Which is it, POTS or Anxiety?

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About Dr Nathan Keiser:
Dr. Nathan Keiser DC, DACNB, FABBIR is a board certified chiropractic neurologist specializing in non-surgical, non-pharmaceutical treatment of dysautonomia, traumatic brain injury (concussion), and movement disorders.
Dr. Keiser was certified as a diplomate in chiropractic neurology by the American Board of Chiropractic Neurology (ACNB) in 2010
and has since served patients from across North America and around the globe in private practice.
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[@maafa21MustSee]

For those watching this, research vitamin b1 thiamine deficiency.

[@glitcheddivinity]

Will do! Thx!

[@pinkkvsh4583]

That’s crazy. You may have cured my suffering cause I relate too much to the symptoms.

[@marianacadore9245]

Very good video. I also add to the doctors: “ if you are saying I have anxiety, then why don’t I have anxiety when I am lying down.” For me is a big and frustrating misdiagnosed when they say you have anxiety but you still get no help and you can’t sit or stand. Treat the body as a whole connected system but don’t let doctors say this is anxiety when clearly is a physical disorder that many don’t even heard about. Keep fighting for your healing. Thanks Nathan 🙏

[@thechronicillnessdiaries2773]

I was told it was anxiety in the ER. Funny thing...apparently I ONLY get "anxiety" when I stand up. It took a few years but was finally diagnosed with POTS, gastroparesis, ect. If you have anxiety...your heart rate would be high even when seated. Tachycardia that presents ONLY when you stand up is KEY to POTS.

[@dockeiser]

Very important distinction! Some people will have anxiety about standing specifically, but this is definitely not always the case

[@Dulcimerist]

The ER is the worst place to go for POTS related issues. Have they tried you on Mestinon (Pyridostigmine) to treat your gastroparesis and POTS? It's an older medication that research hospitals like Mayo Clinic and Vanderbilt Autonomic Dysfunction Center have repurposed to treat those issues. Do you have Ehlers Danlos syndrome? POTS and gastroparesis are often associated with that and other health issues.

[@TonyJavierTV]

Same here! Almost punched the doctor.

[@MusicFandom]

I am 49 and have always been told my symptoms are from anxiety. I do have anxiety along with PTSD, ADHD, severe MDD. So I feel this always gave Dr.s an easy out every time I went to the ER for collapsing (usually 2-6 times per day during bad spells). I was always told it is my anxiety and I have vertigo. I just recently learned about POTS because for fear of a brain tumor or something else in that ball park, I have had MRIs EEGs and CT scans with nothing to show I started doing my own research. I relate to so many symptoms of POTS. I am dizzy all the time, My resting BPM is about average I think 80-90 but when I stand up it starts rapidly climbing to anywhere from 130 to 170 BPM and every once in a while, it will only rise to around 120 bpm. When I sit back down or lay down it starts going back down pretty fast. If I take a hot bath when I get out it shoots to 160-180 bpm and my heart feels like it is trying to beat its way out of my chest. I rarely think clear anymore. I can be asked the easiest of questions and just cannot figure out what I am being asked. It is so frustrating! I finally called my Dr. to schedule a POTS test and before we hung up I was asked "So to be clear, you are wanting a marijuana test?" LORD I hope it goes well when I go for the test in 13 days and they better not just hand me a cup and point to the restroom!.....

[@dockeiser]

Oh man, that is frustrating. I hope you are able to find help with them. We are here if you ever need.

[@Catlily5]

It took me ten years to get diagnosed with POTS! Good luck!

[@user-id4zm1bh3m]

I have almost identical symptoms to yours, but I've always been told they're due to anxiety. However, I believe my physical discomfort came first, followed by the anxiety. I often feel that those doctors fail to look beyond just anxiety as the sole cause. I also experience discomfort in my neck and gastrointestinal issues. l'm seeking the root causes of my symptoms,but as a patient, it's indeed challenging to accurately identify the underlying causes on my own.

[@evonne315]

I can tell you the feeling of anxiety and the feeling of POTs are worlds apart. WORLDS APART.

