Comprehensive Guide to Supplements for POTS | Essential Nutrients and How They Support Dysautonomia

A Complete Guide to Better POTS Management

While lifestyle changes and medications play a key role, many individuals find that targeted supplements for POTS can significantly improve symptom control and quality of life. This guide will explore the most effective supplements, how to get them from food and drink, best practices for timing and dosage, and what brands are worth your time and money.

---

Understanding the Role of Supplements With POTS

POTS is a form of dysautonomia, a condition where the autonomic nervous system doesn’t regulate body functions like heart rate, blood pressure, and digestion properly. Supplements can support these systems by replenishing essential nutrients, improving blood volume, and stabilizing energy levels. They’re not a cure, but they often enhance the effectiveness of other treatments and make symptoms more manageable.

The Core Supplements for POTS

Core Supplements for POTS List:

Electrolyte Powder Blends, B Vitamins, Vitamin D, Magnesium, Omega-3 Fatty Acids, Coenzyme Q10 (CoQ10), Salt Tablets or Salt Capsules, L-Carnitine, Alpha-Lipoic Acid (ALA), Omega-9 Fatty Acids, Vitamin C, D-Ribose, Curcumin (Turmeric Extract), Collagen, Probiotics, Vitamin K2, Taurine, Phosphatidylcholine, Resveratrol, N-Acetyl Cysteine (NAC), Quercetin, Coenzyme B Complex, Glycine, Melatonin

⚠️ ONLY for Known Deficiencies: Multivitamin, Adaptogens, Calcium, Potassium, Iron

⚠️ ONLY if Needed: DAO Enzyme Supplementation Diamine Oxidase (DAO), Bromelain (with Quercetin)

POTS with EDS Support: Hyaluronic Acid, MSM (Methylsulfonylmethane), Glucosamine & Chondroitin, Boswellia (Frankincense Extract)

---

Electrolytes

Due to hypovolemia (low blood volume) in many POTS patients, sodium and electrolyte levels must be carefully maintained. Sodium is particularly crucial for helping the body retain fluid and maintain blood pressure.

Electrolyte Absorption Optimization – Since hydration is key in POTS, adding Coconut Water or Aloe Vera Juice alongside electrolyte powders may improve fluid retention and absorption.

• Sodium: Helps increase blood volume and reduce dizziness.
• Potassium: Regulates nerve function and muscle contractions.
• Magnesium: Supports heart rhythm and nervous system regulation.
• Chloride and calcium: Also important in electrolyte blends.

Sources & Supplementation

• Food: Sea salt, bananas, spinach, avocados, sweet potatoes.
• Drinks: Coconut water, electrolyte powders mixed in water.
• Supplements: Electrolyte tablets, capsoles or powders. Look for clean formulas with no added sugar.

Electrolyte Powder Blends – Some individuals find powder-based electrolyte solutions more effective for fluid retention and absorption, compared to tablets or capsules.

All About Electrolytes – Gnarly Tree

Electrolytes play a vital role in keeping your body balanced, energized, and functioning optimally. For individuals with Postural Orthostatic Tachycardia

gnarlytree.com

B Vitamins – (Especially B12 and B1) (methylcobalamin preferred)

B vitamins are essential for energy metabolism, nerve function, and red blood cell production. Vitamin B12 deficiency can contribute to fatigue and neurological symptoms often seen in POTS. Vitamin B1 (thiamine) deficiency may affect blood pressure regulation and cognitive performance.

1. Energy Metabolism & Fatigue Reduction Many individuals with POTS struggle with chronic fatigue, which can be exacerbated by a deficiency in Vitamin B12 (methylcobalamin preferred). B12 is essential for cellular energy production, helping improve stamina and reduce exhaustion.
2. Nerve Function & Neurological Health Vitamin B12 plays a crucial role in nerve health, supporting proper autonomic function. Deficiencies can lead to numbness, tingling, and cognitive dysfunction, symptoms that many with POTS experience. Ensuring adequate B12 intake can support neurological function and enhance brain clarity.
3. Blood Pressure & Cardiovascular Regulation Vitamin B1 (Thiamine) is essential for blood vessel function and blood pressure regulation. Since POTS is associated with autonomic dysfunction affecting circulation, a B1 deficiency may worsen dizziness, low blood pressure, and cardiovascular instability.
4. Cognitive Performance & Mood Support Brain fog and difficulty concentrating are common complaints among those with POTS. B vitamins, especially B1 and B12, contribute to cognitive clarity and mood stabilization, potentially helping manage anxiety and memory issues.

Sources & Supplementation

• FOOD: B12: Meat, fish, eggs, dairy, and fortified plant-based foods
• FOOD: B1 (Thiamine): Whole grains, legumes, nuts, and seeds
• Supplements: Methylcobalamin (preferred) or sublingual B12 tablets are best absorbed.

Vitamin D

Low levels of vitamin D are common in people with chronic illnesses, including those with POTS. Vitamin D is important for immune regulation, bone health, and muscle function. A deficiency can contribute to fatigue, muscle weakness, and mood disorders.

1. Immune System Regulation Many individuals with POTS experience immune dysfunction or chronic inflammation, which can exacerbate symptoms. Vitamin D plays a crucial role in immune system modulation, helping to regulate inflammatory responses and support overall immune health.
2. Bone & Muscle Health Since POTS can lead to reduced mobility due to fatigue and dizziness, maintaining bone density and muscle strength is essential. Vitamin D helps the body absorb calcium and supports muscle function, which can be beneficial in preventing weakness and improving overall physical resilience.
3. Fatigue & Energy Levels Vitamin D deficiency is commonly linked to fatigue, and many individuals with chronic illnesses, including POTS, experience extreme tiredness. Ensuring adequate Vitamin D levels may help combat fatigue and improve energy production, allowing for better symptom management.
4. Mood & Cognitive Function Brain fog, anxiety, and depression are common struggles for those with POTS. Vitamin D is essential for neurological health, helping regulate neurotransmitters that influence mood. Low levels have been linked to depression and cognitive decline, making proper supplementation crucial for mental well-being.

Sources & Supplementation

• Sun exposure: About 10–30 minutes a day, depending on skin type and location
• Food: Fatty fish, fortified milk or orange juice, egg yolks.
• Supplements: Look for D3 (cholecalciferol), often paired with vitamin K2.

Magnesium

Magnesium supports cardiovascular health, muscle relaxation, and nerve function. A deficiency in magnesium can worsen symptoms such as palpitations, muscle cramps, and poor sleep.

1. Cardiovascular Health & Blood Pressure Regulation Magnesium plays a vital role in maintaining heart rhythm and vascular function. For individuals with POTS, this can be beneficial in reducing palpitations, blood pressure fluctuations, and circulation irregularities.
2. Muscle Relaxation & Cramp Prevention Since POTS is often associated with muscle weakness, spasms, and tension, magnesium helps relax muscles and prevent cramping by supporting neuromuscular function and electrolyte balance. Magnesium glycinate is particularly effective for muscle relaxation, while magnesium citrate can support digestive health alongside muscle function.
3. Nerve Function & Autonomic Support Magnesium is essential for nerve signaling, which can impact autonomic nervous system regulation in individuals with POTS. Proper magnesium levels help balance nerve impulses, potentially reducing dizziness and neurological symptoms associated with autonomic dysfunction.
4. Sleep & Anxiety Management Many individuals with POTS experience sleep disturbances, anxiety, and stress-related symptoms. Magnesium can aid in calming the nervous system, promoting better sleep and reducing stress-related autonomic responses.

Omega-3 Fatty Acids

1. Reducing Inflammation POTS is often associated with chronic inflammation, whether due to underlying autoimmune conditions, viral triggers, or other contributing factors. Omega-3s—found in fish, flaxseeds, and walnuts—can help lower inflammation levels, potentially improving symptoms such as fatigue and joint pain.
2. Cardiovascular Support One of the primary challenges in POTS is blood circulation and autonomic dysfunction, which leads to heart rate spikes upon standing. Omega-3s have been shown to:
   • Improve blood vessel function
   • Reduce blood pressure fluctuations
   • Support heart rhythm stability
3. Neurological & Cognitive Benefits Many individuals with POTS experience brain fog, dizziness, and difficulty concentrating due to blood flow irregularities. Omega-3s contribute to brain health, supporting cognitive function and possibly reducing symptoms of mental fatigue.
4. Blood Volume Regulation Since low blood volume is common in POTS, ensuring proper hydration and electrolyte balance is crucial. Omega-3s may assist in fluid retention and vascular health, helping improve circulation and reducing orthostatic intolerance symptoms.

