from LONG COVID ESSENTIALS
a resources series by The Sick Times x Long COVID Justice
Many people with Long COVID develop a condition called dysautonomia, in which your autonomic functions (or things your body does by itself, like heart beating) are disturbed. There are many kinds of dysautonomia; one form seen commonly in Long COVID is called POTS, or “postural orthostatic tachycardia syndrome.”
POTS symptoms often include:
- Racing heart
- Dizziness, or feeling like you might faint
- Headache
- “Brain fog” or trouble thinking clearly
- Chest pain
POTS can happen when your body doesn’t respond well to changing positions. The automatic bodily functions that are supposed to keep your circulation working properly aren’t quite doing their job, and your heart beats extra hard to try to make up for it.
Cardiologists or neurologists usually diagnose POTS using an active standing or NASA Lean test. These tests monitor what happens when you change position, to see if your heart beats too fast. This is best done by a professional to rule out other issues and ensure you don’t faint. If you don’t have a provider, find a friend (for safety) to help you do an at-home test.
There are some things you can do at home to help manage POTS:
- Move slowly, lie down where possible. Transition from sitting to standing slowly and gradually.
- Get lots of water and salts. This will help your body maintain a reasonable blood volume.
- Compression garments gently squeeze your blood vessels, to help with circulation.
- Try sleeping with your head slightly elevated.
- Eat smaller meals throughout the day.
- Avoid the heat. Hot weather can make symptoms like heat intolerance worse.
Some will find they need additional relief. If so, doctors have used medication to help POTS patients, even though there are no medications officially approved for it in the US. You may want to ask your doctor about:
- Beta blockers, which slow the heart rate
- Fludrocortisone, which helps your body hang on to fluids
- Midodrine, clonidine and pyridostigmine, which can help rebalance your autonomic nervous system in different ways
RESOURCES
- The patient-led organization Dysautonomia International offers educational resources and more
- Long COVID Physio has a helpful video and resources on dysautonomia and POTS
- POTS UK has an informative booklet on managing symptoms
- The Canadian Cardiovascular Society has published a proposed treatment algorithm
- Hot weather can worsen POTS and Long COVID symptoms. Learn more in this feature from The Sick Times
Writer: Kira Signer-Romero • Editor: Miles Griffis • Medical reviewer: Dr. Michelle Haddad
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Notes
- This series was published in fall 2024; some information may be subject to change.
- Although each topic has been reviewed by medical professionals, they are informational resources, not medical advice. Always talk to your medical providers before trying treatments or symptom management strategies.
- Each resource page offers brief information and is not comprehensive. We know there is much more information on each topic we cover, and that there are additional topics not yet addressed in this series.