[@paulmoore6175]

Totally

[@trailerparkferraris7969]

How can you tell? I have not got a diagnosis because they are blaming anxiety

[@samanthanorman6631]

Agreed

[@SaltyDogPerformance]

This is hands down the best explanation of differentiating between anxiety and POTS that I have seen. I’ve been telling my doctors for years that yes I do have anxiety but I have physiological symptoms that come on first and then the anxiety ramps up. In the past 6 months I went from being able to workout and push myself in the gym “except for cardio cause that has always fed my anxiety for high heart rate” to not being able to work out at all. They put me on klonopin 1mg a day with no resolve and then switched me to 10mg of Valium a day with no resolve. Tried taking beta blocker and it kept my heart rate from climbing but made my whole body feel tense like all the adrenaline was trying to go everywhere else. The only medication that has helped a little has been clonidine but that’s simply because it would sedate the hell out of me. Now they want to put me on diltiazem 120mg a day because I’m having resting heart rate of 52 average but then I stand and it stays at 85-100. My cardiologist and electrophysiologist have yet to do a tilt table test on me or other tests. They have just done EKG, Echo, and halter monitor and structurally the heart is fine. They did see some SVT in the halter monitor though. I was just in the ER the other day because my resting heart rate was 100 and then I stood up and it shot it to 160. It took an hour and a half of it going down to 90 or so sitting down and climbing back up rapidly before it finally stopped but stayed at a resting rate of 90 for a while. I decided to go to the ER anyways. Of course they said everything looked fine. I have a neurology appointing at UAB on Monday and I pray that they are able to help me with this. I’ve not been able to workout or do the things I love like boating and jet skiing without the fear of having some sort of issue.

[@charizzemaeinot6349]

hi @sal. i also feel the same way. Ive been to the ER and all my tests were doing fine. also did ecg, 2d echo w/ doppler, halter, and they saw abnormalities in my heartbeat whenever I feel lightheaded. She suggested cardiac mri then I saw these videos about POTS and I think this might be it. I have low BP, and I sometimes feel dizzy whenever I stand for a long time. I also have cold sweats and my heartbeat goes over 100. I just hope I can find someone who can diagnose and help me.

[@skyechambers1968]

I have pots after trying many meds amlodopine has given me a bettet equality of life.. i was told by my cardiologist if heart rate is over 165 for a duration of time to get to ER or call paramedics. Wishing you a good health x

[@stephenmarkmirar4602]

@@charizzemaeinot6349 Any updates about your diagnosis? I'm from Philippines too.

[@Faithandseekerofchrist]

I've been to the hospital four times and they are all pretty much useless. At this point it is probably better for me to go to specialist. If I Collapse on the floor and get unconscious then get an ambulance and if my heart rate is dangerously fast then yes. But I'm not going to call the paramedics or go to a hospital every time I go to these hospitals for hours just for them to say everything is normal and for them to prescribe me anxiety meds. If I wanted anxiety meds I will go through my psychiatrist which I'm already on anxiety meds for the past couple weeks. The only thing that improved was my sleeping but other than that all my other symptoms are still here.

[@Dulcimerist]

Yeah the beta blocker keeps the heart from racing but leaves the alpha receptors open to be triggered by the adrenaline and norepinephrine, causing vasoconstriction and other responses. The Clonidine prevented the large surge of adrenaline and norepinephrine from happening in the first place, which is why it helped you better. Its sister drug, Guanfacine, functions the same as Clonidine, but it doesn't induce drowsiness. Why didn't they switch you from Clonidine to Guanfacine to avoid the sedation, while keeping the same benefit?

[@Dulcimerist]

The hyperadrenergic form of POTS is the worst for getting misidentified as anxiety, due to overactive and exaggerated activity of the sympathetic nervous system (fight or flight response) being at the source of it. Thankfully medications like Guanfacine and Clonidine specifically target the sympathetic nervous system to calm it and prevent the wild swings that trigger this type of POTS. Interestingly enough, Guanfacine and Clonidine are sometimes prescribed to treat anxiety as well.

