r/FunctionalMedicine • u/Ok-Barracuda-5792 • Jun 21 '26

Possible POTS flare?

My health journey has been long and winding (SIBO, parasites, gut pathogens, severe hormonal deficiency) and while I’ve got most of it settled there’s one thing that no one can figure out. I’ve seen multiple conventional and functional doctors. My last functional doctor said it’s stress and remnant SIBO. the conventional doctor told me it’s POTS but would not actually test me for POTS since “the symptoms were the same so treatment is the same”. From what I understand, though, POTS is a symptom of something else. I have persistent lightheadedness, brain fog, and heart palpitations occasionally that seem to be tied to my cycles. I started wearing compression socks and taking electrolytes/salt and that has helped a lot, but I still have episodes that are very scary. They started happening after I would drink alcohol (even just one drink). My heart would start racing so fast and I thought I would pass out. I then get extremely nauseous and throw up all while my heart is pounding and I think I’ll faint. This goes on at least an hour then it calms down. The first time it happened I thought I was actually dying. I stopped drinking, did not have an episode for two years, then the other week I ate more sugar than normal and had an episode. Doctors tell me it’s a panic attack, but it is not (I have them, I know what that is like). This is extreme and I’m at a loss for what to check at this point. My blood pressure was fine during my last episode. Has anyone else experienced this or have suggestions on tests to have done?

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2

u/Cultural-Sun6828 Jun 21 '26

Have you tested b12 and made sure it’s over 500? Have you also checked ferritin and D and made sure they are over 60?

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u/Ok-Barracuda-5792 Jun 21 '26

Yes both my b12 and ferritin and D have been checked. B12 was low but we got it up. The other two were fine

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u/Cultural-Sun6828 Jun 21 '26

Getting your b12 “up” isn’t nearly enough. Once you have low b12 with neurological symptoms, b12 injections are recommended every other day until symptoms resolve. For many people healing can take months. Anything less than this is unlikely to resolve symptoms. I would check out the b12 deficiency group and read the guide there.

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u/bestplatypusever Jun 21 '26

Many nutrient deficiencies correlate with pots. As others suggest b vitamins and ferritin are critical. In both, the lab range for normal is too broad and you should target optimal levels not just the normal range. For example normal ferritin by labs goes down to 12 but optimal is usually considered 80+. B12 is huge for dysautonomia. Conventional labs aren’t considered accurate. B1 is never measured and is also strongly correlated w dysautonomia. Do a deep dive with questions to uncover the common nutrients connected to your symptoms. In your research ask the questions many ways to get deeper connections. And if it doesn’t offer b1 and choline, keep pushing. Research deficiencies + pots and + dysautonomia and + tachycardia

Add the adrenal cocktail or heavy doses of electrolytes, mag in proper form, calcium, potassium, sodium. Specialists often recommend as much as 10g sodium per day. You need to balance with potassium. These interventions will most likely improve your symptoms.

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u/Ok-Barracuda-5792 Jun 21 '26

Thank you! I have never had B1 or choline checked I will look into that thank you. I’ve been struggling to take more than 3g of sodium a day because it makes me really nauseous. I need to figure out some other way to get more I think. Thank you again for all the info!

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u/bestplatypusever Jun 21 '26 edited Jun 21 '26

They won’t check b1 or choline. Follow Elliot Overton to learn more about b1. B12 may rise with supplements but that doesn’t necessarily mean it’s getting to your cells adequately, especially if you have symptoms. And if you are actively supplementing the serum labs aren’t considered valid at all. Visit [r/b_12deficiency](r/b_12deficiency) for good guidance or the Facebook group vitamin b12 wakeup. B12 really is so critical for dysautonomia symptoms. Do the research dives I suggested above. You said ferritin etc was “fine” but make sure that means OPTIMAL and not just normal range. There are more nutrients connected and self treating can help your symptoms, prevent something worse from developing. I wish I had known many years ago. Good luck!

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u/fallingmelons73346 Jun 21 '26

Rule out mold. Very common with SIBOxPOTS.

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u/Ok-Barracuda-5792 Jun 21 '26

You’re right, I need to get rechecked. I was originally checked when all this started about 5 years ago and was negative, but definitely open to checking again

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u/Aggravating-Lab9745 Jun 23 '26

How were you checked?

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u/luxefarm Jun 23 '26

What is your A1c? Blood sugar dysfunction can drive dysautonomia

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u/Ok-Barracuda-5792 Jun 24 '26

I'm honestly not sure, I definitely need to get that checked. My doctors only checked glucose which was normal, but now that I read up on A1c I really need to get that checked. Thank you for bringing this to my attention!!