Published peer-reviewed research shows that Cognitive FX treatment leads to meaningful symptom reduction in post-concussion symptoms for 77% of study participants. Cognitive FX is the only PCS clinic with third-party validated treatment outcomes.
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If you’ve been diagnosed with postural orthostatic tachycardia syndrome (POTS), daily life can feel unpredictable and exhausting. Many POTS patients experience lightheadedness, heart palpitations, brain fog, chest pain, fatigue, and difficulty standing for long periods. These symptoms of POTS often interfere with work, relationships, and overall quality of life.
In this article, we’ll cover natural remedies for POTS, including lifestyle changes and common POTS treatments. These approaches can be effective—especially early on—and many patients see real improvements in heart rate control, blood pressure stability, and hydration.
However, some patients continue to experience orthostatic intolerance, blood pooling, and autonomic symptoms despite doing “everything right.” If that’s you, understanding why these strategies help—and where their limits are—can clarify next steps.
Below, we cover:
POTS is a form of dysautonomia, meaning a dysfunction of the autonomic nervous system (ANS)—the system that regulates heart rate, blood vessels, blood flow, body temperature, breathing, digestion, and more.
Most POTS treatments focus on stabilizing cardiovascular outputs like heart rate, blood pressure, and blood volume. These are important—and often necessary—but they don’t always address the root causes of why the ANS is misfiring in the first place.
Most natural and lifestyle-based approaches work by supporting autonomic regulation. The treatment we offer at Cognitive FX (described below) goes one step further: retraining the autonomic system to achieve long-term regulation improvements (versus just symptom management).
With that context, let’s walk through the most helpful natural strategies first.
Increasing salt intake is the most common natural treatment for POTS. Sodium helps the body retain fluids, increasing blood volume and improving blood flow back to the heart and brain. This can reduce dizziness, heart palpitations, and fainting.
Typical recommendations include:
Ways to increase intake:
Consider salt tablets (with medical guidance)
Be cautious: some patients experience nausea, vomiting, or dehydration if salt tablets are too strong.
Digestive symptoms are common in postural tachycardia syndrome due to ANS involvement in gut motility. Dietary changes can reduce symptom flare-ups and support energy levels.
Some types of diets that may suit patients with POTS include:
These approaches can reduce bloating, nausea, and fatigue, while also improving nutrient absorption. Work with a dietitian when possible.
Eating smaller meals more frequently prevents large shifts in blood flow to the digestive tract that can worsen dizziness and blood pressure drops.
Aim for 5–6 balanced meals per day.
Alcohol causes vasodilation and fluid loss, worsening blood pooling. While individual tolerance varies, even small amounts can exacerbate symptoms, so it's generally recommended to avoid alcohol, especially if your symptoms are severe.
If you choose to drink, make sure you follow these recommendations:
If you start to feel dizzy, stop drinking alcohol and start drinking water
Patients with POTS should monitor their caffeine intake, as it can have mixed effects. For some, caffeine increases heart rate and causes dehydration, which worsens symptoms like dizziness, lightheadedness, and irregular heart rhythm. For others, caffeine may actually help increase alertness and raise blood pressure.
Our advice is to see how your body reacts to caffeine and reduce or avoid it if it aggravates your symptoms or disrupts sleep. Keep a journal of your symptoms and caffeine intake to see if there is a correlation.
Nausea is a common symptom for patients with POTS. Some patients find some relief using natural products, including:
Common supplements used in POTS treatment include:
B Vitamins: B12 and B1 deficiencies have been linked to severe symptoms in patients with POTS. Vitamin B supplementation reduces neurological symptoms and boosts energy.
Magnesium: This mineral is important for heart health and muscle function, and it can improve sleep and anxiety.
Omega-3 Fatty Acids: Fatty acid supplementation can help patients with POTS by improving blood circulation and supporting brain health.
Vitamin D: Deficiency is common in POTS patients and can worsen symptoms like fatigue, muscle weakness, and heart issues. Vitamin D also helps regulate the ANS, which controls heart rate and blood pressure, crucial for managing POTS symptoms.
Other potential supplements: Vitamin C, probiotics, L-Carnitine, CoQ10, and glucosamine may also be beneficial.
Always discuss supplements with your healthcare provider, especially if you have other health conditions.
Appropriate physical activity improves autonomic regulation over time. Regular exercise strengthens the heart and muscles—improving blood circulation and reducing the risk of blood pooling in the legs. In turn, this reduces symptoms such as dizziness, palpitations, and fatigue. Exercise also trains the ANS to better regulate heart rate, blood vessels, and blood flow during posture changes.