[@whitney8931]

This resonates so much with me. It’s that constant battle of what came first; the chicken or the egg? Is the POTS causing my anxiety or is my anxiety fueling my POTS symptoms? Very tiring. 2:24

[@Peace4globe851]

Excellent. This is exactly how I feel. First symptoms then anxiety and they want to lanky me with anxiety as a source. I’m going crazy as I’m not receiving the care I should be receiving

[@mariannesmiley300]

This is brilliant. As usual

[@dockeiser]

Thanks Marianne. Very kind of you… as usual ;)

[@ChristinaHarr]

This is by far one of the videos i have watched. I have been battling with a mirage of related POTS symptoms for 9 years. Sure wish i live close for a possible consult with you. I worked as Physical therapist assistant for 21 years and just recently took a leave of absence from my. As a therapist we statically stand alot, to assist patients or just communicate with them while doing exercises. All of my physiological symptoms manifest in standing. I am hopeful for a diagnosis soon and possibly treatment. Unfortunately tilt table tests through John Hopkins is not till the end of November. Please keep advocating for patients like me.

[@TraceyPoland]

I wish you were my doctor... I started taking corlanor which lowered my heart rate but I’m still highly symptomatic...thank you for putting out content on this.

[@upennucsb]

Very informative! I suspect I have hyperadregenic PoTs. My symptoms started 4 years ago after rounds of viruses my son brought home from daycare. Totally thought I was dying... Saw tons of doctors even herbalists and accupuncturists. Not completely recovered but let's say symptoms on and off with on being the majority. Then last Spring my mom was diagnosed with cancer while I was 1 month postpartum. A lot of emotional stress at that time for 3 plus months, then I definitely feel that the symptomatic days became more. Then I got covid, things became really bad. I am having borderline diagnostic heart rate and blood pressure increases upon standing. Numbers are not important. What's important is the symptoms are just Pots and other dysautonomia. And I also found that anxiety and emotional stress do also worsen the symptoms. For example I used a month of time to gradually decrease my daily symptomatic time. Then a week ago my mom was hospitalized again and was told the cancer relapsed. She was given months by the doctor AGAIN. I could definitely see all the symptoms worsened so noticeably. So for me I think yes it's a two way street. First I had symptoms unexplained and unmanaged by doctors after doctors. So my overall stress level is high. Then specific life events wrecked havoc on mental health status creating more stress hence more physical symptoms. For me, at this particular point of time, I personally think managing symptoms is the key. Because I can foresee that losing my mother is a thing with high possibility. Even if she survived anothet time like she did last year, it's not gonna be easy. It's gonna be rounds of emotional roller coaster rides.

[@dockeiser]

So sorry to hear about your mom. My best to both of you. Yes this is a good point. Anxiety can be a profound catalyst and being sick or dealing with a health concern can certainly leave us susceptible to any additional stressor. I wish you the best. Take care

[@Dulcimerist]

I do have hyperadrenergic POTS, which is why I'm currently on Guanfacine. It specifically targets that by calming the sympathetic nervous system (fight or flight response). It's also commonly prescribed off-label to pediatric patients to treat anxiety, since it doesn't have the long term risks associated with anxiety medications. Its sister drug, Clonidine, can also be used, but that one tends to cause quite a bit of drowsiness.

[@princessmari5063]

I was told it was just "anxiety" for 30 yrs by MANY different doctors. With a new PPO health insurance plan, I was able to make an appointment with a neurologist without a referral. Tilt table test and examination positive for POTS.

[@dockeiser]

That’s a great start! I hope you can get some traction and start feeling better!!

[@princessmari5063]

@@dockeiser thank you so much. Treatment options have started and helped. I just wish my symptoms were not brushed off for so many years.

[@traumagurl9307]

Anxiety attacks and norepinephrine being constantly pumped thru your system 24/7 due to hyperadrenergic pots are not the same or related at all! I don’t get occasionally anxious! I constantly have norepinephrine being pumped through my body due to a dysautonomia. These two are not related at all.

[@vwvr6x]

Thanks for this video. I can relate. Since Covid I think I have POTS though it hasn't been officially diagnosed. I'm being treated for Anxiety. I finally was able to get to see a cardiologist, I am under heart monitor for 30 days. I have Constant heart palpitations. I've counted 20 per minute when they get bad. Tachycardia up to 123bpm upon standing, average resting 85. I used to work out almost every day and can no longer do so. I can not do any heavy physical exertion without getting light headed. I can no longer mow the lawn and had to hire lawn service. My quality of life has decrease dramatically including mental health issues. Some days, like today I feel like absolute garbage. I have IBS. I get lightheaded when standing. I really wish I could find a Dr. like you in my area that is actually putting in research for this debilitating issue. All I'm getting right now is drink more fluids, intake more salt, take propranolol and "try to relax". How can I relax when I am constantly palpitating?