Sources & Supplementation

• Food: Fatty fish (salmon, mackerel, sardines), Flaxseeds and chia seeds, walnuts.
• Supplements: Fish oil capsules, krill oil, or vegan algae-based omega-3. (consult a healthcare provider for appropriate dosage)

Coenzyme Q10 (CoQ10)

Supports Cellular Energy Production POTS is often associated with fatigue and exercise intolerance, which may stem from mitochondrial dysfunction—the process that generates energy at a cellular level. CoQ10 is a key player in mitochondrial energy production, helping boost energy levels and improve physical endurance.

Heart Health Benefits Since POTS primarily affects heart rate regulation, CoQ10 is particularly beneficial for cardiovascular support. It helps:

• Improve blood flow and circulation
• Enhance heart muscle efficiency
• Reduce oxidative stress that may contribute to autonomic dysfunction

Neurological & Cognitive Function Many individuals with POTS experience brain fog, memory difficulties, and trouble concentrating. CoQ10 supports brain cell energy production, which may enhance cognitive clarity and reduce symptoms of mental fatigue.

Anti-Inflammatory & Antioxidant Properties Chronic inflammation is linked to POTS, especially in cases triggered by autoimmune conditions or infections. CoQ10 acts as a powerful antioxidant, helping reduce inflammation and oxidative stress, which could contribute to overall symptom improvement.

Sources & Supplementation

• Food: fatty fish, organ meats, nuts, and seeds, spinach, broccoli.
• Supplements: Typically available in ubiquinone or ubiquinol forms (ubiquinol is often better absorbed)

Salt & Salt Tablets or Salt Capsules

Used when high salt intake is recommended but hard to reach through food.

Brands: Thermotabs, SaltStick, or generic sodium chloride capsules.

1. Increasing Blood Volume & Circulation Many individuals with POTS have low blood volume, which can contribute to dizziness, fatigue, and poor circulation. Sodium helps retain fluid, supporting better blood flow and reducing orthostatic symptoms.
2. Stabilizing Blood Pressure POTS is characterized by blood pressure fluctuations and an excessive heart rate increase upon standing. Higher sodium intake can help maintain stable blood pressure by improving fluid balance and vascular tone.
3. Reducing Dizziness & Lightheadedness Many people with POTS experience orthostatic intolerance, making standing and walking difficult. Salt supplementation, combined with proper hydration, can alleviate dizziness by improving blood circulation and autonomic function.
4. Easy & Convenient Sodium Intake While increasing salt intake through food is ideal, some individuals struggle to consume enough sodium through diet alone. Salt tablets or capsules provide a controlled, convenient way to meet sodium needs without relying solely on food.

Why Salt Matters in POTS Management – Gnarly Tree

Salt plays a critical role in maintaining blood volume and blood pressure—two key issues in POTS. This blog explores how salt can help regulate symptoms

gnarlytree.com

---

L-Carnitine

Supports mitochondrial energy production, which may help combat fatigue and exercise intolerance in POTS.

1. Mitochondrial Energy Production L-Carnitine is a naturally occurring compound that plays a vital role in cellular energy metabolism. It transports fatty acids into the mitochondria, where they are converted into ATP (energy). For individuals with POTS, whose bodies often struggle with energy production and fatigue, optimizing mitochondrial function can help enhance endurance and reduce exhaustion.
2. Exercise Intolerance & Muscle Support Many individuals with POTS experience exercise intolerance, making physical activity challenging due to dizziness, rapid heart rate, and muscle weakness. L-Carnitine helps support muscle function, endurance, and recovery, potentially improving the ability to engage in mild to moderate physical activity.
3. Cardiovascular Benefits Since POTS affects blood circulation, L-Carnitine may help improve vascular function and circulation efficiency, reducing heart palpitations and supporting overall cardiovascular health. Some studies suggest it could enhance blood flow and reduce oxidative stress in blood vessels.
4. Neurological & Cognitive Function Brain fog and difficulty concentrating are common complaints among those with POTS. L-Carnitine has neuroprotective properties, potentially enhancing cognitive function and reducing mental fatigue by optimizing mitochondrial activity in brain cells.

Sources & Supplementation

• Dietary sources: Red meat, fish, dairy, and some plant-based sources like avocados and asparagus.
• Supplementation: Available in Acetyl-L-Carnitine (ALCAR) and L-Carnitine Tartrate forms, with ALCAR often favored for neurological benefits.
• Recommended Dosage: Varies depending on individual needs—consult a healthcare provider for appropriate guidance.

Since mitochondrial dysfunction is commonly associated with fatigue in POTS, L-Carnitine supplementation may help support energy levels, cardiovascular health, and muscle endurance. ⚠️ However, individual responses vary, so it’s best to monitor symptoms and adjust accordingly under medical supervision.

Alpha-Lipoic Acid (ALA)

A potent antioxidant that can support nerve health, blood sugar balance, and mitochondrial function.

1. Powerful Antioxidant Support ALA is a potent antioxidant that helps neutralize free radicals, which can contribute to inflammation and oxidative stress—common concerns for individuals with POTS, particularly those with autoimmune or post-viral triggers.
2. Nerve Health & Neurological Function Many people with POTS experience neurological symptoms such as brain fog, dizziness, and sensory disturbances. ALA is known to support nerve function, potentially improving cognitive clarity, reducing neuropathic discomfort, and aiding autonomic regulation.
3. Blood Sugar Balance & Metabolic Support ALA plays a role in glucose metabolism, helping improve insulin sensitivity and blood sugar stability. Since blood sugar fluctuations can worsen fatigue and dizziness in POTS, ALA may help maintain more balanced energy levels throughout the day.
4. Mitochondrial Function & Energy Production Fatigue is a core challenge for many POTS patients. ALA enhances mitochondrial function, optimizing cellular energy production (ATP) and potentially reducing muscle weakness and physical exhaustion.

Sources & Supplementation

• Dietary sources: Found in small amounts in spinach, broccoli, tomatoes, and organ meats.
• Supplementation: Available in R-ALA (preferred for better absorption) and S-ALA forms.
• Recommended Dosage: Often ranges from 300-600 mg per day, though individual tolerance varies—consult a healthcare provider before starting.

Since oxidative stress and autonomic dysfunction are significant concerns in POTS, ALA supplementation may provide valuable support for nerve health, metabolic balance, and energy levels. ⚠️ However, individual responses can vary, so careful monitoring and professional guidance are recommended.

Omega-9 Fatty Acids (like Olive Oil)

Supports vascular health, anti-inflammatory processes, and autonomic nervous system function.

1. Supports Vascular Health & Circulation Omega-9 fatty acids, found in sources like olive oil, help maintain blood vessel flexibility and integrity, which is important for individuals with POTS who experience blood pressure fluctuations and circulation issues. Healthy blood vessels can contribute to more stable cardiovascular function and reduce symptoms like dizziness upon standing.
2. Anti-Inflammatory Properties Chronic inflammation is a known factor in many autonomic disorders, including POTS. Omega-9s, particularly oleic acid from olive oil, have been shown to reduce inflammation and oxidative stress, supporting immune function and overall well-being. This may be especially helpful for individuals whose symptoms worsen with inflammatory responses.
3. Autonomic Nervous System Support Since Omega-9s contribute to hormonal regulation and nerve signaling, they may play a role in supporting autonomic nervous system stability. A well-functioning autonomic system helps balance heart rate, digestion, and blood pressure, potentially reducing symptom severity in POTS.
4. Heart & Brain Health Benefits Omega-9s are known to support heart rhythm stability, and they may also aid in cognitive function, helping alleviate brain fog and mental fatigue—common symptoms among those with POTS.

Sources & Supplementation

• Olive Oil – A rich source of heart-healthy omega-9s, great for cooking and salad dressings.
• Avocados & Nuts (Almonds, Macadamia, Cashews) – Provide additional sources of Omega-9s.
• Omega-9 Supplements – Available as oils or capsules, though dietary sources are preferred for best absorption.

Since vascular health, inflammation, and autonomic function play key roles in POTS symptom management, incorporating Omega-9-rich foods can be a valuable strategy for improving circulation, nervous system regulation, and overall well-being.

Vitamin C

Helps enhance blood vessel integrity, reduce inflammation, and support immune function.

1. Enhancing Blood Vessel Integrity Individuals with POTS often experience issues with vascular stability, contributing to blood pressure fluctuations and poor circulation. Vitamin C supports collagen production, which helps strengthen blood vessels and improve circulation, potentially reducing symptoms like dizziness and lightheadedness.
2. Reducing Inflammation & Oxidative Stress Chronic inflammation can exacerbate autonomic dysfunction in POTS. Vitamin C acts as a powerful antioxidant, helping to neutralize oxidative stress, which may play a role in reducing fatigue and supporting overall cardiovascular health.
3. Immune System Support Since many individuals with POTS have immune dysfunction or post-viral onset, ensuring adequate Vitamin C intake boosts immune function, helping protect against infections that could worsen symptoms.
4. Iron Absorption & Energy Production Vitamin C enhances iron absorption, which is beneficial for individuals who experience fatigue due to iron deficiency anemia. Supporting iron levels can reduce dizziness, weakness, and energy depletion often seen in POTS.

