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Nutritional support: PoTS and the autoimmune connection.

PoTS stands for Postural Orthostatic Tachycardia Syndrome. The symptoms of PoTS include lightheadedness, fatigue, dizziness, headache, anxiety, shortness of breath, nausea, digestive symptoms, fainting and occur mostly when standing up. It affects heart rate and blood pressure. However, symptoms can range in severity. The symptoms occur because the autonomic nervous system is dysfunctional. The autonomic nervous system controls all the processes that occur automatically in our body and keep us functioning. Processes like breathing, our heart rate and our blood pressure. 

Diagnosis of POTS usually occurs using the Tilt Table Test but there is not a lot of awareness about the condition. There can be misdiagnosis or duel diagnosis with conditions like ME/CFS, and fibromyalgia. 

Recent research has shed light on the causes of PoTS and has given us the tools with which to support people with this condition. The onset of POTS usually occurs after a period of illness or stress, it is more common in women and tends to be less severe during pregnancy. These are all tell-tale signs of an auto-immune condition. Research has found markers of auto immunity in a majority of PoTS patients. It is notable that around 20% of patients presenting with PoTS also have other autoimmune conditions. Treating autoimmune co-morbidities that are present often improves PoTS symptoms.

As more evidence emerges suggesting that PoTS may be primarily an auto immune disorder, there also emerges a clear role for nutritional medicine to support people with this condition. To do this we focus on the health of the gut, including digestion, absorption and the gut bacteria. Over 70% of the immune system is within the gut and its influence over the balance and effectiveness of the immune system is important. Alterations in gut bacteria, food reactions, poor absorption and inflammation are all contributing factors to auto-immunity and using personalised diet and supplement programmes we are able ti influence these factors. 

Lab investigations for POTS include:

Stool Testing:

A comprehensive stool test can identify altered gut flora and possible pathogenic bacteria. Altering the microflora is one way to support immune system function. A comprehensive stool test will also identify any inflammation within the digestive system as well as digestive dysfunction that may be affecting absorption of nutrients.

Omega 3/6 Fatty Acid Testing:

Measuring the ratio between key essential fatty acids can help by identifying and rectifying any pro-inflammatory factors provoking an auto immune response.

Food intolerance testing:

Testing for possible food intolerances can help in a number of ways. You can identify foods that might be triggering an immune response, a high number of intolerances might signify a more permeable gut lining and removing trigger foods can provide some symptomatic relief.

Testing for celiac disease:

Coeliac disease has been found to be more common in those with autonomic dysfunction than in the general population. Begin the process of ruling out coeliac disease with a simple mail order pinprick test. This doesn’t rule out non-coeliac gluten sensitivity which may still be an issue. Or ask your GP for a test. 

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Author: Sarah Hanratty

Sarah is a specialist practitioner at the Brain Food Clinic. She has a degree in Nutritional Medicine and is a certified Gut and Psychology Syndrome Practitioner. Sarah helps people to overcome physical and mental health issues using bespoke nutritional protocols.

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