[@jonhouse7962]

You sound exactly like me until I stated taking Nadolol 10mg a day in the morning. Propranolol did not work for me talk to your cardiologist as I am doing evercise again without spikes in the heart rate, getting back in condition and maybe can come off the nadolol. It helps me with the heart rate which sounds exactly like yours at 123 standing, I would freak out and it would go higher (feed badk loop is a bitch). But, I thought I would share because everyone is different another cool part about nadolol is it has long lasting effects that last over 24 hours so it keeps you pretty level. I started in May 2022 and I am getting back to normal. Interestingly my GP is the one that started me on the Nadolol and I started back to work in a month. I had a non fuctioning gallblader removed 1/2/2022 which I did not eat right until about april. I also lost 35 pounds and stopped moving around, evercise play basketball (every weekend). So again Nadolol. Good luck

[@vwvr6x]

@@jonhouse7962 Thank you for this. I am def. going to ask to switch to the Nadolol. I like the idea that it's longer lasting too.

[@dockeiser]

I’m sorry to hear you’ve been going through this. What is your area? Perhaps we can find someone to help you get started?

[@dockeiser]

The question to consider here is whether the tachycardia is THE problem or is it your body’s way of compensating? If it’s a compensation, what would be the purpose in altering it?

[@vwvr6x]

@@dockeiser I'm in south florida

[@832Pokemom]

When you say anxiety, are we talking about emotional anxiety or the type of anxiety where one doesn't feel anxious at all but has physical symptoms of anxiety such as insomnia or shallow breathing but not feeling anxious for the most part. But my heart rate even when I'm very relaxed does goes up whenni stand up and stays up there.

[@Thaelyn1312]

I really appreciate this, because everyone is gaslighting me that it's anxiety. I have had anxiety & panic attacks before, I know what they feel like; heart palpatations when I stand & walk around slowly is not anxiety! lolsob I have a fitbit & I can see the spikes in my heartrate every time I stand up.

[@stephaniew4168]

My daughter has anxiety around being alone. She's 11 and still sleeps with me. She wants to sleep with her bestie when she sleeps over but she's terrified even to sleep in the next room with her friend or terrified for me to go outside when she's in the house alone. Otherwise, she is pretty balanced but this is starting to hold her back. I'm taking her to you in June and I hope this is 1 "symptom" we can help.

[@Jolei33]

I am dealing with similar to long Covid symptoms but had this prior to Covid. It’s improved some since I explanted my breast implants. I had a reaction to the adhesive silicone gel. It’s been 9 months and fatigue and many of old symptoms returned except the chest pressure and numbness. It however has lasted now for months instead of weeks after cold and flu season. I am hoping my body is still healing and adjusting. I hate that I can’t sleep, internal tremors, wired and tired, muscle weakness and urgency to urinate. The digestive issues have mostly resolved but it all feels so sensitive. It’s disheartening.

[@dockeiser]

I’m glad the explant procedure has been helpful, hopefully your body is still recovering. Let me know if we can help in any way.

[@IPawYou]

Hello Doctor Nathan, is there any way to contact you? Many thanks, Anna

[@lisachristinaconfirmed5067]

Such a great informative video. Very validating for those with POTS. What is the best route to go in terms of which intervention if you have POTS from a concussion?

[@dockeiser]

Thanks so much 😊. I would consider looking for a specialist that focuses on that area. You can send us a message on the website or call and we can see if there is anyone near you that would be a good fit!

[@lisachristinaconfirmed5067]

@@dockeiser ok I will send you a pm. Thank you

[@lisachristinaconfirmed5067]

@@dockeiser sent you an email from Lisa J

[@crystalkeara8868]

Anxiety doesn’t cause your heart rate to increase by 30 bpm or higher when you’re upright. I don’t understand how someone doctors were able to get their degree. Some of the things that come out of their mouths blows my mind. You’re so spot on! I have POTS. The only time I get anxious is when I’m about to pass out. Although, I think it’s my body reacting to what’s going on. The adrenaline seems to fix whatever was happening. After a huge adrenaline sure my body feels better. I don’t know if it’s a reaction to a drop in BP or not. When I did my autonomic testing they said my BP was fine. This condition can be so difficult to figure out. Maybe I need to come see you.