Sources & Supplementation

• Dietary Sources: Citrus fruits, bell peppers, strawberries, leafy greens, and tomatoes.
• Supplementation: Available in ascorbic acid, liposomal, or buffered forms for better absorption.
• Recommended Dosage: Typically 500-1000 mg per day, but individual needs vary—consult a healthcare provider.

Since vascular health, immune support, and inflammation control play a role in POTS symptom management, ensuring proper Vitamin C intake can help improve circulation, reduce oxidative stress, and support overall well-being.

D-Ribose

A naturally occurring sugar that helps boost ATP (cellular energy) production, which may support muscle and heart function in POTS.

1. ATP Production & Cellular Energy Support Many individuals with POTS struggle with chronic fatigue and exercise intolerance, which may be linked to mitochondrial dysfunction. D-Ribose is a naturally occurring sugar essential for ATP (adenosine triphosphate) production, the body’s main energy source. By enhancing cellular metabolism, D-Ribose may help improve energy levels and reduce exhaustion.
2. Muscle Function & Endurance Since muscle weakness and exercise intolerance are common in POTS, D-Ribose may support muscle recovery and endurance by helping cells generate energy more efficiently. This can be particularly beneficial for those working on gradual exercise therapy to improve circulation and strength.
3. Heart Health & Circulation The autonomic dysfunction in POTS can impact blood flow and heart rate regulation, leading to symptoms such as palpitations and lightheadedness. D-Ribose supports cardiovascular function by fueling heart muscle cells, potentially improving circulatory efficiency and reducing heart-related symptoms.
4. Brain Function & Cognitive Clarity Many people with POTS experience brain fog and cognitive difficulties, often linked to poor blood flow and mitochondrial inefficiency. By boosting ATP production in brain cells, D-Ribose may help enhance mental clarity, focus, and overall cognitive function.

Sources & Supplementation

• Natural Sources: Found in small amounts in meats, dairy, and some nuts/seeds.
• Supplementation: Available in powder or capsule form, often recommended at 5-10 grams per day, depending on individual needs.
• Usage Tips: Works best when taken with electrolytes and hydration, as energy production relies on proper cellular function.

Since fatigue, muscle weakness, and cardiovascular dysfunction are common in POTS, supplementing with D-Ribose may offer valuable support for energy levels, heart health, and cognitive function. However, it’s important to consult a healthcare provider to determine appropriate dosing and ensure compatibility with other treatments.

Curcumin (Turmeric Extract)

Has anti-inflammatory and neuroprotective effects, potentially helping with autonomic dysfunction, making it a great Supplement for POTS

1. Anti-Inflammatory Properties Chronic inflammation is a common factor in many autonomic disorders, including POTS. Curcumin, the active compound in turmeric, is a powerful anti-inflammatory agent that may help reduce systemic inflammation, potentially improving symptoms such as fatigue, joint pain, and overall autonomic stability.
2. Neuroprotective Effects Brain fog, dizziness, and cognitive challenges are frequent concerns for individuals with POTS. Curcumin is known to support brain health by enhancing neurotransmitter function, protecting against oxidative stress, and potentially improving memory and focus.
3. Cardiovascular Support Since POTS affects heart rate and circulation, curcumin may help enhance vascular health, improve blood flow, and reduce oxidative damage to blood vessels, contributing to better cardiovascular function and symptom management.
4. Gut Health & Autonomic Stability Research suggests a strong link between gut health and autonomic function. Curcumin supports digestion, reduces gut inflammation, and improves microbiome balance, which may help individuals with POTS experiencing gastrointestinal symptoms.

Sources & Supplementation

• Dietary sources: Turmeric spice (best absorbed with black pepper and healthy fats).
• Supplementation: Curcumin extract (preferably liposomal or with piperine for better bioavailability).
• Recommended Dosage: Typically ranges from 500-2000 mg per day, depending on individual needs—consult a healthcare provider for guidance.

Since inflammation, neurological function, and vascular health play critical roles in POTS symptom management, Curcumin may offer valuable support in reducing autonomic dysfunction. However, as absorption can vary, pairing it with piperine (black pepper extract) or fats like olive oil may enhance its effectiveness.

Collagen

Supports blood vessels, joints, and connective tissue (important for those with comorbidities like Ehlers-Danlos Syndrome).

1. Supports Blood Vessel Integrity & Circulation Collagen is a key structural protein in blood vessels, helping maintain their strength and flexibility. Since vascular instability is common in POTS—leading to blood pressure fluctuations and poor circulation—adequate collagen levels may support vessel health and reduce symptoms like dizziness and pooling.
2. Joint & Connective Tissue Health Individuals with Ehlers-Danlos Syndrome (EDS), a common comorbidity of POTS, often experience joint hypermobility, instability, and pain due to connective tissue defects. Collagen supplementation may help support joint strength, improve cartilage integrity, and reduce excessive joint movement, potentially easing symptoms of pain and fatigue.
3. Autonomic Function & Muscle Support Collagen plays a role in muscle and nerve function, and since POTS can cause muscle weakness and poor circulation, ensuring adequate collagen levels may enhance musculoskeletal resilience and overall physical endurance.
4. Gut Health & Nutrient Absorption Many individuals with POTS experience digestive issues, including poor absorption of nutrients. Collagen supports gut lining integrity, which may help reduce gastrointestinal discomfort and improve overall nutrient absorption for better autonomic health.

Sources & Supplementation

• Dietary Sources: Bone broth, fish, chicken skin, egg whites, and gelatin-rich foods.
• Collagen Supplements: Hydrolyzed collagen peptides are easily absorbed and often recommended for joint and vascular health.
• Pairing with Nutrients: Collagen works best with Vitamin C, which enhances its absorption and effectiveness in supporting connective tissue.

Since blood vessel health, joint stability, and muscle function play important roles in POTS and related conditions, incorporating collagen-rich foods or supplements may be beneficial for circulatory, musculoskeletal, and autonomic support

Probiotics

Gut health is closely linked to autonomic nervous system function. Supporting digestion can help with nutrient absorption and inflammation.

1. Gut Health & Autonomic Nervous System Function The gut and autonomic nervous system are deeply interconnected through the gut-brain axis. When gut health is compromised—due to imbalances in gut bacteria, poor digestion, or inflammation—it can negatively impact autonomic regulation, potentially worsening POTS symptoms like dizziness, fatigue, and digestive distress.
2. Nutrient Absorption & Energy Support Many individuals with POTS struggle with nutrient deficiencies, which can contribute to fatigue, brain fog, and muscle weakness. Probiotics help enhance digestion and nutrient absorption, ensuring the body receives vital vitamins and minerals for optimal autonomic function.
3. Inflammation & Immune System Regulation Chronic inflammation is a key factor in autonomic dysfunction. Since the gut plays a major role in immune system modulation, maintaining a healthy gut microbiome with probiotics may help reduce systemic inflammation, supporting vascular health and nervous system stability.
4. Reducing Gastrointestinal Symptoms Individuals with POTS often experience digestive issues, such as bloating, nausea, and gastroparesis (slow digestion). Probiotics can improve gut motility, support regular digestion, and help rebalance beneficial gut bacteria to alleviate gastrointestinal symptoms.

Vitamin K2

Supports blood vessel integrity and calcium regulation, helping prevent issues related to vascular stiffness, which can impact circulation in POTS.

1. Supports Blood Vessel Integrity & Circulation Vitamin K2 is essential for vascular health, as it helps prevent calcium buildup in arteries. This contributes to better blood vessel flexibility, reducing vascular stiffness that can negatively affect circulation and blood pressure regulation in individuals with POTS. Maintaining healthy, elastic blood vessels is crucial for preventing pooling and stabilizing autonomic function.
2. Calcium Regulation & Bone Health Since calcium metabolism plays a role in vascular and skeletal health, Vitamin K2 ensures calcium is properly directed to bones instead of accumulating in arteries. This supports bone density and helps prevent issues related to arterial hardening, which can contribute to poor circulation and cardiovascular instability—key concerns in POTS.
3. Potential Cardiovascular Benefits Vitamin K2 may play a role in heart rhythm stability by regulating vascular tone and blood flow, potentially benefiting individuals who experience palpitations or blood pressure fluctuations as part of autonomic dysfunction.
4. Pairing Vitamin K2 with Other Nutrients
   • Vitamin D – Works alongside Vitamin K2 to ensure proper calcium absorption and utilization.
   • Magnesium – Helps relax blood vessels and prevent vascular calcification, supporting circulation.
   • Omega-3 Fatty Acids – May further enhance vascular flexibility and reduce inflammation.

