Most experts advise avoidance of alcohol in patients with postural orthostatic tachycardia. Alcohol use prevents blood vessels tightening as usual, stopping the return of the blood to the upper body and the head. This may lead to low blood pressure, dizziness and possibly passing out. Alcohol is also a strong diuretic (Roberts).
Dehydration needs to be avoided, as it will worsen orthostatic intolerance and other symptoms. Fluid intake should be increased in POTS and care taken to ensure adequate fluid replacement.
See the section on diet for an in depth look at diet and POTS. In addition to increasing fluid intake, POTS patients should increase salt intake. Smaller meals low in carbs are preferred. Caffeine limitation may be beneficial in some. Energy drinks should be avoided.
Doctors Inexperienced in POTS
A POTS diagnosis can be very frustrating, a large part of which is getting the diagnosis in the first place. Despite being common, POTS syndrome is generally not recognized by most Dr’s and symptoms are frequently diagnosed as anxiety. In fact there is a trend towards less anxiety in POTS patients as compared to the general population (Raj et al). It’s vital that POTS patients find a doctor experienced in the treatment of dysautonomias.
Some Medications That Can Worsen POTS
There are so many drugs that can worsen POTS that there’s no point writing out a long list here. It’s critical though, that before starting new medications that POTS patients inquire whether there could possibly be any worsening of orthostatic symptoms. Your Dr will be able to answer these questions if asked whenever a new medication is prescribed.