The most common recommended progression includes:
Start in a recumbent position: Patients should start in a horizontal or reclined position to avoid triggering symptoms. Examples include recumbent biking, rowing, or swimming. Ideally, patients should begin with just a few minutes at a time and slowly increase the duration.
Gradually add upright exercises: Gradually, patients should start doing some exercises in the upright position, using a combination of cardio and resistance training.
Leg and core exercises: It’s important to include exercises that strengthen leg and core muscles to improve blood return to the heart. Examples include leg presses, leg curls, abdominal crunches, and planks.
By applying gentle pressure to the legs, compression garments (such as compression stockings) prevent blood from pooling in the legs and promote blood circulation back to the upper body. This prevents a rapid increase in heart rate when standing up and alleviates symptoms such as dizziness, palpitations, and lightheadedness.
There are various types of garments that patients can wear, but ideally these should cover the calves, thighs, and lower abdomen. Compression socks are easy to use, but are less effective than garments that cover the full lower part of the body.
How to choose the right compression level for you:
Start low: If you have never worn compression garments before, start with a low compression level (like 8-15 mmHg or 15-20 mmHg) to get used to the feeling.
Increase gradually: As you get used to them, you may find that you need a stronger compression (like 20-30 mmHg or 30-40 mmHg) to help with more pronounced symptoms.
Consult a doctor: It is crucial to discuss with your healthcare provider before buying any compression garment. Your doctor can help you determine the right level of compression for you and ensure there are no contraindications, such as reduced blood supply to the legs caused by peripheral vascular disease or diabetes.
Wear them during the day: These garments should be worn during the daytime when you may need to stand up. Remove garments during sleep.
Many POTS patients live in a constant fight or flight state, experiencing the feeling of being “tired but wired,” and making sleep difficult.
Helpful strategies include:
Establish a regular sleep schedule: Go to bed and wake up at the same time each day, even on weekends, to regulate your body's internal clock.
Enjoy a relaxing bedtime routine: Take a warm bath or shower, listen to calming music, or read a book to wind down before bed. Avoid using your mobile phone before bedtime.
Keep your room comfortable: Ensure your bedroom is clutter-free, dark, quiet, and cool. Dim lighting in the evenings can be helpful.
Avoid certain foods and drinks: Limit caffeine, especially in the hours leading up to bedtime, as it can interfere with sleep.
Raising the head of the bed 4–6 inches can reduce morning dizziness by encouraging fluid retention overnight.
Acupuncture shows some promise in helping with POTS symptoms by encouraging the ANS to reduce sympathetic overdrive and increase parasympathetic activity to relax the body. However, research is limited, and more large-scale clinical trials are needed to confirm its effectiveness.
Specific points, particularly on the ear, are known to stimulate the vagus nerve, which in turn decreases heart rate and increases parasympathetic activity.
Our advice is to speak with your doctor before trying acupuncture, especially if you have other health conditions, are pregnant, or have implants like a pacemaker.
Patients with POTS should avoid environments with hot temperatures, such as hot weather (especially humid days) and hot showers or saunas, which may increase body temperature.
Heat triggers symptoms because it forces the body's already dysfunctional ANS into overdrive to cool down. Blood vessels dilate, making it easier for blood to accumulate in the legs. This triggers an increase in heart rate, causing dizziness and lightheadedness.
Put simply, heat adds significant stress to the cardiovascular system, making it harder for patients with POTS to manage blood pressure and heart rate.
Some practical strategies to help minimize POTS symptoms:
To help manage symptoms during the day, patients can use physical countermeasures to prevent blood pooling in the legs.
Patients with POTS should avoid bending over at the waist. This tends to worsen dizziness and lightheadedness by pooling blood in the head and chest. This sudden change in blood flow can trigger a sudden increase in heart rate, leading to dizziness, palpitations, or fainting.
Instead:
Bend at the Knees (Squat): Instead of bending at your waist, squat down by bending your knees. Keeping your head above your waist allows your body to maintain normal blood flow.
Change Positions Slowly: If you need to sit or bend, change positions slowly to allow your body to adjust. For example, when getting out of bed, spend a few seconds sitting on the edge before you stand up.
Patients are also advised to avoid prolonged periods of standing. If blood accumulates in the legs, it triggers a sudden, excessive increase in heart rate, causing symptoms like dizziness, weakness, and brain fog.