Sources & Supplementation

• Dietary Sources: Fermented foods (natto), egg yolks, cheese, liver, and dark leafy greens.
• Supplementation: Often found in MK-7 or MK-4 forms (MK-7 is more bioavailable and longer-lasting).
• Recommended Dosage: Varies based on individual needs—consult a healthcare provider for optimal intake.

Since vascular health, calcium regulation, and circulation stability play a role in POTS symptom management, ensuring proper Vitamin K2 intake may help support blood vessel flexibility and autonomic function. However, supplementation should be monitored to avoid interactions with medications such as blood thinners

Taurine

A key amino acid that supports electrolyte balance, nerve function, and heart stability, potentially helping with POTS, autonomic dysfunction and palpitations.

1. Electrolyte Balance & Cellular Hydration Taurine helps regulate electrolyte movement across cell membranes, ensuring optimal sodium, potassium, and magnesium balance. Since individuals with POTS often struggle with fluid retention and blood volume regulation, taurine may help improve hydration and stabilize blood pressure.
2. Nerve Function & Autonomic Stability Taurine plays a role in neuromodulation, supporting healthy nerve signaling and autonomic nervous system function. Since POTS is characterized by dysregulated autonomic responses, taurine may help smooth nervous system activity, potentially reducing symptoms like dizziness, fatigue, and sensory overstimulation.
3. Heart Stability & Circulation Support One of taurine’s major benefits is its ability to support heart rhythm stability and vascular function. It helps regulate calcium flow within heart muscle cells, ensuring proper contractions and reducing excessive heart rate fluctuations—which may help individuals with POTS experiencing tachycardia or palpitations.
4. Anti-Inflammatory & Antioxidant Benefits Taurine possesses anti-inflammatory properties, potentially helping individuals with POTS who experience oxidative stress and systemic inflammation. By supporting cellular protection and immune function, it may contribute to better recovery from flare-ups.

Sources & Supplementation

• Dietary Sources: Found in meat, fish, dairy, and eggs.
• Supplementation: Available in capsule or powder form, typically 500–3000 mg per day depending on individual needs.
• Usage Tips: Works best when combined with electrolytes and hydration strategies.

Since electrolyte balance, autonomic stability, and heart function are critical in POTS symptom management, taurine supplementation may offer valuable support in reducing palpitations, improving blood pressure stability, and optimizing hydration. However, individual responses vary, so it’s best to monitor symptoms and consult a healthcare provider before supplementing.

Phosphatidylcholine

Supports brain function and autonomic nervous system health, potentially improving cognitive clarity and nerve signaling in POTS patients.

1. Brain Function & Cognitive Clarity Many individuals with POTS experience brain fog, memory issues, and difficulty concentrating due to autonomic dysfunction. Phosphatidylcholine, a key component of cell membranes and neurotransmitter synthesis, supports mental clarity, focus, and cognitive performance, potentially helping improve executive function and memory recall.
2. Autonomic Nervous System Stability Since phosphatidylcholine is a precursor to acetylcholine, a neurotransmitter involved in autonomic nervous system regulation, it may help enhance nerve signaling, improving blood pressure control, digestion, and heart rate balance—all critical factors for POTS symptom management.
3. Cellular & Neuroprotective Benefits Phosphatidylcholine supports cell membrane integrity, helping maintain healthy nerve function and reducing oxidative stress that may contribute to autonomic dysfunction. By promoting neuroprotection, it can assist in nerve repair and resilience for individuals experiencing autonomic nervous system irregularities.
4. Gut & Liver Health Support Since digestion plays a role in nutrient absorption and autonomic stability, phosphatidylcholine supports liver detoxification and gut barrier function, potentially aiding those with digestive discomfort, nutrient deficiencies, or inflammatory issues related to POTS.

Sources & Supplementation

• Dietary Sources: Eggs, soybeans, sunflower seeds, fish, and beef liver.
• Supplementation: Often available in lecithin or phosphatidylcholine capsules, typically 300-1200 mg per day depending on individual needs.

Since cognitive function, autonomic nervous system signaling, and cellular health are key components of POTS symptom management, phosphatidylcholine supplementation may offer valuable support for brain function, nerve transmission, and autonomic stability. Consulting a healthcare provider to determine optimal dosing and compatibility with other supplements is recommended.

Resveratrol

Resveratrol is a powerful antioxidant that may support vascular function, circulation, and inflammation control for POTS. Found naturally in grapes and berries.

1. Vascular Function & Circulation Support Resveratrol promotes healthy blood flow by enhancing endothelial function, which helps blood vessels relax and widen. This could be beneficial for individuals with POTS experiencing poor circulation, blood pooling, or fluctuations in blood pressure.
2. Anti-Inflammatory & Oxidative Stress Reduction Since chronic inflammation is a concern in many autonomic disorders, Resveratrol acts as a powerful antioxidant, neutralizing oxidative stress that can contribute to autonomic instability and cardiovascular strain.
3. Heart Health & Autonomic Regulation Resveratrol may support heart function by protecting against excessive oxidative damage in cardiac tissues. It also plays a role in modulating autonomic nervous system activity, which could help reduce heart rate fluctuations or palpitations experienced by individuals with POTS.
4. Neuroprotective Benefits Brain fog and cognitive dysfunction are common in POTS, and resveratrol may enhance brain function by supporting neurotransmitter activity and reducing neuroinflammation. This could contribute to better focus, memory, and mental clarity.

Sources & Supplementation

• Natural Sources: Found in red grapes, blueberries, cranberries, and dark chocolate.
• Supplementation: Available in capsule or liquid extract form—often paired with Quercetin for enhanced bioavailability.
• Recommended Dosage: Varies based on individual needs—consult a healthcare provider for appropriate intake.

Since vascular health, inflammation, and autonomic regulation play crucial roles in POTS symptom management, resveratrol could be a valuable addition to a supplement regimen—but should always be incorporated under professional guidance to ensure compatibility with individual needs.

N-Acetyl Cysteine (NAC)

A potent antioxidant that may help support POTS with mitochondrial function, detoxification, and autonomic nervous system balance.

1. Mitochondrial Function & Energy Production Many individuals with POTS experience fatigue and exercise intolerance, which may be linked to mitochondrial dysfunction—the inability of cells to produce enough ATP (energy). NAC serves as a precursor to glutathione, the body’s most potent antioxidant, which supports mitochondrial efficiency and cellular resilience, potentially improving energy levels and reducing exhaustion.
2. Detoxification & Oxidative Stress Reduction Since oxidative stress can exacerbate autonomic dysfunction, NAC plays a critical role in neutralizing free radicals and reducing inflammation. Its ability to support liver detoxification may help individuals with POTS who experience chemical sensitivities, medication side effects, or environmental toxin sensitivity.
3. Autonomic Nervous System Regulation NAC may support neurotransmitter balance, aiding in the regulation of heart rate, blood pressure, and digestion—key areas affected by autonomic dysfunction in POTS. Some research suggests that NAC modulates vagal nerve activity, potentially improving nervous system stability and reducing symptoms like dizziness or lightheadedness.
4. Cardiovascular & Blood Flow Support NAC has been shown to enhance endothelial function—improving blood vessel dilation and circulation. This may be particularly beneficial for individuals with POTS who experience blood pooling, circulation irregularities, or blood pressure instability.

Sources & Supplementation

• Natural Sources: Found in small amounts in protein-rich foods (meat, eggs, dairy), though supplementation is often required for therapeutic effects.
• Supplementation: Typically available in capsule or powder form, with dosages ranging from 600-1200 mg per day, depending on individual needs.
• Pairing with Nutrients: Works well alongside Alpha-Lipoic Acid (ALA) and CoQ10 to further support mitochondrial function and energy production.

Since oxidative stress, energy production, and autonomic nervous system regulation are key components of POTS symptom management, NAC supplementation may offer valuable support for detoxification, cardiovascular health, and neurological stability. As individual responses vary, consulting a healthcare provider for personalized guidance is recommended.

Quercetin

A vascular-supporting flavonoid that may enhance circulation, reduce inflammation, and support histamine regulation, particularly helpful for Mast Cell Activation Syndrome (MCAS), which can overlap with POTS.

1. Vascular Function & Circulation Support Quercetin promotes healthy blood flow by improving endothelial function—supporting blood vessel flexibility and reducing vascular inflammation. This may help stabilize circulation in individuals with POTS who experience blood pooling, pressure fluctuations, and dizziness upon standing.
2. Anti-Inflammatory & Autonomic Regulation Chronic inflammation can worsen autonomic dysfunction, contributing to fatigue, cognitive issues, and cardiovascular strain. As an anti-inflammatory agent, Quercetin helps modulate cytokine activity, potentially reducing systemic oxidative stress and immune-related inflammation.
3. Histamine Regulation for MCAS & POTS Overlap Many individuals with POTS also experience MCAS, which leads to excessive histamine release, resulting in flushing, palpitations, allergic reactions, and gastrointestinal distress. Quercetin acts as a natural mast cell stabilizer, helping regulate histamine levels, which may improve symptoms associated with MCAS-related POTS flares.
4. Cognitive & Neurological Benefits Since brain fog and sensory sensitivity are common in POTS, quercetin may provide neuroprotective benefits, potentially improving mental clarity, neurotransmitter balance, and autonomic nerve function.

