The Part No One Prepares You For
Living with POTS isn’t just about managing symptoms. It’s about managing everyday life in a body that doesn’t regulate itself well. Some days feel predictable. Others don’t. What makes the biggest difference over time isn’t one miracle treatment — it’s small, repeatable strategies that support your nervous system daily.
Start with the Basics (They Matter More Than You Think)
Hydration and sodium are not optional with POTS. They are foundational. Many people need significantly more fluids and salt than they were ever told was “healthy.” Skipping either often shows up quickly as dizziness, fatigue, or brain fog.
In general, I recommend starting with basic sodium chloride 1g tablets. There are supplements that have a mix of sodium, potassium, magnesium, and calcium like Nuun and LMNT, but these are going to be significantly more expensive especially when starting out. Plus, as we have discussed in previous blogs, they may not have enough sodium chloride to improve symptoms. Generally I have my patients start at 2g per day and increasing slowly from there. Once you determine the needed dose of sodium then you can try out the different brands that are flavored and add those in as you wish.
Change How You Change Positions
Fast transitions are a common trigger. Sitting up slowly, pausing before standing, and using muscle engagement in your legs can reduce symptom spikes. Simple things like ankle pumps or squeezing your glutes before standing help move blood upward. These habits seem small but add up over time.
Build Strength Without Crashing
Deconditioning worsens POTS, but overdoing it can also backfire. The goal is consistent, low-level movement. Recumbent exercises, floor-based strength work, and gradual progress matter more than intensity. If you’re wiped out for days, it was too much.
Respect Heat (Even When It’s Annoying)
Heat is one of the most common symptom amplifiers. Cooling vests, fans, cold drinks, and planning around the hottest parts of the day can reduce flares. This isn’t weakness. It’s physiology. Managing heat exposure is a legitimate treatment strategy.
Eat in a POTS-Friendly Way
Large, heavy meals can worsen symptoms by pulling blood into the digestive system. Smaller meals, balanced with protein and salt, are often better tolerated. Lying down or reclining after meals can also help as the blood gets pulled out of circulation into the digestive tract.
Give Yourself Permission to Pace
POTS is not a willpower problem. Pacing isn’t giving up — it’s choosing sustainability. Planning rest before symptoms hit helps prevent crashes. Over time, pacing often allows you to do more, not less. Looking at your day and determining what activities are going to be the most difficult then giving yourself small breaks to restore your system can go a long way. This does not need to always be 2-3 hours of laying down. Even 5-10 min of gentle breathing exercises can help regulate your nervous system.
You’re Allowed to Build Life Around Your Nervous System
Living with POTS requires creativity, flexibility, and self-trust. Strategies that help may look different from what others need — and that’s okay. Progress isn’t linear, but it is possible.
Share Your Story
What daily strategies have made the biggest difference for you with POTS? What took time to figure out? Your experience could help someone feel less alone.
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References
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What is HSD?. The Ehlers Danlos Society. https://www.ehlers-danlos.com/what-is-hsd/
What is eds?. The Ehlers Danlos Society. https://www.ehlers-danlos.com/what-is-eds/
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Smith, C., & Wicks, D. (2017). Understanding Hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorder: (previously known as Ehlers-Danlos Syndrome Hypermobility Type & Joint Hypermobility Syndrome, respectively). Redcliff-House Publications.
Cox, C. (2022). Holding it all together when you’re Hypermobile. Journey2Joy
Afrin, L. B. (2016). Never bet against Occam: Mast cell activation disease and the modern epidemics of chronic illness and medical complexity. Sisters Media, LLC.
Freeman, K., Goldstein, D. S., & Thompson, C. R. (2025). The dysautonomia project: Understanding autonomic nervous system disorders (2nd ed.). Bardolf.
Disclaimer
This blog is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no provider/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user’s own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.