Edit protocol

Name

Category

Slug

URL fragment. Auto-generated from name if blank.

Content (Markdown)

# POTS (Postural Orthostatic Tachycardia Syndrome) Protocol

## Core Therapy: IV Fluids (Primary Intervention)

- Normal saline 500ml
- Magnesium Sulphate 500mg
- B-Complex Plus - 2ml (see breakdown in Quick Reference Guide)

**\*\* Please avoid NAD+** \*\* - can trigger tachycardia, anxiety)

## Frequency Framework

Short-term stabilization model:

### Week 1–2:

- 1–2 infusions weekly if severe

### Week 3–4:

- Reassess symptom scale

### Then:

- Taper
- Encourage oral fluids + salt loading
- Compression garments
- Graded exercise therapy

Long-term weekly IV fluids without review = poor clinical governance

## Adverse Reactions

- Fluid overload
- Peripheral edema
- Hypertension
- Electrolyte imbalance
- Vasovagal reaction
- Increased anxiety if infused rapidly

## Absolute Contraindications

- Heart failure
- Significant renal impairment
- Uncontrolled hypertension
- Structural cardiac disease
- Severe electrolyte imbalance
- Pregnancy (relative — assess individually)

## Further treatment:

### Oral salt loading (8–10g/day where appropriate) - please use celtic salt

- 2–3L daily fluid intake
- Compression therapy
- Structured exercise rehabilitation

Many POTS patients have:

- Low circulating blood volume
- Poor vascular tone
- Blood pooling in lower limbs

Increasing salt:

- Helps the body retain water
- Expands plasma volume
- Reduces tachycardia on standing
- Improves dizziness

## Salt Must Be Combined With Fluids

Salt loading without fluid intake will not work.

Typical recommendation in POTS care:

**2–3 litres of fluids daily PLUS increased salt intake**

## What Does 8–10 g of Salt Look Like?

Approximate examples:

1 level teaspoon salt ≈ 5–6 g

So 8–10 g ≈ 1.5–2 teaspoons per day (spread out)

This can be achieved through:

- Salted food
- Electrolyte powders
- Salt capsules
- Oral rehydration solutions

## Who Should NOT Salt Load?

Avoid or use caution in:

- Hypertension
- Kidney disease
- Heart failure
- Pregnancy-related hypertension
- Certain cardiac conditions

**Always under medical guidance.**

Cancel