Sources & Supplementation

• Natural Sources: Found in onions, apples, citrus fruits, berries, and green tea.
• Supplementation: Available in capsule or powder form, often combined with Bromelain for enhanced absorption.
• Recommended Dosage: Typically 500–1000 mg per day, but individual needs vary—consult a healthcare provider before supplementing.

Since vascular health, inflammation control, and histamine regulation play crucial roles in POTS symptom management, Quercetin may offer valuable support in reducing circulatory instability, autonomic dysfunction, and MCAS-related symptoms.

Coenzyme B Complex

If you’re already taking B vitamins, consider a methylated B-complex, as many individuals with POTS have difficulty absorbing folate and B12 in their standard forms.

1. Optimized Absorption & Bioavailability Many individuals with POTS have difficulty metabolizing standard forms of B vitamins, particularly Folate (B9) and B12, due to genetic variations like MTHFR mutations or digestive issues. A methylated B-complex ensures better absorption and utilization, allowing the body to convert nutrients into their active forms for optimal support.
2. Energy Metabolism & Fatigue Reduction Since chronic fatigue and exercise intolerance are common in POTS, B vitamins play a crucial role in mitochondrial energy production. Coenzyme B Complex supports the conversion of food into ATP (cellular energy), potentially reducing weakness, dizziness, and overall exhaustion.
3. Nervous System & Autonomic Support B vitamins, particularly B1 (Thiamine), B6 (Pyridoxine), and B12 (Methylcobalamin), are essential for nerve health and autonomic nervous system stability. They help regulate neurotransmitters, maintain myelin sheath integrity, and support healthy nerve signaling, which may improve symptoms like brain fog, sensory sensitivity, and autonomic imbalances.
4. Cardiovascular & Circulatory Benefits B vitamins aid in red blood cell formation, ensuring proper oxygen transport and preventing anemia-related dizziness and fatigue. B6 and B12 also help regulate homocysteine levels, reducing the risk of vascular dysfunction that can exacerbate blood pressure instability in POTS.

Sources & Supplementation

• Dietary Sources: Eggs, meat, poultry, dairy, leafy greens, whole grains, and legumes.
• Supplementation: Look for a methylated or coenzyme B-complex formula, containing Methylfolate (L-5-MTHF) and Methylcobalamin (B12) for enhanced absorption.
• Recommended Dosage: Varies based on individual needs—consult a healthcare provider for personalized guidance.

Since energy production, nerve function, and cardiovascular health play a role in POTS symptom management, using a Coenzyme B Complex with methylated B vitamins may enhance absorption, reduce fatigue, and support autonomic balance.

Glycine

Supports neurological function, relaxation, and cognitive clarity, potentially helping with brain fog and autonomic nerve health with POTS.

1. Neurological Function & Cognitive Clarity Many individuals with POTS experience brain fog, difficulty concentrating, and sensory sensitivity, often due to autonomic dysfunction. Glycine plays a role in neurotransmitter regulation, helping to enhance mental clarity, memory, and focus while supporting healthy nerve signaling.
2. Relaxation & Sleep Support Glycine has calming effects on the nervous system, promoting relaxation and stress resilience. Since many people with POTS struggle with sleep disturbances or nervous system overstimulation, glycine may aid in improving sleep quality and reducing nighttime autonomic symptoms.
3. Autonomic Nervous System Regulation Glycine acts as an inhibitory neurotransmitter, helping to balance excitatory signals in the brain and spinal cord. This may assist individuals with autonomic dysregulation, supporting heart rate stability, blood pressure control, and overall nervous system function.
4. Anti-Inflammatory & Vascular Support Since oxidative stress and inflammation can worsen POTS symptoms, glycine’s anti-inflammatory properties may help reduce systemic inflammation, supporting blood vessel health and circulation.

Sources & Supplementation

• Natural Sources: Found in bone broth, meat, fish, eggs, and gelatin.
• Supplementation: Available in powder or capsule form, often taken at 1-3 grams per day depending on individual needs.
• Pairing with Nutrients: Works well alongside Magnesium, Taurine, and B Vitamins to enhance neurological and autonomic function.

Since neurological function, autonomic balance, and relaxation play key roles in POTS symptom management, glycine supplementation may offer valuable support in reducing brain fog, improving sleep, and stabilizing autonomic responses

Melatonin (if sleep is affected)

May help regulate circadian rhythms, improving sleep quality and autonomic balance for those with dysregulated sleep cycles like in POTS.

1. Circadian Rhythm Regulation Many individuals with POTS experience disrupted sleep cycles, which can worsen symptoms like fatigue, cognitive fog, and autonomic instability. Melatonin helps regulate the body’s internal clock, promoting consistent sleep-wake cycles that may improve overall rest and recovery.
2. Improving Sleep Quality & Recovery Since sleep is essential for autonomic nervous system restoration, melatonin may help increase deep sleep duration, enhance REM sleep, and reduce nighttime wakefulness, leading to more restorative sleep for those affected by POTS.
3. Autonomic Balance & Nervous System Support Melatonin influences parasympathetic nervous system activity, helping to reduce stress, lower heart rate, and regulate blood pressure overnight. For individuals with autonomic dysregulation, improving nighttime autonomic stability can contribute to better daytime symptom control.
4. Anti-Inflammatory & Mitochondrial Benefits Melatonin also functions as a potent antioxidant, protecting mitochondrial health and reducing oxidative stress, which can be beneficial for individuals experiencing chronic inflammation, fatigue, or cellular dysfunction related to POTS.

Sources & Supplementation

• Natural Sources: Found in small amounts in tart cherries, walnuts, grapes, and tomatoes.
• Supplementation: Typically available in capsule, tablet, or liquid forms, with dosages ranging from 0.5–5 mg per night, depending on individual needs.
• Usage Tips: Best taken 30–60 minutes before bedtime, in a low-dose formulation to prevent grogginess the next day.

Since circadian rhythm regulation, sleep quality, and autonomic balance play a critical role in POTS symptom management, melatonin supplementation may help support restful sleep and autonomic nervous system stability. However, individual responses vary, so working with a healthcare provider to determine an optimal dose is recommended.

---

🩺 Always consult a healthcare provider to ensure proper dosing and avoid interactions with existing treatments.

---

Address Nutritional Deficiencies with POTS – Gnarly Tree

For individuals with POTS, addressing nutritional deficiencies plays a crucial role in symptom management. Understand the Link Between POTS and Nutrition

gnarlytree.com

Multivitamin (?)

When to Consider Multivitamin Supplements for POTS

✅ If daily nutrition is inconsistent due to symptoms. ✅ If taking individual supplements is too expensive or complex. ✅ If needing broad nutritional support without excessive dosages. ❌ Avoid if already using a complete supplement plan with sufficient nutrients.

While multivitamins can be helpful for general health and nutrient balance, they should be chosen carefully to avoid excessive nutrient intake, particularly when combined with individualized supplements for POTS management. Working with a healthcare provider to assess individual needs is recommended before making a decision.

1. Filling Nutritional Gaps Many individuals with POTS experience dietary inconsistencies due to symptoms such as fatigue, nausea, or digestive issues, which can affect regular and balanced eating habits. A multivitamin serves as a broad-spectrum safety net, ensuring the body receives essential vitamins and minerals even when daily food intake is unpredictable.
2. Avoiding Overlap with a Comprehensive Supplement Plan While multivitamins provide many essential nutrients, they should only be taken with caution in combination with other targeted supplements to prevent excessive intake of certain vitamins and minerals. Overlapping nutrients, such as too much Vitamin A, Iron, or Zinc, can lead to imbalances or toxicity, making it crucial to evaluate supplement combinations carefully.
3. A Cost-Effective Alternative Supplements tailored for POTS symptom management, such as Magnesium, Omega-3s, CoQ10, and Electrolytes, can be costly when taken individually. If a comprehensive program of supplements is financially difficult to maintain, a well-balanced multivitamin may serve as a low-cost, minimal-effort option for covering basic nutritional needs.
4. Multivitamin Quality Matters
   • Look for third-party tested multivitamins to ensure purity and potency.
   • Avoid excessive fillers or low-quality formulations with unnecessary additives.
   • Consider multivitamins with bioavailable forms (e.g., Methylcobalamin for B12, Chelated Minerals for better absorption).

Adaptogens (Optional)

Herbs like ashwagandha and rhodiola may help stabilize stress and fatigue.

