What Does Your Gut Have to Do with POTS?

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that affects the autonomic nervous system, the part of your nervous system responsible for regulating functions like heart rate, blood pressure, digestion, and temperature regulation.

While many people think of POTS as primarily causing dizziness or a racing heart, gastrointestinal symptoms are also very common. Bloating, abdominal discomfort, constipation, diarrhea, and nausea can all occur in individuals with POTS.

Recent research suggests there may be another important piece of the puzzle: the gut microbiome.

What Is the Gut Microbiome?

Your gut microbiome is the collection of trillions of bacteria, fungi, and other microorganisms that live in your digestive tract.

These microbes play important roles in:

• Digesting food
• Producing certain vitamins
• Supporting the immune system
• Maintaining the intestinal barrier
• Producing compounds that communicate with the nervous system

Rather than simply helping with digestion, the gut microbiome influences many aspects of overall health.

The Gut-Brain Connection

Researchers often refer to the "gut-brain axis," which describes the constant communication between the digestive system and the nervous system.

The autonomic nervous system helps regulate:

• Intestinal movement
• Blood flow to the digestive tract
• Digestive secretions

At the same time, the gut microbiome produces molecules that can influence immune function, inflammation, and communication with the nervous system.

This relationship works in both directions.

Changes in the nervous system may affect the gut, and changes in the gut may influence the nervous system.

What Did Researchers Find?

A recent study compared the gut microbiomes of individuals with POTS, people with post-acute COVID syndrome (Long COVID), and healthy controls.

Researchers found that people with POTS had:

• Lower overall microbial diversity
• Differences in the types of bacteria present
• Associations between gut bacteria and symptoms such as fatigue, bloating, and gastrointestinal discomfort

Interestingly, these microbiome changes were more pronounced in people with POTS than in those with Long COVID.

Does This Mean the Gut Causes POTS?

Not necessarily.

This study cannot determine whether changes in the microbiome contribute to POTS or whether autonomic dysfunction leads to changes in gut bacteria.

It is likely that the relationship is complex and works in both directions.

More research is needed before we can determine whether improving the gut microbiome directly improves POTS symptoms.

Supporting Gut Health

While there is no single supplement or diet proven to treat POTS, supporting overall gut health remains an important part of wellness.

General strategies include:

• Eating a variety of fiber-rich whole foods
• Including fermented foods when appropriate
• Staying hydrated
• Managing stress
• Prioritizing sleep
• Working with a healthcare provider if persistent gastrointestinal symptoms are present

Final Thoughts

The connection between the gut and nervous system continues to be an exciting area of research. Studies like this remind us that the body functions as an interconnected system rather than a collection of separate organs.

As we continue learning more about the gut microbiome, we may gain additional insight into conditions like POTS and how supporting overall health can play a role in improving quality of life.

If persistent digestive or autonomic symptoms are affecting your daily life, our functional medicine team in Gardner, KS can help you look at the whole picture. Start that conversation with Root Function Health.

Reference: Hamrefors, V., Kahn, F., Holmqvist, M. et al. Gut microbiota composition is altered in postural orthostatic tachycardia syndrome and post-acute COVID-19 syndrome. Sci Rep 14, 3389 (2024). https://doi.org/10.1038/s41598-024-53784-9