POTS and Long COVID: Exploring Acupuncture, Herbal Approaches and Mitochondrial Support

Feeling exhausted, dizzy or unsettled by your heartbeat is not something you should have to figure out alone.

For some people, persistent symptoms following COVID may be associated with autonomic dysfunction or postural orthostatic tachycardia syndrome, commonly known as POTS.

POTS can affect the body's ability to regulate heart rate and circulation when standing. Symptoms may extend beyond dizziness to include fatigue, brain fog, digestive difficulties and reduced tolerance for everyday activities.

When symptoms continue for weeks or months, it can be difficult to know where to turn or which supportive approaches are worth exploring.

At Zen Attitude Hawaii in Honolulu, an individualized approach to wellness may include exploring acupuncture alongside appropriate medical care, nutritional assessment and other supportive strategies. Understanding the condition and identifying potential contributors to your symptoms are important first steps.

What Is POTS?

Postural orthostatic tachycardia syndrome (POTS) is a form of autonomic dysfunction characterized by an excessive increase in heart rate when moving into an upright position, accompanied by symptoms of orthostatic intolerance.

The autonomic nervous system normally helps regulate heart rate, blood pressure, digestion, sweating and other automatic functions. In people with POTS, these regulatory responses may not work as expected.

In adults, diagnostic criteria generally include a sustained heart rate increase of at least 30 beats per minute within 10 minutes of standing, without significant orthostatic hypotension. Diagnosis also requires evaluating other potential causes of the symptoms.

POTS is not simply a fast heartbeat. It can involve several interconnected physiological processes, including altered autonomic regulation, blood pooling, reduced circulating blood volume and difficulties maintaining adequate circulation when upright.

Common Symptoms of POTS

POTS can affect multiple body systems, and symptoms may fluctuate throughout the day. They can become more noticeable after standing for extended periods, exposure to heat, meals or physical activity.

Common clinical features include:

• Heart palpitations: A racing heartbeat or increased awareness of the heartbeat, particularly when standing.

• Dizziness and lightheadedness: Feeling faint, unsteady or close to passing out.

• Persistent fatigue: Difficulty maintaining energy for everyday responsibilities.

• Exercise intolerance: Reduced tolerance for physical activity or prolonged recovery afterward.

• Brain fog: Difficulty concentrating, remembering information or thinking clearly.

• Headaches and migraines: Recurrent headaches that may accompany other symptoms.

• Gastrointestinal symptoms: Nausea, bloating, constipation or other changes in digestive function.

• Temperature regulation difficulties: Feeling unusually hot or cold or experiencing changes in sweating.

• Sleep disturbances: Difficulty sleeping or waking without feeling refreshed.

Some people also experience post exertional symptom exacerbation, in which physical or cognitive activity triggers a delayed worsening of symptoms.

Because these symptoms can overlap with other medical conditions, a proper clinical evaluation is essential.

The Connection Between POTS and Long COVID

COVID can affect more than the respiratory system. Research has documented autonomic dysfunction in some people experiencing Long COVID, including difficulties regulating heart rate, blood pressure and other involuntary functions.

For some individuals, symptoms begin during an infection or develop in the weeks and months that follow.

Researchers are investigating several possible contributors, including immune dysregulation, altered vascular function, changes in autonomic signaling and impaired energy metabolism.

These mechanisms may overlap, but they are not necessarily present in every patient. Not everyone with Long COVID develops POTS, and not every case of POTS follows a viral infection.

Recognizing this connection matters because persistent dizziness, palpitations and fatigue should not automatically be attributed to stress, anxiety or ordinary postviral recovery.

A healthcare professional can help determine whether POTS or another condition is contributing to the symptoms and recommend appropriate care.

Mechanism Based Herbal Approaches: Looking Beyond Individual Symptoms

Herbal medicine is sometimes considered as part of an integrative approach to health and wellbeing. When exploring botanical support for someone with suspected or diagnosed POTS, the focus should be on the person's specific clinical needs rather than assuming one formula will work for everyone.

