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POTS and Alcohol: Understanding the Risks

In this article, we will take a close look at Postural Orthostatic Tachycardia Syndrome (POTS), a disorder affecting the autonomic nervous system. We will delve into the symptoms, diagnostic criteria, and potential effects of alcohol on this condition. The article also provides insights into the precautions POTS patients should take when considering alcohol consumption.

Jakub Gwiazdecki

Author - Jakub Gwiazdecki

Fifth year medical student at the Medical Faculty of Comenius University in Bratislava.

Jakub used MediSearch to find sources for this blog.
MediSearch gives instant answers to medical questions based on 30 million scientific articles.

How does alcohol impact POTS?

The effects of alcohol on POTS have not been researched. However, the general influence of alcohol on the body is known. Based on that, we can say what impact alcohol can have on POTS.

Alcohol impacts the cardiovascular system and blood pressure. One of the effects is a decrease in blood pressure in the supine position [1]. This can lead to an increase in POTS symptoms when standing up.

On the other hand, it increases the effect of vasopressin (ADH). High levels of this hormon lead to a temporary increase in blood pressure [2].

However, alcohol also causes a disbalance in the renin-angiotensin system. This system is key to fluid and blood pressure balance. The lost balance in the regulation of blood pressure can potentially lead to further symptoms after alcohol [3].

Can I drink alcohol if I have POTS?

You should not drink alcohol with POTS. Generally, the impact of alcohol on POTS is unfavorable. After alcohol, your symptoms can get worse.

Especially excessive alcohol consumption can be dangerous. When drinking a lot of alcohol, you are at higher risk of arrhythmia and other heart problems [4]. A combination of heart arrhythmia and POTS-related tachycardia can lead to more frequent fainting.

Also, alcohol can interfere with some medications. For example, drinking alcohol while taking beta-blockers for POTS can cause a drop in blood pressure. This can exacerbate your symptoms.

However, every POTS is different. When your POTS is mild, it might be possible for you to drink a small amount of alcohol. Nevertheless, before drinking even a little alcohol with POTS, you should always consult your doctor.

What is POTS?

POTS stands for postural orthostatic tachycardia syndrome. It is a disorder that affects the autonomic nervous system. POTS causes a significant increase in heart rate when standing up from a supine position [5, 6].

The POTS affects mostly young women, especially in their 20s [7]. However, it can also occur in older or adolescent people [8, 9].

Symptoms of POTS

Symptoms of POTS can severely influence life quality. They include:

  • palpitations,
  • fatigue,
  • anxiety,
  • lightheadedness,
  • generalized weakness,
  • exercise intolerance,
  • feeling of heavy legs [10, 7].

Also, POTS can lead to pre-syncope or syncope [10].

Dignosis of POTS

The diagnosis of POTS is made based on the heart rate change during a head-up tilt test. POTS criteria in this test are met when the heart rate is equal to or higher than 30 BPM. Also, POTS is probable when the heart during the head-up tilt test beats faster than 120 beats per minute [11, 12].

In children, the diagnostic criteria are higher. To be diagnosed with POTS a child has to have a difference in heart rate when standing up of at least 40 beats per minute [13].

Treatment of POTS

At the moment, POTS is uncurable. However, many management approaches to this condition exist. They minimize the strength of the symptoms of POTS.

The pivotal thing in POTS is hydration. Drinking a lot of fluids allows the body to maintain good blood pressure [14]. Having normal blood pressure with POTS is crucial, as, among others, it minimizes the chance of syncope.

Another management strategy for POTS is dietary change. Particularly helpful in POTS is an increase in salt consumption. More salt in the body increases blood pressure [14].

However, it is crucial to follow your doctor's instructions. A lot of salt is not healthy. Additionally, salt is contraindicated in some conditions, like kidney diseases or GERD.

A further management approach for POTS is exercise. Particularly, the special training created for POTS can be of great help in alleviating the symptoms [14]. Regular physical exercise strengthens the cardiovascular system and makes it easier to cope with POTS.

For some people, compression socks can be helpful [14]. Use of them can help maintain better blood flow. The compression socks prevent blood stagnation in the legs.

At the moment, there is no official FDA treatment for POTS. However, doctors can prescribe medication to support the cardiovascular system in handling POTS. Among the drugs that can be used are:

  • beta-blockers,
  • fludrocortisone,
  • midodrine,
  • ivabradine [15, 16, 17].

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