If you need to stand for a long period, don’t just stand still. Use counter-maneuvers such as flexing foot and calf muscles, leg crossing, and squeezing your glutes, or shifting weight between your legs to help pump blood back to the heart and improve circulation. If these don’t work, try sitting down or even squatting to promote blood flow to the brain.
About 90% of patients with POTS experience breathing problems when stressed, such as hyperventilation, shallow breathing, chest pain, and shortness of breath. This activates the fight or flight response and aggravates POTS symptoms.
The good news is that breathing is one part of the autonomic nervous system you can control. Unlike heart rate or blood pressure, you can consciously slow your breathing down and change how deeply you breathe. That makes it a powerful, practical tool for calming the nervous system and managing POTS symptoms.
Research shows that slow, deep breathing helps shift the body into a more relaxed, parasympathetic state. It can also improve oxygen delivery to the brain and help prevent you from blowing off too much CO₂—something that often contributes to dizziness, chest tightness, and feeling short of breath.
Two examples of breathing techniques that can help POTS patients include:
Diaphragmatic (Belly) Breathing
Pursed Lip Breathing
Severe physical and cognitive fatigue is common in people with POTS and, in some cases, can overlap with chronic fatigue syndrome. Some patients feel exhausted all the time, while others notice sudden waves of fatigue that come and go throughout the day. This fatigue can appear unexpectedly—even right after waking up.
When fatigue becomes overwhelming, it often leads to inactivity, muscle stiffness, and disrupted sleep. Over time, this makes it harder for the body to regulate blood flow, which can worsen symptoms like dizziness, brain fog, and heart palpitations, creating a difficult cycle to break.
To manage this, patients are encouraged to pace their activities throughout the day. Break larger tasks into smaller, more manageable steps, prioritize what truly needs to be done, and schedule regular rest breaks. Gentle activities like yoga or mindfulness exercises can also help calm the nervous system.
The goal is to learn your body’s limits and avoid pushing past the point where symptoms flare, such as dizziness or a rapid heart rate. Keeping a daily log of activities and symptoms can be especially helpful for identifying patterns and recognizing personal triggers.
Many people try all of the above—increased salt intake, compression garments, gentle exercise, supplements, and recommended lifestyle changes—yet still find themselves dealing with dizzy spells, brain fog, and exhaustion that never seems to go away fully.
That’s because these natural remedies and commonly prescribed treatments primarily focus on helping to manage their POTS symptoms, without addressing the underlying dysfunction of your autonomic nervous system.
While the above strategies can help, many patients agree—it’s no way to live your life!
If you’re in this group of patients for whom standard treatments haven’t worked, it’s worth pursuing treatment through a clinic that offers a neurologic-focused treatment that targets the root causes of POTS.
This is what we do at our clinic, Cognitive FX.
Our 4-day 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 treatment.
Our approach focuses on retraining autonomic regulation, using a carefully designed set of therapies that target different components of ANS dysfunction:
Comprehensive medical and neurophysiological assessment: Functional testing of orthostatic response, vestibular function, cranial‑nerve inputs, and breathing mechanics to create a customized treatment plan.
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.
Vestibular Recalibration: Exercises that improve vertical‑change sensing and reduce orthostatic overreactions.
Breathing Mechanics & Chemistry: Nasal/diaphragmatic technique; longer exhales; CO₂ support as indicated.
Cranial‑Nerve Stacking: Taste/scent inputs (e.g., salt intake pre‑interval, calming scents during recovery) to steer autonomic tone.
CO₂‑Based Recovery: End‑of‑day CO₂ suit for relaxation and tissue perfusion.
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 POTS 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.
Andy is a Certified Athletic Trainer (ATC) and Z-Health Performance Master Trainer. He began his career in Orthopedics, then worked as Head Athletic Trainer and Director of Human Performance at a specialty physical therapy clinic. Here, his passion for innovative human body approaches ignited. In 2010, he founded Fitness Evolved in Berkeley, CA, focusing on a neurologically informed health and exercise paradigm. Andy mastered the Z-Health Performance Solutions system, creating brain-centric training and rehab at Fitness Evolved, serving diverse clients, including pro athletes and brain injury survivors. He's an accomplished Z-Health instructor, having trained professionals worldwide. Andy is thrilled to join Cognitive FX, contributing to our revolutionary concussion and TBI recovery techniques.
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Published peer-reviewed research shows that Cognitive FX treatment leads to meaningful symptom reduction in post-concussion symptoms for 77% of study participants. Cognitive FX is the only PCS clinic with third-party validated treatment outcomes.
READ FULL STUDY