Currently, there is insufficient high quality clinical evidence to establish specific herbs as effective treatments for POTS itself. However, understanding the physiological processes involved can help guide informed discussions about supportive care.

1. Circulation and Vascular Function

Blood vessel responses play an important role in maintaining circulation when standing. In some people with POTS, blood may pool in the lower body, reducing the amount returning to the heart.

This can contribute to dizziness, palpitations and weakness.

Some botanicals are traditionally used to support circulation, but traditional use does not establish that they improve POTS symptoms. Herbs that affect blood pressure, blood clotting or vascular tone may also interact with medications or worsen particular symptom patterns.

Any botanical approach should therefore account for blood pressure, cardiovascular history, medications and other relevant health factors.

2. Autonomic Regulation and Sleep

The autonomic nervous system regulates many functions that occur without conscious effort, including heart rate, digestion and temperature control.

Poor sleep and physiological stress can complicate the experience of persistent illness. Certain botanicals traditionally used for relaxation or sleep may be considered for specific symptoms in selected circumstances.

However, improving relaxation is not the same as correcting autonomic dysfunction. Evidence that herbal products directly treat POTS is limited, and potential sedative effects and medication interactions must be considered.

3. Inflammatory and Postviral Contributors

Researchers are investigating the relationship between immune activity, vascular function and persistent symptoms following viral infections.

Certain botanical compounds have been studied for antioxidant or anti inflammatory properties in laboratory and clinical settings. However, these findings do not establish that the herbs effectively treat POTS or Long COVID.

A more informed approach involves evaluating relevant symptoms, addressing documented deficiencies or coexisting conditions, and avoiding assumptions about the underlying cause.

4. Digestive Function and Nutritional Status

Gastrointestinal symptoms are common in POTS and may affect hydration, food intake and overall quality of life.

Depending on the individual, an assessment may include dietary intake, gastrointestinal symptoms, medication effects and possible nutrient deficiencies.

Herbal approaches for digestive discomfort may be appropriate in selected circumstances, but persistent symptoms should be evaluated rather than managed solely with supplements.

Mitochondrial Health and Persistent Fatigue

Mitochondria are structures within cells that help produce usable energy. Because the nervous system, heart and skeletal muscles have substantial energy requirements, mitochondrial metabolism has attracted attention in research on persistent fatigue and postviral illness.

Some people with POTS or Long COVID describe reduced stamina, prolonged recovery after activity and a feeling that their energy reserves are unusually limited.

These experiences are real, but they do not establish mitochondrial dysfunction as the cause in every individual. Research into the role of cellular energy metabolism in POTS and Long COVID is ongoing.

An individualized evaluation may consider sleep, nutritional status, anemia, thyroid function, medication effects and other possible contributors to fatigue.

Mitochondrial NRG: A Nutritional Support Option to Explore

Mitochondrial NRG by Designs for Health is a nutritional supplement formulated to support cellular energy metabolism. Its formula contains ingredients involved in energy related biochemical pathways, including CoQ10, L carnitine, R lipoic acid, D ribose, B vitamins and other compounds.

These ingredients have roles in normal cellular processes, but evidence about individual ingredients does not establish that the complete supplement treats POTS, Long COVID or cardiac symptoms.

For people interested in exploring nutritional support, Mitochondrial NRG may be a product to discuss with a qualified healthcare professional as part of a broader wellness plan.

The supplement is available through selected professional supplement channels. Ask your healthcare practitioner about current availability and whether its ingredients are appropriate for your circumstances.

Important: Mitochondrial NRG has not been established as a treatment for POTS, Long COVID, arrhythmias or other heart conditions. It should not be used to self treat a racing heartbeat, dizziness or unexplained cardiovascular symptoms, or as a replacement for medical evaluation and prescribed treatment.

Before starting any supplement, review its ingredients, potential interactions and suitability with a qualified healthcare professional, especially if you take prescription medication or have an underlying medical condition.

Acupuncture and Integrative Wellness for People Navigating Persistent Symptoms

When symptoms affect several aspects of daily life, it is understandable to look for supportive approaches that complement conventional medical care.

