Finding Balance in POTS Care

For many people living with Postural Orthostatic Tachycardia Syndrome (POTS), each day can feel like walking a tightrope — heart racing, dizzy spells, fatigue, and a body that just doesn’t respond the way it used to. 

Western medicine offers helpful tools for managing the condition, but Chinese medicine brings a different lens — one that sees the body as an interconnected system, always seeking harmony. In this article I’ll explore how Chinese medicine understands the symptoms of POTS and dysautonomia, and how practices like acupuncture, herbal medicine, and lifestyle support can help restore balance and resilience.

Current research suggests a multi-disciplinary approach is best for managing patients with POTS. Chinese medicine can be safely combined with Western medical treatment, working supportively to improve your health and quality of life. 

What is POTS?

Postural Orthostatic Tachycardia Syndrome is a disorder of the circulatory and nervous systems. It is characterised by a collection of symptoms that occur when standing. A rapid increase in heart rate of at least 30 beats a minute when going from lying to standing is commonly diagnostic of POTS. 

In Chinese medicine, the flow of Qi (energy) and Blood, and the balance of Yin and Yang are central to health. Patterns of disruption and disharmony in these systems can cause illness. By identifying these disharmonies and using acupuncture, herbs and lifestyle changes to restore balance, Chinese medicine offers a personalised and holistic approach. 

POTS in Chinese Medicine

Dysautonomia and POTS are modern disease names but Chinese medicine understood these patterns of disharmony and the associated symptoms in texts nearly 2000 years ago. Classical texts describe symptoms such as heart palpitations, digestive disturbance, chronic pain, alternating chills and fevers, and anxiety as indicative of Ying-Wei disharmony –  an imbalance between the body’s nutritive Qi and protective Qi.

POTS Subtypes 

POTS can be divided into a number of different subtypes, depending on the predominant signs and symptoms. Most people experience a blend of these subtypes, with one pattern being more dominant. 

Each subtype aligns with Chinese medicine patterns, and identifying these can help guide the acupuncture point combinations, herbal medicine formulas and lifestyle modifications that will be most effective. I’ve covered the 3 main subtypes of POTS here, although some researchers recognise additional categories. 

Related conditions such as Mast Cell Activation Syndrome (MCAS), Ehlers Danlos Syndrome (EDS), fibromyalgia, endometriosis and Chronic Fatigue Syndrome (CFS) that commonly occur with POTS may change your Chinese medicine pattern presentation. 

Hyperadrenergic POTS

In hyperadrenergic POTS, the sympathetic nervous system is overactivated. Norepinephrine, the key hormone that regulates the “fight or flight” response, is often elevated, causing high heart rate, tremors, anxiety and reduced resilience to stress. 

From a Chinese medicine perspective, this presentation may correspond to patterns involving the Liver. The Liver’s main function is to ensure the smooth flow of Qi throughout the body. It supports the Spleen and Stomach — the organs of digestion — and helps regulate emotional balance.

When Liver Qi becomes stagnant  it can impair digestive function, leading to nausea, bloating and constipation. Over time, stagnant Qi can build into Heat and Fire and Heat, which rises and causes dizziness, anxiety and insomnia. There is a saying in Chinese medicine “The Qi leads the Blood”. If the Qi is not flowing, Blood can stagnant as well, which may manifest as painful, clotty periods, cold hands and feet, or Raynauds disease. 

Acupuncture is an important tool for moving stagnant Qi. Gentle, regular movement such as walking, swimming or yoga can help to promote the flow of energy and support the Liver function. While alcohol and coffee can initially feel as though they “smooth” Liver Qi, they are hot in nature and, in excess, may aggravate Heat and worsen Qi stagnation. Hot and spicy foods, red meat, and deep-fried dishes can also increase Heat — best avoided during symptom flares. In herbal medicine, Gui Zhi (cinnamon twig) is often used in formulas to warm the blood vessels and gently invigorate stagnant Blood; a cup of cinnamon tea can be a simple home remedy for cold hands and feet.

Hypovolemic POTS

Hypovolemic POTS is characterised by abnormally low blood volume. Renin and aldosterone are hormones that regulate blood pressure and fluid balance in the body. In hypovolemic POTS, this system is dysregulated, causing the kidneys to lose too much water and salt. This further reduces blood volume, forcing the heart to work harder to circulate blood, and can lead to tachycardia, low blood pressure and dizziness. 

In Chinese medicine the symptoms often reflect Spleen and Kidney Yang deficiency. The Spleen governs digestion and the transformation of food into Qi, while the Kidneys store Essence and provide the foundational Yang Qi that warms and supports the function of all organs, including fluid metabolism.

When Yang Qi is deficient, the body is cold and fatigued, and fluid metabolism is impaired, leading to oedema and bloating. Overwork and chronic stress can weaken both the Spleen and Kidneys, so rest is essential to avoid further depletion. Dietary care is also key – the Spleen Spleen thrives on warm foods, both in temperature and energetic nature, while cold, raw foods and chilled drinks can hinder its function. Damp-forming foods such as dairy, processed items, and sugar should also be minimised. Chinese herbal medicine and moxibustion are excellent therapies for building both Spleen and Kidney Yang.

Neuropathic POTS

Characterised by a decrease in sympathetic nerve function, especially in the lower limbs, leading to poor blood vessel constriction and pooling of blood in the legs. This can occur after an infection, surgery or trauma, or may be the result of an autoimmune process. The reduced circulation can cause the feet to appear blue or mottled, and symptoms such as numbness or tingling are common.

In Chinese medicine the healthy circulation of Blood depends on adequate Qi. In neuropathic POTS, Qi deficiency may fail to move Blood effectively, which can lead to Blood stagnation. Qi deficiency can manifest as both physical and mental fatigue, brain fog and dizziness. Poor circulation of Qi and Blood poor circulation can cause cold feet, numbness, and tingling in the extremities.

Supporting the Spleen is essential, as it is the source of both Qi and Blood. Warm, nourishing foods and adequate rest can help rebuild these foundations. Qigong — whether practised seated or standing — is a gentle exercise that combines movement and breath to gradually build Qi and encourage smooth circulation, preventing blood from pooling in the lower limbs. Acupuncture is also effective for promoting the circulation of both Qi and Blood.

Your Unique Pattern, Your Unique Treatment

POTS is a form of dysautonomia that primarily affects women, resulting from disruption of the autonomic nervous system and impacting multiple organ systems. Chinese medicine, with its 3000-year-old framework, focuses on identifying and correcting the underlying patterns of disharmony to restore balance. 

Through acupuncture, herbal medicine, lifestyle adjustments, and gentle exercise, Chinese medicine offers tools to help manage symptoms, improve quality of life, and support long-term recovery. While POTS subtypes can be broadly aligned with Chinese medicine patterns, most people present with a mix of patterns. A skilled practitioner can help identify your unique presentation and guide you toward greater balance and resilience. Book an appointment to experience how Chinese medicine can support your health and wellbeing.