⚠️ Use with caution and under guidance if autonomic symptoms are severe.⚠️

1. Stress Regulation & Nervous System Balance Since POTS can be exacerbated by stress, adaptogens like ashwagandha and rhodiola may help regulate cortisol levels, reducing the body’s overall stress response. This can be beneficial in managing sympathetic overactivity, which often contributes to symptoms like heart palpitations and anxiety.
2. Energy & Fatigue Support Chronic fatigue is a common challenge for individuals with POTS. Adaptogens work by supporting mitochondrial function and reducing adrenal fatigue, helping to promote steady energy without overstimulation. Rhodiola, in particular, may improve endurance and reduce mental and physical exhaustion.
3. Cognitive Function & Mental Clarity Brain fog and difficulty concentrating are frequent struggles for those with autonomic dysfunction. Adaptogens may enhance cognitive performance and help support focus by modulating neurotransmitter activity.
4. Use with Caution While adaptogens can be beneficial, they should be used cautiously and under medical guidance, especially if autonomic symptoms are severe. Some adaptogens can influence blood pressure or interact with medications, so personal tolerance and dosage must be considered.

Ways to Incorporate Adaptogens

• Ashwagandha: Available in capsule, powder, or tincture form. Often used for stress relief and nervous system balance.
• Rhodiola: Commonly taken in capsules or extracts, helpful for energy and mental endurance.
• Tea & Herbal Blends: Adaptogens can be incorporated into daily routines through herbal teas or supplements tailored to autonomic health.

Since POTS is highly individualized, working with a healthcare provider to assess suitability is essential. Adaptogens may offer valuable support, but they should be personalized to avoid unwanted effects.

Calcium (Only if deficient)

🩺 Consulting a healthcare provider for optimal dosage is recommended, especially if dietary intake is insufficient.

While calcium is not a direct treatment for POTS, ensuring adequate intake supports muscle health, cardiovascular stability, and overall autonomic function.

1. Supports Muscle & Nerve Function Since POTS affects autonomic nerve signaling, calcium plays a key role in neuromuscular function, helping regulate muscle contractions and nerve impulses. Low calcium levels may contribute to muscle cramps, weakness, and nerve dysfunction.
2. Bone Health & Long-Term Stability Many individuals with chronic conditions like POTS may have reduced mobility or limited weight-bearing activity, which can affect bone density. Calcium helps maintain strong bones and reduces the risk of osteoporosis, particularly if mobility is limited.
3. Cardiovascular & Blood Pressure Regulation Since blood pressure instability is a hallmark of POTS, calcium is essential for blood vessel function and heart rhythm stability. It helps maintain vascular tone, preventing excessive fluctuations in blood pressure and circulation.
4. Pairing Calcium with Other Nutrients
   • Vitamin D: Enhances calcium absorption and supports immune function.
   • Magnesium: Works with calcium to promote muscle relaxation and nerve health.
   • Potassium: Helps balance electrolytes to maintain proper hydration and blood pressure stability.

Sources & Supplementation

• Dietary sources: Dairy (milk, yogurt, cheese), leafy greens, almonds, fortified plant-based milk.
• Supplementation: Calcium citrate or calcium carbonate (absorption may vary—consult a healthcare provider).

Potassium (Only if deficient)

🩺 Consulting a healthcare provider for optimal dosage is recommended, especially if dietary intake is insufficient.

Helps with blood pressure regulation and hydration balance. While Potassium is often obtained through diet, some individuals with POTS may require supplementation.

1. Blood Pressure Regulation & Cardiovascular Stability Potassium plays a critical role in maintaining vascular tone and circulation, helping to balance sodium levels and prevent excessive blood pressure fluctuations. Since POTS is characterized by orthostatic intolerance, ensuring proper potassium levels can stabilize blood pressure, potentially reducing dizziness and lightheadedness when standing.
2. Electrolyte Balance & Hydration Support Many individuals with POTS struggle with hydration and electrolyte imbalances, often due to blood pooling, poor fluid retention, or excessive sweating. Potassium works alongside sodium and magnesium to maintain optimal hydration, ensuring the body’s cells can function efficiently without contributing to further autonomic instability.
3. Muscle & Nerve Function Since muscle weakness, cramping, and nerve dysfunction are common in POTS, adequate potassium intake helps regulate muscle contractions and nerve impulses, preventing fatigue-related complications and improving overall physical resilience.
4. Dietary Sources vs. Supplementation
   • Natural sources: Bananas, potatoes, avocados, spinach, oranges, beans, and coconut water.
   • Potassium supplements: Generally only needed if dietary intake is insufficient, or if individuals experience chronic low potassium levels due to medication use or autonomic dysfunction.
   • Important note: Excess potassium supplementation should be used with caution, as high doses can lead to heart rhythm disturbances or interfere with other electrolyte levels.

Since electrolyte balance, cardiovascular function, and hydration stability are key components of POTS symptom management, ensuring sufficient potassium intake through food or supplements may help alleviate dizziness, blood pressure fluctuations, and muscle weakness. However, supplementation should always be monitored by a healthcare provider to ensure safe and effective use.

Iron (Only if deficient)

🩺 Consulting a healthcare provider for optimal dosage is recommended, especially if dietary intake is insufficient.

Many individuals with POTS experience low iron or ferritin levels, which can contribute to fatigue, dizziness, and poor circulation. If blood tests confirm low iron, supplementation can be beneficial.

1. Fatigue & Energy Production Low iron or ferritin levels can lead to iron-deficiency anemia, which causes fatigue, weakness, and reduced oxygen delivery to tissues. Since many individuals with POTS struggle with extreme tiredness, ensuring adequate iron intake may help improve energy levels and stamina.
2. Dizziness & Circulation Support Iron is essential for the production of hemoglobin, the protein in red blood cells that carries oxygen throughout the body. A deficiency can lead to lightheadedness and poor circulation, potentially exacerbating orthostatic intolerance and dizziness in POTS patients.
3. Heart & Autonomic Function Iron plays a crucial role in cardiovascular health, supporting heart function and autonomic regulation. Individuals with low iron may experience palpitations, rapid heart rate, or shortness of breath, which can overlap with POTS symptoms.
4. When to Supplement
   • Only if blood tests confirm low iron or ferritin levels (excess iron can be harmful).
   • Pair iron with Vitamin C to enhance absorption.
   • Consider different forms such as ferrous bisglycinate or iron sulfate, based on tolerance.

Sources of Iron

• Dietary sources: Red meat, spinach, lentils, fortified cereals, beans, and pumpkin seeds.
• Supplementation: Best taken with food and away from calcium-rich meals, as calcium can inhibit absorption.

Since iron deficiency is common in chronic illnesses, proper monitoring and supplementation can help reduce dizziness, improve circulation, and support overall energy levels. However, too much iron can lead to oxidative stress, so it’s best to work with a healthcare provider to determine individual needs.

---

Ehlers-Danlos Syndrome and POTS – Gnarly Tree

Ehlers-Danlos Syndrome EDS and Postural Orthostatic Tachycardia Syndrome POTS are two chronic conditions that frequently overlap. Individuals diagnosed with

gnarlytree.com

Additional Supplements for POTS/EDS Support

Histamine-Balancing Support (Only if needed)

Given POTS and Mast Cell Activation Syndrome (MCAS) overlap, some individuals benefit from DAO enzyme or Vitamin C paired with Quercetin, further supporting histamine regulation.

Histamine regulation is a key factor for individuals managing both Postural Orthostatic Tachycardia Syndrome (POTS) and Mast Cell Activation Syndrome (MCAS), as excess histamine can contribute to flushing, dizziness, palpitations, and digestive discomfort.

1. DAO Enzyme Supplementation Diamine Oxidase (DAO) is an enzyme responsible for breaking down histamine in the digestive tract. Some individuals with histamine intolerance or MCAS-related POTS may have reduced DAO activity, leading to excess histamine accumulation and worsening symptoms. Supplementing with DAO may support histamine degradation and improve digestive function.
2. Vitamin C as a Natural Mast Cell Stabilizer Vitamin C plays a vital role in reducing histamine levels and stabilizing mast cells, potentially minimizing inflammatory and allergic reactions. Since Vitamin C also supports immune function and collagen synthesis, it can be particularly helpful for individuals with Ehlers-Danlos Syndrome (EDS) who also have POTS.
3. Quercetin for Histamine Modulation Quercetin is a potent flavonoid that helps regulate histamine release by blocking mast cell activation. It may reduce histamine-induced symptoms, such as brain fog, dizziness, itching, and heart rate fluctuations, making it a valuable supplement for MCAS-related autonomic instability.
4. Pairing with Other Nutrients for Enhanced Effects
   • Bromelain (with Quercetin) – Enhances absorption and supports anti-inflammatory action.
   • Electrolytes – Helps stabilize blood pressure and hydration, reducing histamine-related circulation issues.
   • Magnesium – Can act as a mast cell modulator, calming nervous system hyperactivity that may worsen histamine-related symptoms.

