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The Best Diet for POTS?

Updated: Jun 7, 2022

The transcript can be found under the video.


Are you wondering what the best diet is for POTS?



There's so much conflicting information out there. It's hard to discern what is a fad diet vs.

what is real? What is not?


So let's dive into it.


When you have a condition like POTS, food becomes much more of a complicated topic.


You might struggle with lots of flare-ups and low energy, and that can make planning and preparing meals a lot more difficult.


You might also be experiencing symptoms before or after meals, and are just confused at what to do to lessen those.


And on top of all that, you're probably wondering what meals you should even prepare to make the most of your precious energy and to minimize symptoms. Although every single person is incredibly different and reacts so differently to different foods and diets, I would like to share with you some of the research that's come out about POTS and various dietary choices.


Low Carb Diets


So let's start with the first one... Low carb...is this just a new buzzword or what's really the science behind this?


You might have noticed that your symptoms are worse after eating meals, or after eating a large meal and you might be wondering why. I remember when I was doing a Holter Monitor Test, I had to write out every time when I was eating my meals so that they could track how my heart rate differed before and after my meals. So I always kind of wondered what was the relationship between my heart rate and the meals.


Now eating requires a lot of blood flow to the digestive system since it needs to carry out that work. And since POTS is a condition that affects blood flow, that's exactly why people with POTS are recommended to wear compression stockings to get the blood flowing right to the top half of the body and to increase the blood return to the heart. But when you eat, more of that blood has to go to the digestive tract to help with the digestion of the food.


So that's why sometimes POTS symptoms like lightheadedness, brain fog, fatigue, or palpitations, tend to be especially severe after carb and gluten heavy meals. Probably this is because of the heaviness of the meal, and the body has to work quite a bit to digest that right. So after eating, blood is diverted to the digestive tract and away from maintaining the blood pressure and the heart rate which then increases symptoms.


Hypoglycemia and POTS


Another aspect of this is blood sugar. If a high-carb meal is consumed without adequate protein, fiber, or fat, the blood sugar levels will rise. Now, why is this a big deal? People with POTS also tend to have reactive hypoglycemia, which is also known as sugar crashes. This generally happens after eating meals a few hours after eating a meal.


So there are a few recommendations for reactive hypoglycemia but one of them is to eat less carbs, and more balanced carbs so we kind of come back to that first point. So what can you do? You could still consume carbs, but perhaps include complex carbs too like brown rice, quinoa, or grain bread, etc., and spacing out the meal so that you have smaller, more frequent meals. This helps with both the reactive hypoglycemia and it helps too so that the body is not just focused on the digestive tract and on digesting all that food and then the blood can actually flow in the other places that your body needs it.


So for example, I'll usually take my lunch and I'll break it into two or three portions. That way, I don't have to cook as much and it prevents me from having crushes throughout the day. And to be perfectly fair, I also get to take a nice break and practice mindful eating.


Celiac Disease and POTS


Another caution food that we hear about a lot is gluten. Going gluten-free has been reported to help some patients. So why is that?


Now, studies have shown that people with POTS have a higher rate of celiac disease. People with POTS have more than double the rate of celiac disease than the general population. Now, for everything that I've mentioned in this video you could see the links in the bio of the research studies that I'm talking about.


So if you have celiac disease, eating gluten triggers an immune response in the small intestine. This not only damages the small intestine, but it could also result in nutrient deficiencies, which interestingly enough is also something that quite a lot of people with POTS struggle with.


For example, Vitamin B12 is a vitamin that gets affected due to celiac disease, and interestingly enough, it's also a vitamin that many people with POTS are deficient in.


There was also another study that came out and said that 56% of celiac patients had some form of autonomic nervous system impairment. So that's very interesting. This might be due to the fact that eating gluten causes more prolonged intestinal inflammation. Gluten also causes mast cell activation in the gut, leading to disorders such as IBS.


Gluten-Free Diets


So now that we know about the connection between gluten, POTS, even mast cells, and inflammation, what can be done about this? Some practitioners recommend trying at least a month of gluten-free. But when you're doing a diet like this, be careful as gluten isn't a lot more products than you might think it is. It can even be in things like candy, chewing gum, French fries, hot dogs, mayo etc., so check labels carefully.


A few weeks ago, there was also a study that was published where POTS patients were put on a gluten-free diet for 4 weeks. They discovered that all the patients reported improved symptoms while doing this diet. You could read more about the specific percentages and how they did the study below. They found that the greatest benefit was found in reducing the symptoms related to being upright, and also to reduce gastrointestinal symptoms.


Now, even if you don't feel a difference necessarily while avoiding gluten, reducing gluten in our diets also allows us to have more variety in our diets as we are forced to turn to things like sweet potatoes, quinoa, millet, and other healthy starches and grains that benefit the gut bacteria. It's also a really nice way to experiment with eating different kinds of foods.


Now I realize I have not really touched on salt and water which are extremely important with POTS, also things like caffeine, sugar, alcohol, etc., are all extremely important topics and I'll be sure to touch on them in the future video. So those are two of the most recommended measures, and the reason they're recommended. But! Food is an incredibly individual thing. Everyone is different, you have to figure out your own triggers. One way to do this for example is to keep a diary, or you could even do something like a symptom tracker, and keep track of how you feel and what you're eating.


Another and probably more efficient way is to do something like an elimination diet, eliminate some foods, and see how you're feeling.


Diets for MCAS and EDS


And although this video was made for those with POTS, many with POTS also have MCAS and EDS. Those with Mast Cell Activation Syndrome also might benefit from a Low-Histamine Diet or something like a Low-FODMAP Diet.


Research has even found that a Low-FODMAP Diet decreases histamine by 800% compared to those who did not consume a Low-FODMAP Diet. So as more research is coming out about food and their interaction with how we feel, and with these conditions it's really been quite fascinating to see. And it gives us more choices and things that we could experiment with so that's also exciting.


We covered a little bit about mast cells but when it comes to EDS, EDS sometimes means that the muscles which help the gut work are weakened, and that can cause also digestive issues. So it's so important to keep that in mind too. Everyone is different and it takes a lot of experimenting with different things to see what helps. And there's no one-size-fits-all approach, but nutrition and diet do have a pretty big part to play in managing or alleviating certain symptoms.


This is also where working with a health coach is really beneficial although us coaches, we don't prescribe diets to clients. We do provide information on different types of diets and supplement options to explore and even help you figure out how to incorporate it as a healthy habit because again, this is not, this is not easy.


There's so much on this topic, and this is just the tip of the iceberg.


I'd love to hear your biggest takeaway down in the comments below. Let me know. What dietary changes have you tried? How have they helped?

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