If you have POTS, then you know how awful it feels to be in a POTS flare up. You’ll want to try anything to potentially relieve your symptoms and get back to feeling like yourself. Whether it’s just one day long, persists more than a week, or is seemingly constant, POTS symptoms can be debilitating to deal with. Trust me, I get it. I live it too–even still today, despite being much better than I used to be.
Actually, a pretty bad POTS flare up hit me just two days ago. I think I was starting to feel the effects of spending the last week packing, moving, and unpacking. My pulse was over 100 bpm just sitting and typing this post because I stood to wash dishes for ten minutes before this! Crazy, right?!
But waking up to intense symptoms isn’t new to me. Luckily, in the time since I was diagnosed with POTS, I’ve learned some tricks to help relieve my symptoms during a POTS flare up. Some of them just may work for you too. Spoiler alert, you’re gonna need to refill your salt shakers!
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1. Take Your Vitals
The first thing I do when I notice my symptoms coming on strong is to measure my vital signs. I’ll check my pulse on my Fitbit Sense
For example, two days ago I felt the typical shortness of breath, heart racing, I’m-feeling-faint, symptoms shortly after eating lunch. I grabbed my gear and discovered my pulse was over 100 bpm and that my blood pressure was running low (92/65).
Why do I monitor these values?
Well, one, because I want to make sure that they aren’t terrible — aka so low or so high that I need to seek immediate medical help.
Two, it confirms that, yes, I’m probably feeling this way because my pulse is running high and my blood pressure is low. With that confirmed, I can go ahead with my arsenal of tricks to attempt to improve both values.
Shop Fitbit Sense here.
Shop Omron Wrist Blood Pressure Cuff here.
2. Contact Your Doctor
Speaking of immediate medical attention — if you feel so bad that you think something’s not right, please do not hesitate to call your doctor, or for help! Your vitals can be a helpful indicator of what’s going on in your body, so that’s why I stress monitoring them so much.
But even if your POTS flare isn’t a medical emergency, you should update your doctor if your symptoms persist. They may alter your medication or make other suggestions that can help you. It’s never a bad thing to keep your doctors in the loop.
3. Eat Salty Foods
When I’m in a POTS flare up, I know I need to make sure I’m eating a high salt diet to get through it. As a quick reminder, more salt, paired with an increased fluid intake helps to increase blood volume and blood pressure. An increase in both of these things can help POTS symptoms!
So stock up on all your favorite salty foods during a POTS flare up. Things like broths, pickles, salted nuts, pretzels, popcorn, and even bread (you’d be surprised how much sodium is in bread!) are excellent options.
Just remember, if you have the hyperadrenergic form of POTS, eating more salt is not recommended! Ask your doctor if you are unsure whether or not more salt would be beneficial to your POTS.
4. Make An Electrolyte Replenisher Drink
Oh, electrolyte drinks, what would I do without you?! Seriously, guys, electrolyte replenisher drinks, such as Liquid I.V. Hydration Multiplier
I’ve been drinking them every day now since it’s summer and I’m trying to survive the heat daily. But during a flare, I depend on them even more. I mix up a half of a packet (it’s recommended to use an entire packet, but this works well for me!) into my 18 oz water bottle and drink the entire thing in 5-10 minutes. You don’t have to chug it, but I find that the quicker I can get it into my system, the sooner I’ll start to feel better.
After doing this during my POTS flare up the other day, I felt revived after a half hour! It really is amazing how badly a lack of proper hydration and electrolyte imbalance can make us feel.
If you’ve never tried electrolyte replenishers, I cannot recommend trying them more! They are a staple on the list of my top products for people living with POTS.
5. Wear Compression Garments in a POTS Flare Up
In a POTS flare up? Compression will come to your rescue! At least, for me it does. I’ve noticed that compression socks lower my heart rate when it’s uncomfortably high.
As I mentioned earlier, my pulse was over 100 bpm while writing this post. So after making my electrolyte drink, I bravely endured the fight to get my Copper Fit Energy Compression Socks
6. Keep Up With Your Medications
This may only be applicable to those who are prescribed medications to control their POTS. I’ve mentioned in my POTS diagnosis story that I take pyridostigmine. While this medication is most often prescribed to myasthenia gravis patients, it’s also given to POTS patients because it enhances muscular stamina (aka higher energy levels for POTSies) and improves tachycardia.
So, any time I’m in a POTS flare, I make sure to stay on top of this medication. My doctor has advised me to take it anywhere from 1-3 times a day, but this changes depending on how I’m feeling. That’s why it’s key to stay in touch with your doctors! Right now, I’m taking it between 0-2 times a day because I’m trying to see if it is affecting my MALS stomach pain.
The moral of the story here is that I have to judge (along with my doc’s input) how frequently I need to take pyridostigmine to relieve my POTS symptoms. In a flare, I’m most likely taking it more than once a day. Stay on top of your medications too!
7. Limit Time Standing
I mean, I don’t need to explain this to you, POTSies! You already live through the difficulty of just trying to stand and not pass out. To keep this tip short and sweet, I’ll just reiterate it. To get through a POTS flare, I limit how much time I spend standing. Sure, I get up to stretch and walk around a bit so I don’t get completely stiff and encourage deconditioning. But I put more focus on resting and not draining myself by too much upright activity, especially if I’m feeling very faint.
8. POTS Flare Ups = REST!
Since I just said it, I’ll say it again! REST IS SO IMPORTANT!!! Rest is crucial to relieving symptoms during a POTS flare. Don’t feel guilty or ashamed to rest and stay in bed during bad symptom days. You have to do what your body needs, and what it needs to feel better is often just rest. If you try to do too much, you’ll tax your body even more, which will make your symptoms worse.