Sources & Supplementation

• DAO Enzyme Supplements: Often taken before meals to help with histamine breakdown in food.
• Vitamin C: Found in citrus fruits, bell peppers, and berries, or taken as a buffered supplement (500-1000 mg daily) for better tolerance.
• Quercetin: Naturally present in apples, onions, and green tea, but supplementation (500-1000 mg daily) is often recommended for stronger effects.

Since histamine sensitivity, autonomic regulation, and inflammation control are major concerns for individuals with POTS and MCAS, addressing histamine balance with DAO, Vitamin C, and Quercetin may provide significant symptom relief and stability.

Joint & Connective Tissue Support (if EDS is present)

Many with POTS also have Ehlers-Danlos Syndrome (EDS), and Hyaluronic Acid or MSM (Methylsulfonylmethane) can complement collagen supplementation for joint stability.

Joint and connective tissue support is particularly important for individuals with Ehlers-Danlos Syndrome (EDS), as it can help maintain joint integrity, reduce pain, and improve overall mobility, especially in those with hypermobility-related POTS symptoms.

1. Hyaluronic Acid (HA) for Joint Lubrication
   • Hyaluronic Acid helps maintain joint hydration and cushioning, reducing friction between bones.
   • This is especially beneficial for individuals with joint instability and hypermobility, as it improves synovial fluid quality in the joints.
   • Also supports skin and tissue elasticity, which can be compromised in EDS-related connective tissue dysfunction.
2. MSM (Methylsulfonylmethane) for Joint & Inflammation Support
   • MSM provides sulfur, a key component for collagen production and connective tissue integrity.
   • Has anti-inflammatory effects, helping reduce joint pain, stiffness, and muscle soreness in individuals with EDS-POTS overlap.
   • May also support cartilage regeneration and flexibility, reducing discomfort from repetitive joint strain.
3. Collagen for Structural Support
   • Since connective tissue weakness is a hallmark of EDS, collagen supplementation helps strengthen ligaments, tendons, and cartilage.
   • Types I, II, and III collagen are particularly beneficial, supporting skin elasticity, joint durability, and vascular integrity.
   • Pairs well with Vitamin C, which enhances collagen synthesis and reduces oxidative damage to connective tissues.
4. Additional Nutrients for Joint Stability
   • Glucosamine & Chondroitin: Supports joint cushioning and cartilage repair, commonly used for hypermobility-related pain.
   • Magnesium: Aids in muscle relaxation and cramp prevention, helping reduce EDS-related spasms.
   • Omega-3 Fatty Acids: Has anti-inflammatory properties, potentially reducing joint discomfort and systemic inflammation.

Glucosamine & Chondroitin for EDS and POTS

Glucosamine & Chondroitin are widely recognized for their ability to support joint integrity, reduce discomfort, and improve mobility, making them particularly beneficial for individuals with Ehlers-Danlos Syndrome (EDS) who experience hypermobility-related joint pain and instability.

1. Joint Cushioning & Cartilage Repair
   • Glucosamine helps support the production of synovial fluid, which acts as a lubricant for joints, reducing friction and wear over time.
   • Chondroitin enhances cartilage integrity, preventing excessive joint degradation—a major concern for individuals with connective tissue disorders like EDS.
2. Reducing Pain & Inflammation in Hypermobile Joints
   • Joint instability from EDS hypermobility can lead to chronic pain and micro-tears in connective tissue.
   • Chondroitin has anti-inflammatory properties, which may help mitigate joint swelling and stiffness, while Glucosamine supports repair mechanisms, reducing pain severity over time.
3. Enhancing Joint Flexibility & Longevity
   • Since individuals with EDS often experience loose joints that are prone to subluxation or dislocation, maintaining joint strength and flexibility is crucial.
   • These compounds help sustain joint elasticity, potentially preventing excessive hyperextension or instability.
4. Pairing with Other Nutrients for Maximum Benefit
   • Collagen & Hyaluronic Acid – Supports connective tissue resilience alongside Glucosamine & Chondroitin.
   • Omega-3 Fatty Acids – Helps reduce inflammation, enhancing joint mobility and comfort.
   • Curcumin (Turmeric Extract) – Works synergistically to reduce inflammatory responses and support pain relief.

Sources & Supplementation

• Natural Sources: Found in shellfish, animal cartilage, and bone broth, though supplementation is often required for therapeutic effects.
• Supplementation: Typically available in capsule or powder form, with dosages ranging from 1000–2000 mg per day depending on individual needs.
• Usage Tips: Best taken with meals and paired with Vitamin C or anti-inflammatory nutrients to optimize joint recovery.

Since joint support, cartilage repair, and pain management are crucial for individuals with EDS and POTS, Glucosamine & Chondroitin supplementation may offer valuable assistance in enhancing joint stability, reducing discomfort, and improving mobility.

Boswellia & POTS/EDS

Boswellia (Frankincense Extract) is a powerful anti-inflammatory herb that may provide support for joint discomfort, connective tissue health, and autonomic-related inflammation, making it particularly beneficial for individuals with Postural Orthostatic Tachycardia Syndrome (POTS) and Ehlers-Danlos Syndrome (EDS).

1. Anti-Inflammatory Support for Joint & Connective Tissue Health
   • Boswellia contains active compounds (Boswellic acids) that inhibit inflammatory pathways, potentially reducing joint pain and connective tissue stiffness.
   • May help individuals with hypermobile EDS, who experience joint instability, inflammation, and chronic musculoskeletal discomfort.
2. Autonomic Nervous System & Inflammation Regulation
   • Chronic inflammation can exacerbate autonomic dysfunction, worsening symptoms like brain fog, fatigue, and circulation instability in POTS patients.
   • Boswellia’s anti-inflammatory action may support neurological function and vascular health, indirectly helping regulate autonomic balance.
3. Vascular & Cardiovascular Benefits
   • Boswellic acids support endothelial function, potentially helping circulatory regulation and blood flow, which are common challenges in POTS.
   • May reduce inflammatory vascular responses, helping stabilize blood pressure and prevent excessive blood pooling.
4. Pairing Boswellia with Other Nutrients for Enhanced Effectiveness
   • Curcumin (Turmeric Extract) – Works synergistically with Boswellia to enhance anti-inflammatory action and joint support.
   • Collagen & Hyaluronic Acid – Helps reinforce connective tissue repair, especially in those with EDS hypermobility concerns.
   • Omega-3 Fatty Acids – Supports joint lubrication and inflammation control, complementing Boswellia’s effects.

Sources & Supplementation

• Natural Sources: Found in Frankincense resin, traditionally used in herbal remedies.
• Supplementation: Available in capsules, tablets, or extracts, typically 100–500 mg per dose, depending on concentration.
• Usage Tips: Best taken with meals and combined with healthy fats for enhanced absorption.

Since joint health, vascular function, and inflammation regulation are key concerns in POTS and EDS, Boswellia supplementation may provide valuable support in reducing discomfort, stabilizing autonomic responses, and improving connective tissue integrity.

---

Best Practices for Taking Supplements For POTS

• Daily or Flare-Based? Most supplements are taken daily, but electrolytes can be increased during symptom flares.
• With Food or Empty Stomach?
  • Take fat-soluble vitamins (A, D, E, K) with food.
  • B12 can be taken on an empty stomach for better absorption.
  • Magnesium and CoQ10 are best taken with meals.
• Timing:
  • Electrolytes in the morning and before standing-intensive activities.
  • Magnesium in the evening can help with sleep and muscle relaxation.

---

Generic Brands vs Name Brands Supplements for POTS

• Generic brands can be effective if they list active ingredients and have third-party testing.
• Name brands like Thorne, Pure Encapsulations, and NOW Foods often ensure higher purity and bioavailability.
• Tip: Always check for certifications like NSF or USP for quality assurance.

---

Combining Food, Drink, and Supplements for POTS

A layered approach works best:

• Start your day with an electrolyte drink or salty broth.
• Use meals to include leafy greens, healthy fats, and protein.
• Supplement strategically to fill in the gaps—especially for nutrients like magnesium, omega-3s, and B12.

---

Supplements for POTS to Use with Caution

Some supplements may have potential interactions with medications or unwanted effects on autonomic function in individuals with Postural Orthostatic Tachycardia Syndrome (POTS). While they can provide benefits, they should be used with caution and under medical supervision.