[@MusoStuu]

Nathan, what exercises did you prescribe for this lady?

[@berguzarkorel5350]

What exercises did you give to this patient ?

[@ChrisGascoigne1]

Thank you for this video Nate, really fascinating insight into this topic and as you said, anxiety is at times, a 'palm off' diagnosis that is all too often being wrongly handed out and it's making people lose their minds because it's making them believe that they have control over what are ultimately, automatic symptoms; they believe that the continual dysfunction of these systems is down to their own mindset. The case study you discussed is fascinating, because as POTS sufferers, we're often under the impression that there is a lack of vasoconstriction in the body causing inadequate blood flow to the brain; so we carry out activities and tense our bodies in ways that may promote this delivery of blood or at least reduce the distance it has to travel against gravity. Are there often symptom differences you recognise between those with vasoconstriction issues vs those with vasodilation issues? I also found it very interesting when you spoke about the metabolism having an impact on POTS and an elevated heart rate. Some years ago, seemingly all at once I ended up with severe constipation/poor gastric motility, cold hands/feet with blood pooling, a lower body temperature (35.5c - 36.5c) and a resting heart rate of around 75 seated, which raises to around 100 on standing. Needless to say that these symptoms have caused me immense anxiety over the last 6 years, whereas previously I had so much confidence during each day and never thought about my health at all. Is there any advice you can offer on what to do with an extremely slow/damaged metabolism? If not, are there any articles or journals on the topic you could point me in the direction of? Any advice is greatly appreciated. Once again, great video and hugely needed within this community, keep up the amazing and inspiring work! 😁

[@dockeiser]

Hi Chris, my heart goes out to your for what you've been dealing with and working through. As I'm sure you've learned through this time, what you've experienced isn't exactly common, but it also isn't without precedent. I'm attaching a link to an article from the journal neurology that describes post-antibiotic encephalopathies that are known to occur and may provide a framework of understanding. For you specifically, I am happy to have a conversation. We should probably change the forum in order to have a more useful conversation. Feel free to reach out via email at [e-mail] and we can connect. Take care, great to hear from you again. prd-medweb-cdn.s3.amazonaws.com/documents/darbylab/files/Neurology-2016-Bhattacharyya-Darby_antibiotic_encephalopathy.pdf

[@ChrisGascoigne1]

@@dockeiser Thank you very much for your reply Nate and for presenting that information on antibiotics and brain trauma - it's really appreciated. I've just sent you an email to the address you mentioned above and I look forward to hearing back from you. Best Wishes, Chris

[@dockeiser]

@@ChrisGascoigne1 any time. looking forward to hearing from you. 🙏

[@nancylouin2002]

@@ChrisGascoigne1 it's interesting that when I read your description I thought it sounded like sepsis and the paper was about post antibiotic symptoms. Perhaps it was inadequate antibiotics and an undiagnosed infection. I have been septic several times and they don't understand how to diagnose it.

[@2blackcatz426]

Thanks so much for this. I have been diagnosed with epilepsy my whole life. I have always known this syncope is not epilepsy. 58 years, still no GP listening Might be vasal vagal syncope but the recent collapse (first in 14 years) outdoors in a driveway with ambulance has put me back in fear mode again and I fight agrophobia I'm in Australia and would love to have my diagnosis corrected My GP actually said "why bother?" ppppfffttt I need to inform family and others the correct first aid for episodes. Can you recommend any practitioner here in Australia that would take me seriously?

[@dockeiser]

Im sorry to hear you’re trying to work this out for so long! There are some great doctors in Australia. You can go to acnb.org. Click the doctor locator tab and search near you. I hope that helps!

[@siobhancunningham2923]

I have been diagnosed with pots 1 year ago nessrly 2 years symptomatic. I think a surgery caused it. I have noticed i walk off balance and get alot of vertigo i habe noticed lately my left akde goes numb my hand ? Where can i get a better diagnosis like you mentioned im from ireland

[@sergiogomez6]

Do you know of anyone in the Georgia area that works similar to how you do

[@natashapryor8154]

I hope to heal my pots, I'm in Australia, I also suffer FND, Doppler ultrasound says vtos and possible eds .your videos are fantastic information

[@dockeiser]

Thank you so much for the compliment. I am rooting for you down there. Let me know if you need help or want me to talk about anything specific

[@audreygu327]

Brain Hub in Sydney will be able to help you. I’ve got pots from the c virus, I’ve been going for treatment at brain hub, it’s helping me a lot.

