Hormones & Autonomic
Your heart pounds when you stand up. You feel lightheaded in the shower, grey out in line at the store, crash after errands, and your brain fogs by afternoon. POTS — postural orthostatic tachycardia syndrome — commonly shows up or gets dramatically worse in perimenopause, after a viral illness, or both.
Serving Lowell, Fayetteville, Rogers, Bentonville, Springdale & Bella Vista — Northwest Arkansas
Estrogen influences blood vessel tone, fluid and sodium handling, and nitric oxide; progesterone affects fluid balance too. As those hormones swing, blood volume and vascular tone become less reliable — so standing up dumps blood into your legs and your heart rate jumps to compensate. Add poor sleep, low ferritin and a recent virus and the pattern locks in.
A NASA lean or active stand test (heart rate rise of 30+ bpm within 10 minutes without a big blood pressure drop), plus labs: ferritin and iron studies, B12, thyroid with antibodies, morning cortisol and ACTH, estradiol and progesterone, electrolytes, A1C and insulin, celiac screen, and mast cell markers when flushing or reactivity is part of the picture. We also screen for long-COVID and sleep apnea.
Aggressive fluid and sodium loading (often 2–3 L plus 3–10 g sodium daily), compression, recumbent-first reconditioning, correcting ferritin and B12, IV hydration and nutrient support on rough weeks, treating any mast cell component, and thoughtful hormone therapy for the menopausal driver. Medications — beta blockers, ivabradine, midodrine, fludrocortisone — are used when the foundation is not enough.
POTS, mast cell activation and hypermobility cluster together, and long-COVID has made all three far more common. Treating one and ignoring the others is the usual reason someone is still symptomatic.
FAQ
At Healing Art Centers in Lowell, AR — about 10 minutes from Rogers, 15 from Bentonville and Springdale, 25 from Fayetteville — or by telemedicine across Arkansas. Call or text 479-715-3928.
For women whose POTS began or worsened with perimenopause, stabilising estradiol and progesterone often improves standing tolerance and fatigue. It is one part of a plan that also includes fluids, sodium, iron and reconditioning.
IV hydration with electrolytes can meaningfully help during flares and hard weeks, and we often pair it with B12 and magnesium. It is a bridge, not the whole treatment.
Often no. Post-viral POTS frequently improves substantially over months with a structured plan, and hormone-driven POTS often improves once hormones are stabilised.
Book a one-on-one consultation with Dr. Tammy and get a personalized plan built around your labs, symptoms, and goals.
Our staff would love to help you choose the service that's right for you.
Prefer texting? You can text us at 479-715-3928.