Long-Covid Linked to Rare, Dangerous Heart Condition

What You Need to Know About COVID and POTS

It is becoming more and more clear that COVID-19 can have a significant impact on the nervous system. In some cases, this leads to the development of POTS (Postural Orthostatic Tachycardia Syndrome). If you are one of the growing number of people who suffer from mysterious symptoms after COVID, it is critical that you understand the connection between COVID-19 and POTS, and learn to recognize symptoms.

Let's dive into how POTS may be triggered by dysregulation of the nervous system as a result of long COVID.

Learn more about Post-Covid Recovery at CentreSpringMD.

First, what is POTS?

POTS is a disorder that affects the body's autonomic nervous system. This is the part of the nervous system that controls involuntary actions, like the beating of your heart and the widening or narrowing of your blood vessels. When something goes wrong with this part of the nervous system, it causes problems with the heart, blood pressure, or respiratory function.

Problems with the ANS are also called dysautonomia. POTS is a type of dysautonomia. Dysautonomia usually involves failure of the sympathetic and parasympathetic parts of the ANS. Think about it like confusion between the "rest-and-digest" and "fight-or-flight" arms of the nervous system.

Dysautonomia and POTS can involve failure of parts of the ANS as well as too much activity. It can show up in the body in different ways, all of which reduce the ability to function in daily life. POTS symptoms include (1):

Cardiac symptoms like a rapid heartbeat, palpitations, chest pain, or high blood pressure

  • Presyncope (the feeling that you’re about to faint)
  • Generalized weakness and/or intolerance to physical exertion
  • Light-headedness
  • Nausea
  • Headache that lasts for more than three months.
  • Mental clouding/“brain fog”
  • Fatigue
  • Gastrointestinal symptoms
  • Sleep disturbances
  • Chronic pain

Viral or bacterial infections can cause dysautonomia and POTS, though doctors and scientists aren't sure exactly why this happens, but they do have some theories.

Related: Anxiety & Other Neurological Symptoms Now Linked with Mold Toxicity

Post-COVID Infection & heart problems

Recent reports indicate that 2%–14% of COVID-19 patients develop POTS and 9%–61% experience POTS-like symptoms, such as increased heart rate, abrupt changes in blood pressure upon standing, fatigue, and cognitive impairment. These symptoms usually occur within 6–8 months of COVID infection (2). 

You’re not contagious if you’re experiencing post-COVID syndrome or Post-Covid POTS. Long COVID is caused by your body recovering from the initial infection’s impact upon your immune system.

Why does long-covid cause POTS?

There are a few theories about why long-covid causes postural orthostatic tachycardia syndrome, or POTS (3).

The first is that the viral infection damages the autonomic nervous system, leading to cardiovascular symptoms and problems with blood pressure regulation. 

Another theory is that inflammation caused by the viral infection leads to changes in hormones, which can disrupt the function of the body's autonomic nervous system.

Finally, some researchers suggest that the virus may induce an autoimmune response, resulting in long-term damage to the autonomic nervous system, and increased risk of developing POTS.

Surprisingly, although long-term prognosis of POTS is poorly explored, around 50% of POTS patients spontaneously recover within 1-3 years. What’s clear is that long COVID can have a profound impact on your health, even after you have recovered from the initial infection. It's important to recognize POTS symptoms and to get help if you suspect you may be suffering from it.

Read: Long-Covid Driven by Gut Bacteria, According to New Research

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Other viruses can cause POTS or dysautonomia

It’s not just COVID-19 that can cause POTS. Other viruses, such as Epstein Barr virus (EBV), varicella zoster virus (VZV), and human herpesvirus 6 (HHV6) have been linked to POTS or other types of dysautonomia. The onset of POTS is typically precipitated by immunological stressors such as viral infection, vaccination, trauma, pregnancy, surgery or severe psychosocial stress (4).

So if you think you may have POTS, it’s important to talk to your doctor about your medical history, as well as other life events.