[@Dulcimerist]

@@dockeiser "Rooting" means something different in Australia.

[@k91985]

I went on a tilt table at a friend's house just to stretch my back. I didn't fit till later that evening. Also with me amatriptylene and sumatriptan cause me to collapse and fit. I am ok lying down and get strong anxiety or very breathless when I start moving ie house work 😂 it is much worse if I'm already upset so partially anxiety

[@sheilapatterson4140]

Is pots similar to orthostatic tremor? I’ve been diagnosed after 10 years with orthostatic tremor and severe anxiety. The tremor on standing brings on anxiety.

[@kevinfitzgerald7474]

It's pots and or the causes of pots which does cause anxiety. But to label someone with anxiety and or depression without looking at records that prove of the pots symptoms nor listening to the patients is very wrong and misdiagnosing. This is also happening to me and I am absolutely disgusted at how these drs just ignore reality and just speculate and make stuff up.

[@djcardwell]

Can you do a video on medical cannabis and POTS? I'm POTS diagnosed and also suffered a car accident neck injury and I'm considering medical cannabis for treatment instead of pain medications.

[@Dulcimerist]

How badly did your vagus nerve get injured in your accident?

[@VintageRayne]

For me. Anxiety is my head. Thought train off the rails type situation. POTS is purely physical. I’ll be calmly coloring or whatever. And bam! HR at 150+.

[@mrs.g4997]

Have you seen any correlation with Gastric Dumping and Autoimmune Metaplastic Atrophic Gastritis? I have been suffering for over 32 years. I was just told I likely have POTS. I failed a portion of the tilt table test. I cant each large meals, I will faint.

[@nancylouin2002]

For me, the behavior of standing up creates the physiologic effect and if I change that behavior to lying down I feel better. So it is behaviorally related. I do become anxious when I think I'm going to die because of chest pain and unstable blood pressure but at this point, I'd rather die at home than the er.

[@peterparaskov7379]

Thank you for the great videos. I'm wondering at which heart level difference do you consider that a patient have pots? Per example I'm 41 years old always had a rest heart rate of 55-60bpm but in the last months my heart rate is more around 80 when sitting and 100 when I stand up. Doctors say it is normal, only one mentioned about pots related to covid, so it is very confusing for me is it really pots or no?

[@dockeiser]

Thank you! Great question. This doesn’t specifically fit into the diagnostic criteria of POTS, but it is also a departure from typical physiology for you. If you’d like we can make time for a conversation and we can learn more about the full picture of what you’re dealing with. Take care

[@CelestialTrailblazer]

Apparently, everyone with Long Cov!d or post cov!d syndrome experiences the exact same issue. Shortness of breath and abnormal high pulse rate upon slight exertion. It could be that the part of the brain responsible for respiration and the diaphragm muscle temporarily freezes or malfunctions due to post viral infection damage or post cov!d damage in our case. That's why this strange type of shortness of breath is experienced. As I had mentioned before, I think cov!d damaged both the autonomic nervous/muscle systems. Apparently, everyone with Long Cov!d or post cov!d syndrome experiences not just shortness of breath due to what could be respiration/ diaphragm muscle freeze/malfunction along with abnormal high pulse rate upon slight exertion but also malfunction with the LES (Lower Esophageal Sphincter Muscles). If you have a LES problem, then stomach acid will inflame the upper trachea area, causing shortness of breath. (That's what I've been told by a gastroenterologist) In my case, I apparently had chronic gastritis due to poor diet and it also could be due to inflammation caused by post-cov!d damage. Additionally, I also had a h.pylori infection with symptoms that was blamed on anxiety nonsense for 8 months until it was diagnosed by a gastroenterologist after doing an upper endoscopy procedure. I think the h.pylori bacteria remained dormant until my whole system started to malfunction after catching cov!d. So, all in all, most of my symptoms could be linked to post-cov!d damage, GERD, stomach and esophagus inflammation caused by both poor diet and, h.pylori infection .