Acupuncture is a traditional Chinese medicine practice used in individualized wellness care. Researchers have investigated its potential effects on pain, stress responses and aspects of autonomic regulation, but evidence remains insufficient to establish acupuncture as a treatment for POTS specifically.

At Zen Attitude Hawaii in Honolulu, Phi Lan Nguyen, LAc, offers acupuncture for individuals interested in incorporating this traditional practice into their broader wellness routine.

For someone navigating persistent fatigue or other symptoms after an illness, an acupuncture visit can provide an opportunity to discuss personal wellness goals, relevant health history and whether acupuncture may be an appropriate supportive option.

Phi Lan's role is to provide acupuncture care within the scope of her practice, not to replace medical evaluation for POTS or other cardiovascular and autonomic conditions.

Acupuncture should be considered alongside appropriate medical care, particularly when symptoms include palpitations, faintness or significant exercise intolerance.

What Else Can Be Part of an Individualized POTS Support Plan?

POTS management depends on the individual's diagnosis, symptoms, blood pressure, heart rate, medical history and response to treatment.

Depending on clinical findings, a healthcare professional may recommend several approaches.

Medical evaluation: Assessing heart rate, blood pressure and possible underlying causes of palpitations, dizziness or fatigue.

Hydration and fluid management: Following an individualized hydration plan. Additional salt may be appropriate for some people, but not everyone, particularly those with certain cardiovascular or kidney conditions.

Compression garments: Considering compression to help reduce blood pooling for selected individuals.

Nutritional assessment: Reviewing dietary intake, gastrointestinal symptoms and possible nutrient deficiencies.

Activity pacing: Adjusting physical and cognitive activity to reduce symptom flares. People experiencing post exertional symptom exacerbation should avoid pushing through worsening symptoms and seek individualized guidance.

Targeted supplementation: Considering products according to clinical needs, safety, evidence and potential medication interactions.

Supportive wellness care: Exploring options such as acupuncture when appropriate, while maintaining medical oversight for the underlying condition.

There is no universal supplement, herbal formula or acupuncture treatment that addresses every POTS presentation. An individualized plan is more appropriate than relying on a single product or therapy.

When Should You Seek Medical Attention?

Recurring palpitations, dizziness upon standing, unexplained exercise intolerance and persistent fatigue deserve medical attention, particularly when symptoms interfere with work, sleep or everyday activities.

A healthcare professional may recommend orthostatic heart rate and blood pressure measurements, an electrocardiogram, laboratory testing or additional cardiovascular and autonomic evaluation.

Seek urgent medical care for new or severe chest pain, fainting during exertion, severe shortness of breath or a sustained rapid or irregular heartbeat accompanied by significant symptoms.

Do not assume that these symptoms are caused by POTS or attempt to manage them with supplements alone.

Explore Acupuncture and Integrative Wellness at Zen Attitude Hawaii

Living with persistent symptoms after a viral illness can be frustrating, especially when fatigue, dizziness or brain fog interfere with everyday activities.

Understanding the potential causes, obtaining an appropriate medical evaluation and exploring supportive options can help you make more informed decisions about your health.

At Zen Attitude Hawaii, Phi Lan Nguyen provides acupuncture services for individuals interested in incorporating traditional acupuncture into their broader wellness journey.

Whether you are exploring acupuncture, looking for supportive wellness options or seeking to better understand your health goals, taking the time to discuss your needs with an appropriate healthcare professional is a meaningful first step.

Ready to explore acupuncture with Phi Lan Nguyen?

Contact Zen Attitude Hawaii to learn more about available acupuncture services and schedule your visit.

Take the next step toward a more informed approach to your wellbeing. Reach out to Zen Attitude Hawaii to learn more about acupuncture and available services in Honolulu.

Medical disclaimer: This article is for educational purposes only and is not intended to diagnose, treat, cure or prevent any disease. POTS requires appropriate medical evaluation. Acupuncture, herbal medicine and nutritional supplements are not established cures for POTS or Long COVID. Consult a qualified healthcare professional regarding persistent symptoms and before starting any supplement or changing your treatment plan.