---

Stacking POTS Supplements for Maximum Benefit

Now, let’s focus on stacking these supplements effectively for maximum benefit. I’ll break this down into two categories:

Stacking Supplements for POTS (Core Focus)

1. Morning Routine (Energy, Circulation & Autonomic Support) ✅ Electrolyte Powder Blends – Hydration first thing in the morning is essential for stabilizing blood pressure. ✅ B Vitamins & Coenzyme B Complex – Kick-starts energy metabolism and supports nervous system function. ✅ Magnesium & Taurine – Helps regulate blood pressure, circulation, and muscle function. ✅ CoQ10 & Alpha-Lipoic Acid (ALA) – Boosts mitochondrial function for sustained energy and cardiovascular support.
2. Midday (Cognitive & Autonomic Balance) ✅ Phosphatidylcholine – Enhances neurotransmitter function, supporting cognitive clarity. ✅ Resveratrol & Quercetin – Helps with inflammation control and vascular health. ✅ Vitamin D & Vitamin K2 – Supports immune regulation and vascular integrity.
3. Evening (Recovery & Sleep Optimization) ✅ Collagen & Probiotics – Supports gut health and connective tissue repair. ✅ D-Ribose & Glycine – Promotes cellular energy and relaxation. ✅ Melatonin (if needed) – Regulates sleep cycles and autonomic stability.

Stacking Supplements for POTS with EDS (Joint & Connective Tissue Priority)

🔹 Morning Routine (Same POTS Stack + Joint Support Additions) ✅ Hyaluronic Acid & MSM (Methylsulfonylmethane) – Supports connective tissue hydration and joint resilience. ✅ Glucosamine & Chondroitin – Improves joint cushioning, reducing instability and hypermobility discomfort.

🔹 Midday (Anti-Inflammatory & Connective Tissue Repair) ✅ Boswellia (Frankincense Extract) & Curcumin – Provides joint and inflammatory support. ✅ Vitamin C & Collagen – Enhances connective tissue strength, reducing EDS-related strain.

🔹 Evening (Recovery & Relaxation) ✅ Taurine & Glycine – Helps calm overstimulated nerves and promotes muscle relaxation for better joint recovery. ✅ Melatonin (if needed) – Supports autonomic balance and nighttime healing.

---

The BIG Question – How to Implement Into My Routine

⚠️ This is just and EXAMPLE Core list – Yours will vary according to your symptoms and doctor recommendations based on LABS.⚠️

BASE SUPPLEMENTS 💊 LIST: Magnesium, Vitamin B12, Vitamin D, Salt Tablet, Omega-3 Fatty Acids, CoQ10 with an optional Daily Multi-vitamin or Calcium seems to be the CORE LIST of supplements…

---

Structured Dosing Plan for Supplements for POTS

Morning (Energy, Circulation & Nervous System Stabilization)

🕗 Before Breakfast ✅ Electrolyte Powder Blends (Hydration & blood pressure support) ✅ B Vitamins & Coenzyme B Complex (Boosts energy metabolism & nerve function)

🕙 With Breakfast ✅ Vitamin D & Vitamin K2 (Fat-soluble vitamins—best absorbed with food) ✅ Magnesium (Supports muscle & autonomic balance) ✅ CoQ10 & Alpha-Lipoic Acid (ALA) (Mitochondrial support for energy & cardiovascular health) ✅ Omega-3 Fatty Acids (Heart & nervous system stability)

Midday (Cognitive & Autonomic Balance)

🕛 With Lunch ✅ Phosphatidylcholine (Enhances neurotransmitter function & memory) ✅ Resveratrol & Quercetin (Anti-inflammatory & vascular support) ✅ Taurine (Electrolyte regulation & nervous system modulation) ✅ Vitamin C (Boosts antioxidant defense & immune function)

Evening (Recovery & Sleep Optimization)

🕗 With Dinner ✅ Collagen (Supports connective tissue & skin health) ✅ Probiotics (Gut health for autonomic support) ✅ D-Ribose (Energy metabolism for fatigue reduction)

🕙 Before Bed ✅ Glycine & Magnesium (Relaxation, nervous system recovery & sleep support) ✅ Melatonin (if needed) (Regulates sleep cycles & autonomic recovery)

Structured Dosing Plan for Supplements for POTS with EDS

Follows the same POTS structure, with key additions for joint & connective tissue support:

🕗 With Breakfast ✅ Hyaluronic Acid & MSM (Connective tissue hydration & joint resilience) ✅ Glucosamine & Chondroitin (Joint cushioning & stability)

🕛 With Lunch ✅ Boswellia (Frankincense Extract) & Curcumin (Anti-inflammatory agents for joint & autonomic health)

🕗 With Dinner ✅ Vitamin C & Collagen (Boosts connective tissue repair)

Cycling Supplements for POTS Long-term Effectiveness

Cycling supplements can help prevent tolerance, optimize absorption, and support long-term effectiveness while allowing your body time to adjust and respond optimally. Here’s how you can structure supplement rotation:

1. Core Daily Essentials (Always Taken)

These supplements provide continuous foundational support for POTS and EDS symptoms, so they should remain consistent without cycling: ✅ Electrolyte Powder Blends (Daily hydration & blood pressure stability) ✅ B Vitamins & Coenzyme B Complex (Essential for nervous system function & energy metabolism) ✅ Magnesium (Supports circulation, muscle relaxation & autonomic balance) ✅ Omega-3 Fatty Acids (Reduces inflammation & supports vascular health) ✅ Probiotics (Gut health & nutrient absorption)

2. Supplements That Can Be Cycled (Every 4-8 Weeks)

These supplements work best in rotation, preventing tolerance buildup and optimizing their effects:

🔁 Cycle Every 4-8 Weeks: ✅ CoQ10 & Alpha-Lipoic Acid (ALA) – Boosts mitochondrial function but should be cycled to avoid diminishing effects over time. ✅ Curcumin (Turmeric Extract) & Boswellia (Frankincense) – Excellent for inflammation control but can be cycled to maintain potency. ✅ Resveratrol & Quercetin – Can be taken for vascular & histamine regulation, then cycled out for a few weeks to balance absorption. ✅ Glycine & Melatonin – Works well for sleep & relaxation, but melatonin should be used strategically (not nightly) to prevent dependency.

3. Symptom-Specific Rotation (As Needed)

These supplements can be used during symptom flare-ups or periodically based on needs rather than every day: ✅ D-Ribose – Taken during periods of severe fatigue or post-exertional malaise, then reduced when energy levels stabilize. ✅ DAO Enzyme (Diamine Oxidase) & Bromelain (with Quercetin) – Use only when experiencing histamine overload or MCAS flare-ups. ✅ Glucosamine & Chondroitin, MSM, Hyaluronic Acid – Supports connective tissue but can be cycled based on joint pain intensity.

4. Long-Term Cycling Approach (Yearly Optimization)

To maximize effectiveness, some supplements can be rotated seasonally or yearly: ✔️ Iron & Potassium – Only taken when blood tests confirm a deficiency. ✔️ Multivitamins & Adaptogens – Used during stress-heavy periods, then cycled off to prevent nutrient overload.

---

Final Thoughts: A Deeper Look

Managing Postural Orthostatic Tachycardia Syndrome (POTS) is a long-term journey—one that requires patience, adaptability, and a strategic approach. There’s no single solution that works for everyone, but by fine-tuning your nutrition, selecting the right supplements, and timing their intake effectively, you can create a regimen that supports better energy levels, reduces symptom flare-ups, and helps stabilize your daily routine.

The Role of Nutrition & Supplements

Your body thrives when given the right nutrients in the right amounts. Supplements can serve as reinforcements, filling nutritional gaps and optimizing bodily functions that might be disrupted by POTS. Electrolytes, magnesium, and adaptogens like ashwagandha can help with circulatory balance, while coenzyme Q10, B vitamins, and amino acids can support mitochondrial function and energy production. The goal is to create a foundation of nourishment that strengthens your ability to manage symptoms.

Listening to Your Body

One of the most critical aspects of managing POTS is self-awareness. Symptoms and triggers vary greatly from person to person, so staying attuned to your body’s responses can guide you toward adjustments that make a real difference. If a certain supplement exacerbates dizziness, fatigue, or heart rate fluctuations, it’s worth reassessing its role. Likewise, if adding specific nutrients provides sustained energy and reduces postural instability, you can fine-tune your regimen for optimal effect.

Consistency & Adaptability

POTS management isn’t about chasing instant fixes—it’s about building resilience over time. Some supplements may take weeks to show noticeable improvements, while others may need periodic reassessment based on seasonal or lifestyle changes. Maintaining a flexible mindset ensures that your approach stays aligned with your evolving needs.

In the end, effective POTS management is a collaboration between knowledge, discipline, and intuition. By carefully integrating supplements into a broader wellness strategy, you can take meaningful steps toward more consistent energy, fewer symptom spikes, and a greater sense of control over your daily life.

Daily Juicing System For POTS & Health | A Simple Method That Works | Gnarly Tree

A Daily Juicing System for POTS helps support overall health while making nutrition effortless. Learn how a structured setup keeps this habit sustainable, even on tough days.

gnarlytree.com

---