[@carmella88]

I have this too its definetly not anxiety

[@Catlily5]

Your heart rate has to go up at least 30 beats from lying down to standing. This is for adults. There is a test for it. You can do the poor man's test at home.

[@brigittebeal2237]

This was very helpful, but is the big picture just that she just has issues when she breathes really hard? How was the origin of the issue dealt with?

[@GumowyJoe]

If I have a really stressful days it looks like I have POTS - resting hr is about 60-70, then when I stand up it goes up to 110-120. It may stay there till I sit down/lay down again. Sometimes it drops to 90-100. For example today my hr in the morning was 60, and there are no POTS symptoms - I stand up and it goes to 80-85, drops to 75-80 in a moment, so my nervous system response is quite normal. In the evenings and late evenings my symptoms go away totally - 60-65 resting, 70-75 standing. So I think it's not POTS.

[@annyies20]

It's happens to me!! I was diagnosed with anxiety two years ago, at the beginning I thought it was post because I wasn't able to stand up or walk without feeling bad... when I started to go to therapy it gets better but sometimes I feel like you, maybe you can find out what can you do for yourself (therapy, exercise, medication) and if doesn't work considered medical option (sorry for my English)

[@GumowyJoe]

@@annyies20 thx for answering! Can I contact you some way?

[@annyies20]

@@GumowyJoe do you have Twitter?

[@sheelawal7616]

@@annyies20how can I contact you how did you solve yours

[@_jessialvarez]

I have this same situation ! Only that my anxiety causes my resting heart rate to go up too. Sometimes past 100s at rest. But usually it’s 80-90 and increases while moving or standing and comes back down. Have you found a way to resolve it ?

[@lisachristinaconfirmed5067]

Dr Keiser, do you work with or have success with neuropathic POTS? Do you do a QSART test?

[@dockeiser]

A lot of POTS that we work with I combined neuropathic. I do not do a qsart currently, we do orthostatic peripheral nerve testing to hone in the differential.

[@andee0101]

It took me a year and a half to get diagnosed with POTS and the only person that’s given me relief is Dr. Fili Talamantez which is also a chiropractic neurologist. My cardiologist can only help symptoms with my heart but I’ll never be cured by him because my heart isn’t where the problem originates. So Dr. T actually works with the part of the brain that’s causing all my problems:)

[@dockeiser]

Dr. Fili is awesome! I’m so glad you have found him 😊

[@832Pokemom]

Doc, please I am in the middle of trying to figure out how to fix my POTS. I herniated a c4/c5/c6 disc's in Feb. They weren't bad, like 1.5mm. I started going to a chiro for IDD therapy to address it. But I had a lot of anxiety and panic the first three to four weeks after the injury until some of the pain went down 2 weeks after IDD. It's been 7 weeks since Injury. I noticed racing heart and so forth while I was having all the pain which I assumed was from anxiety. But I started tracking things and how I couldn't work out cardio wise because my heart was beating too fast with PVCs (which I have less than 1% burden off and on for years). But I now know I have POTs. My heart rate is always 25-30 bpm higher when I'm standing up. I used to be 70 bpm when I was standing but now 95-100. No fainting but I do get adrenaline dumps especially when I'm trying to fall asleep. Do you think anxiety could cause pots? I was thinking my pots is being caused by my neck which is reverse curve slightly and the herniated disc or the atlas that's slightly off. But if you think anxiety could actually make my standing heart rate different from sitting or laying down then I will try some meds to help with the anxiety. What are your thoughts? I was super normal before this neck thing happened and I don't even know what caused it. It was subtle since January then I played golf one day and the pain blew up.

[@832Pokemom]

Right now when I'm laying down it's like 65, sitting it's 80..up is usually 95. I need some light at the end of the tunnel. I'm 40yo and have two young boys. If it's not anxiety do you think my disc herniation could have started the pots?

[@SparkVisionHub]

I have the same issue. Ill keep you updated, I’m going to a a neurologist, also started on vitamin B1 and B12 which I noticed help

[@Dulcimerist]

@@832Pokemom If it's putting pressure on your vagus nerve, I suppose it could be possible.