If for some reason you feel like you need permission to rest, then I’m happy to oblige. I give you full permission to rest! Now, go put your feet up. Take a nap. Do some deep breathing or light stretching. If you have work to do, then take it to your couch or your bed. I got through grad school by doing this, so it’s completely possible to be in boss mode while resting in bed during flares.
Just please don’t feel bad about resting!!! It doesn’t make you lazy!
9. Keep Yourself Cool
I’m not talking about your temper here, although, you shouldn’t get angry during a flare either. That won’t help relieve your POTS symptoms. No, see, what I mean here is to literally keep your body cool. Use ice packs, sit in the AC or in front of a fan, or apply cold compresses to your body. Even drinking ice cold water helps.
Staying cool does two things:
One, it activates the vagus nerve (especially when exposing the face and neck to anything cold), which in turn activates the parasympathetic nervous system. If you didn’t know, the parasympathetic nervous system is the part of the autonomic nervous system responsible for relaxing the body. With me so far?
With POTS, we are often in the fight-or-flight mode (sympathetic nervous system) too much, thanks to the dysfunction of our autonomic nervous systems. So, finding any ways to turn on the parasympathetic nervous system will help us to relieve POTS symptoms during a flare.
However, staying cool also helps reverse what being too hot can do to our bodies. When we are too hot, our vessels dilate, which encourages blood pooling for us POTSies. Blood pooling equals symptoms!
So do whatever you can to stay cool — not just during summer — but during a POTS flare.
10. Find Your Zen
You know how I just mentioned that the activation of the parasympathetic nervous system can relieve POTS symptoms? Guess how else you can activate that handy dandy system? By finding your zen!
To get through a POTS flare, you need to spend time doing things you find relaxing. Read a new and exciting book. Listen to your favorite uplifting music. Video chat with your best friend. Bake a delicious treat. You get the idea! Be creative here!
I know real life doesn’t always allow for the complete elimination of stress, especially with work, school, families, and relationships to juggle. But it’s SO important to carve out some time each day for a relaxing activity. Even if it’s just a few minutes of some deep breathing exercises before you start work for the day. Make this one a priority, guys!!!
11. Try Light Exercises, If Able
This may not be a solution for everyone. However, personally, I find that when I’m feeling very symptomatic, some light exercise does help. Notice I said light. Remember, we don’t want to push ourselves too hard during a flare. Recumbent exercise like biking, rowing, or swimming, or floor exercises you can do on a mat, like pilates or yoga, are great options to try!
I will say, getting up to walk or do pilates while actively blacking out, tachycardic, or short of breath may not be the best idea. Again, this solution may not be for everyone. But it often does help me get out of a funk. Be your own judge here; only you know your body!
12. Avoid Large Meals And Overeating
Finally, when you’re experiencing a flare, it may be helpful to avoid large meals to relieve POTS symptoms. Overeating, especially meals high in carbs, makes some people feel worse. Instead, opt to eat smaller, more frequent meals throughout the day, making sure those meals have a healthy balance of carbs, protein, and fat.
Listen, we all have bad days with our chronic illnesses. So don’t beat yourself up about it when they happen! Instead, show yourself some compassion and understanding, and try some tricks to help you cope with your symptoms. For getting through POTS flares, these tips I just shared work really well to relieve me of my symptoms. I hope some of them work for you too!
Sending my fellow POTSies and other chronic illness warriors love for getting through any flares you may be enduring at the moment! Hold on for better days ahead! Let me know if you’ve tried any of these tricks below!
If you liked this post, you may like to read my post about my top POTS triggers to avoid next.
XO,
Laurie
Can I ask… When your not having a flare of pots is your heart rate normal (slightly rises, but the corrects to a sensible rate) ? Or is it always high on standing regardless of flare or not?
Hi Sammie! I don’t have any recent data to quantify this (maybe I should do an experiment with my HR monitors?!), but the last time I went to my neurologist for a check-up (I was doing well) my heart rate still increased when I stood. However, it did not rise as dramatically as before AND it recovered to a normal range within 1-2 minutes of standing. Hope that answers your question!
It does thank you so much. I have definitely been suffering with pots for several years, but only recently put two and two together with many symptoms and having a finger monitor to check but my symptoms can vary each day. I seem to have had a particularly bad spell of it since March which I would say was a flare but over the last few days I have had several consecutive days without issues . I have days when my heart rate acts as normal when standing up and standing still, it probably rises higher than a person without on initially standing but it does reduce to a more resting rate as you would expect a person without pots. This mostly seems to occur on days when I’m cold ( a colder day or environment) , on hotter days or hotter environments it generally acts up all the time increases but won’t reduce to a normal rate when standing for over 10 minutes and increases the longer I stand. I do have days on the colder days when I do have symptoms but not as extreme. I was confused trying reading about pots though as to whether you have to have symptoms all the time everyday or if you can have periods when your heart rate does act normal. So when I noticed you mentioned your pots can flare i thought well perhaps that is the case you can have good, bad spells or none for a while then it could return.
Hi Sammie! Sorry for the confusion! In the beginning when I first got sick, my symptoms were pretty much constant, and my heart rate was almost always high when I stood. Now, I mostly don’t have symptoms unless something triggers it (I have a post on my triggers) or I’m not keeping up with lifestyle modifications. My heart rate can still spike when I first stand up (even when I’m feeling great) but the difference is that it now recovers to baseline within a few minutes instead of staying high. But as you pointed out, POTS can seem to have a mind of its own and sometimes I just have a bad spell or a really good spell. Stay positive though, even on the bad days when it’s hard to!