The good news is that you can treat POTS with functional medicine. Talk to your doctor about the best approach for you.

Treatment for POTS & Dysautonomia with Functional Medicine

The various disorders that long-covid can trigger are the exact types of health issues that conventional medicine struggles to treat. They involve multiple systems, are complex, and don’t respond well to established medication protocols.

But this is where a functional approach is well suited to POTS recovery and healing from Long-Covid. An integrative team will tailor an approach to each individual, often targeting the following areas for POTS patients.

Adrenal Support

Supporting the adrenals is an important part of POTS recovery, as they play a major role in regulating blood pressure and other bodily functions. An integrative team may prescribe adaptogenic herbs to help your body better cope with stress, while also providing education on lifestyle strategies like reducing caffeine intake and optimizing salt intake (5).

Learn more about conditions we treat: Adrenal Dysfunction & Fatigue

Nutrition & Gut Health

Poor gut health can also contribute to POTS and long-COVID-19, so it’s important to prioritize nutrition and dietary changes that support digestive health (6). A growing body of evidence has now implicated the gut microbiome—the trillions of bacteria, fungi, and other microbes that inhabit the gut, lungs, and elsewhere—in Covid-19 severity and the development of long Covid (7). 

An integrative team may recommend an anti-inflammatory diet as well as supplements like probiotics or digestive enzymes to help restore the balance of beneficial bacteria in your gut microbiome.

Cardiovascular & Lymphatic

A functional approach to POTS may also include supportive cardiovascular and lymphatic treatments such as bio-identical hormone replacement, massage therapy, infrared sauna therapy, and techniques like meditation or yoga. These methods can help reduce inflammation within the body, promote relaxation and improve blood circulation throughout the body’s systems.


Optimizing thyroid function is also paramount to POTS recovery. An integrative team may test for and treat any underlying hormonal imbalances with the use of bio-identical hormones or dietary supplements.


Chronic inflammation contributes to many of the symptoms associated with POTS, so it’s important to identify and address any underlying causes that could be triggering an inflammatory response in the body (8). An integrative team may recommend changes to diet, IV therapy, or other lifestyle modifications to reduce inflammation that restricts healing.

Get started with Post-Covid recovery with functional medicine at CentreSpringMD

More ways functional medicine can treat lingering COVID symptoms

If you’re still experiencing symptoms after day 14, you should continue to take care of your body as it works hard to recover. There are many things you can do to support respiratory recovery, as well as take care of your physical and mental health

  • Return to normal activities slowly, and monitor levels of fatigue.
  • Support the production of glutathione–your body’s most powerful antioxidant–with n-acetyl cysteine, milk thistle, or an IV therapy drip.
  • Protect your mental health by staying active, reaching out to friends or family, or setting up an energy healing session for recovery.
  • Soothe body aches and pains with regular stretching, yoga, or lymphatic massage.
  • Get adequate sleep, and try supportive supplements that help calm overactive neurotransmitters to help your body relax.
  • Eat a healthy diet with protein, healthy fats like omega-3s, and plenty of fruits and vegetables. Minimize added sugars and processed carbohydrate foods.

Try these: The 8 Best Immune Support Supplements for the Entire Family

Understanding the connection between long COVID and POTS can help you take steps to protect your health. Proper diagnosis, management, and lifestyle changes may help reduce the impact of POTS on your life. Talk to your doctor if you’re experiencing any of these symptoms and look into lifestyle changes that might help manage the condition.


  1. https://www.ninds.nih.gov/health-information/disorders/dysautonomia
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9287587/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9789535/
  4. https://pubmed.ncbi.nlm.nih.gov/30372565/ 
  5. http://www.dysautonomiainternational.org/page.php?ID=44
  6. https://www.gastrojournal.org/article/S0016-5085(20)34701-6/
  7. https://gut.bmj.com/lookup/doi/10.1136/gutjnl-2021-325989
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914580/


COVID, heart health

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