[@hehunches]

U must live in a place that tests this stuff. I don't think I do

[@user-vm7ql8ce2v]

Please tell me what you think. Does this sound anxiety or pots Everyone keeps telling me it’s just anxiety I’ll be laying down and I can feel panic SOMETIMES my heart rate will be 70-100 depending but most of the time 88-95 When I even move like if I just roll over it will go to 105-110 If I sit up sometimes it will stay normal and sometimes 140-144 If I stand it will sometimes do a 170-140 and sometimes it will stay normal like 110. Sometimes I can feel anxiety symptoms and sometimes I won’t. These also come and go. Like for two weeks I’ll feel this and the next two I won’t. I will get a little faint feeling but if I breathe in and breathe out it will go away just kinda like the standing heart rate will relax but if I walk around it will get high again. It’s ups and downs. It never always does it every day. I do have anxiety disorder but I generally don’t understand what’s going on here

[@youssefhalhoussine8952]

Hello doctor, thanks for the video. I am Youssef, from Morocco, 23 years old. I got pots in March 2022 as a result of food poisoning. I am now taking beta blockers low dose (1.25mg) and working, and the symptoms have subsided, but I still suffer from shortness of breath and dizziness when standing. What can I do about it? I feel that my condition is simple and that I can recover, but I need a doctor with your competence.

[@dockeiser]

I think you are right. I’m not sure if I know anyone in Morocco. I have colleagues in Western Europe. Have you been able to get back into any exercise or endurance work?

[@youssefhalhoussine8952]

​​@@dockeiser I am currently working, but in terms of exercise, I do cardio a few times at home.

[@Dulcimerist]

Did the shortness of breath begin to worsen a bit when you went on the beta blockers?

[@Gramnae7105]

What kind of clinic am I looking for to have these issues looked into? My blood pressure rises when I go to stand.

[@dabear2438]

You could have POTS + orthostatic hypertension (an increase in BP on standing).

[@sheelawal7616]

@@dabear2438so how is the solved

[@sheelawal7616]

What are you doing about it

[@Gramnae7105]

What am I doing about it? Just trying to cope, hoping I'll figure it out. Been to doctor about it several times, numerous tests and all come back with no concerns

[@teddylovell9615]

Its ruff i hAve adhd n ptsd n pots , and its hell ! I wake with pots n with no reason have issues & its hard to understand. But at times i cant tell you my bf’s name im so fogged out

[@teddylovell9615]

Dsyautonomia is real & 15% of al covid have dsyautonomia

[@christinealdridge2760]

Where are you and how can my daughter see you.

[@todotheimpossible31]

Okey but POTs isn't caused by Anxiety this is wrong. It might cause it but it is not the cause. Again Anxiety symptom can have similar presentation but don't cause major physiological changess like the ones seen in POTs patients.

[@MusoStuu]

So so many camera cuts - in the end it was totally putting me off listening and watching..

[@berguzarkorel5350]

Also if you have anxiety it will not go away if you lye down

[@annechesley8565]

This was HARD to watch because of the editing. One camera angle and not changing the how close or far the camera is at would have been much better.

[@berguzarkorel5350]

Anxiety is part of POTS

[@alphafitter4699]

My symptoms seems to be related to digestion only..then I get the fatigue, brain fog, low blood pressure and POTS..always 30mins to 1hr after eating..especially certain foods.

[@dockeiser]

kzbin.infoUKS9L4t3loM?si=AD81aQfQ8xX0DBG7

[@dockeiser]

This is very common so you are definitely not alone. I made a video about why this happens, hopefully this will answer some of your questions!

[@alphafitter4699]

@@dockeiser that’s excellent Dr! Thank you for the video and your response.

[@alphafitter4699]

@@dockeiser something I did not mention is the histamine intolerance that I’ve been dealing with. The brain fog and POTS seem to be driven by the release of histamine and mast cells in my system. This only started 6 months ago when my digestion went bad.. anyways thank you for your help. I am actually getting better at controlling the histamine and the POTS seems to be getting better as well.. I will be checking out your neural training exercises to help with my autonomic system. It definitely needs retraining.

[@Adolf_Biden]

What's up with all the edits? I felt like I was going to have a seizure.

[@MrPartch]

did he say he is a CHIROPRACTIC NEUROLOGIST? lmao. you need to go to med school if you wanna become a neurologist and it will take at least 12 years of education