out this form to see if you’re a good fit for our program or call our patient care coordinator at: 385-334-6093.
Frequently Asked Questions About POTS Clinics
What Services Does a POTS Clinic Offer?
Services vary by clinic, but most provide a mix of diagnostic testing, symptom management, and multidisciplinary care.
Diagnostic services may include:
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Tilt-table test: A key test for POTS diagnosis. The patient is secured on a table that tilts upright while clinicians monitor heart rate and blood pressure changes from lying down to standing.
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Cardiovascular testing: Tools like an ECG, echocardiogram, or cardiopulmonary exercise test help assess heart and blood vessel function.
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24-hour monitoring: A Holter monitor or ambulatory blood pressure cuff may be used to track heart rate and blood pressure during normal daily life.
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Blood and urine tests: These check for underlying medical conditions that may worsen symptoms.
Management and treatment services may include:
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Lifestyle and symptom management: Guidance on hydration, salt intake, compression garments, sleep, pacing, and nutrition.
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Physical therapy or rehabilitation: Some clinics offer customized exercise or therapy programs to improve tolerance and reduce orthostatic intolerance.
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Medication management: Providers may prescribe medications such as beta-blockers, fludrocortisone, or midodrine for symptoms like low blood volume or tachycardia.
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Multidisciplinary care: Collaboration between cardiology, neurology, physical therapy, psychology, and other specialties.
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Education and support: Resources for patients and families, along with access to support groups.
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Referrals to other specialists: For concerns related to gastrointestinal, autoimmune, or rheumatologic issues, or for mental health support.
How Do I Find a POTS Clinic?
There’s no single pathway to finding the right clinic, but these strategies can help:
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Search online: Use terms like “POTS clinic,” “POTS specialist,” or “dysautonomia clinic” to find providers near you.
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Ask your primary care provider for a referral: They can connect you to cardiology, neurology, or autonomic specialists familiar with POTS.
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Use specialized directories: Organizations such as The Dysautonomia Project list vetted providers and clinics.
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Check major hospitals and academic centers: Places like Mayo Clinic or Cedars-Sinai often have autonomic testing units or POTS-focused programs.
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Look for POTS-focused programs: Some medical centers run autonomic or dysautonomia clinics as part of their broader cardiovascular or neurology departments.
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Call clinics directly: Ask about their experience with POTS, diagnostic capabilities, treatment approach, and what the intake process looks like.
It’s completely appropriate to seek multiple opinions. You don’t need to commit to the first clinic you find, and you shouldn’t feel obligated to stay with a provider who isn’t addressing your symptoms effectively.
