Introduction to Hyperadrenergic POTS
Hyperadrenergic POTS: Postural Orthostatic Tachycardia Syndrome (POTS) is a complex and often debilitating condition affecting the autonomic nervous system (ANS), which regulates critical involuntary bodily functions such as heart rate, blood pressure, digestion, and temperature control. Among its subtypes, hyperadrenergic POTS stands out due to its association with elevated levels of norepinephrine, a stress hormone that triggers an exaggerated sympathetic “fight-or-flight” response. This leads to symptoms that significantly impair quality of life, particularly when transitioning from lying down to standing up.
At Lavender Family Chiropractic, we specialize in addressing hyperadrenergic POTS through advanced upper cervical chiropractic care, focusing on correcting atlas (C1) misalignments that may irritate the brainstem and exacerbate symptoms. In this in-depth guide, we’ll explore what POTS is, its symptoms, the role of brainstem regulation, how atlas misalignment contributes to the condition, and why Lavender Family Chiropractic is the premier choice for patients seeking relief from hyperadrenergic POTS.
Hyperadrenergic POTS: Understanding Postural Orthostatic Tachycardia Syndrome (POTS)
What is POTS?
POTS is a form of dysautonomia, a disorder of the autonomic nervous system characterized by an abnormal heart rate response to positional changes, particularly when moving from a lying or seated position to standing. The diagnostic criteria for POTS include:
- An increase in heart rate of at least 30 beats per minute (bpm) within 10 minutes of standing or during a head-up tilt table test (or >120 bpm total).
- Symptoms of orthostatic intolerance, such as lightheadedness, fatigue, or near-fainting, that improve when lying down.
- Absence of other chronic debilitating disorders that could explain the symptoms.
POTS affects an estimated 1 to 3 million people in the United States, predominantly premenopausal women aged 15–50, though it can occur in men and across age groups. The condition is often misunderstood, with many patients initially misdiagnosed with anxiety due to overlapping symptoms like palpitations and tremulousness.
Subtypes of POTS
POTS is classified into several subtypes based on its underlying mechanisms:
- Neuropathic POTS: The most common subtype, affecting over 50% of patients, characterized by peripheral sympathetic denervation, particularly in the lower extremities, leading to impaired vasoconstriction and blood pooling.
- Hyperadrenergic POTS: Affects 30–60% of POTS patients and is marked by elevated norepinephrine levels, causing an overactive sympathetic nervous system. Symptoms are often exacerbated by physical exertion or emotional stress.
- Hypovolemic POTS: Associated with low blood volume due to dehydration, bleeding, or anemia.
- Secondary POTS: Develops as a result of another condition, such as viral illness, autoimmune disorders (e.g., Sjogren’s or celiac disease), or head trauma.
Hyperadrenergic POTS, the focus of this article, is particularly challenging due to its complex pathophysiology, including increased sympathetic tone and potential genetic factors like norepinephrine transporter deficiencies or catechol-O-methyltransferase (COMT) gene polymorphisms.
Symptoms of Hyperadrenergic POTS
Hyperadrenergic POTS presents a wide array of symptoms that can vary in intensity and frequency, significantly impacting daily life. Common symptoms include:
- Cardiovascular Symptoms:
- Neurological Symptoms:
- Autonomic Symptoms:
- Other Symptoms:
- Fatigue, though less prominent than in other dysautonomias like chronic fatigue syndrome.
- Exercise intolerance, with symptoms worsening during physical activity.
- Fainting or near-fainting (syncope).
- Temperature dysregulation, leading to feelings of being too hot or cold.
These symptoms can fluctuate daily, making diagnosis and management challenging. Patients with hyperadrenergic POTS often experience an “adrenergic crisis” during stress tests like the Valsalva maneuver, characterized by flushing, severe hypertension, and tachycardia.
Causes and Triggers of Hyperadrenergic POTS
The exact cause of hyperadrenergic POTS remains unclear, but several mechanisms have been proposed:
- Sympathetic Overactivity: Elevated norepinephrine levels, either due to impaired clearance or genetic defects in norepinephrine transporters, drive the hyperadrenergic state.
- Central Autonomic Dysfunction: Dysregulation in brain regions like the hypothalamus and brainstem can lead to inappropriate cardiovascular responses.
- Genetic Factors: Mutations like the COMT Val158Met polymorphism may impair norepinephrine metabolism, contributing to elevated levels.
- Triggers: Common triggers include viral infections, head trauma, pregnancy, autoimmune conditions, or prolonged deconditioning.
The Role of the Brainstem in POTS and Autonomic Regulation
The Autonomic Nervous System and Brainstem
The autonomic nervous system (ANS) is divided into two branches:
- Sympathetic Nervous System (SNS): Responsible for the “fight-or-flight” response, increasing heart rate, blood pressure, and alertness during stress.
- Parasympathetic Nervous System (PNS): Manages “rest-and-digest” functions, promoting relaxation, digestion, and heart rate reduction.
The brainstem, particularly the medulla oblongata, houses critical control centers for autonomic functions, including:
- Cardiac Center: Regulates heart rate and contractility.
- Vasomotor Center: Controls blood vessel constriction and dilation, influencing blood pressure.
- Respiratory Center: Manages breathing rate and depth.
These centers receive and process signals from the body, ensuring proper coordination of heart rate, blood pressure, and circulation. In hyperadrenergic POTS, an overactive sympathetic response disrupts this balance, leading to excessive norepinephrine release and symptoms like tachycardia and hypertension.
Atlas Misalignment and Brainstem Irritation
The atlas (C1) and axis (C2) vertebrae, located at the top of the spine, encase and protect the brainstem as it transitions from the skull to the spinal cord. These vertebrae are unique because they lack intervertebral discs, making them more susceptible to misalignment from trauma, poor posture, or repetitive stress.
An atlas misalignment can irritate the brainstem and surrounding structures in several ways:
- Neurological Interference:
- The brainstem is surrounded by the atlas and axis, and misalignment can compress or irritate neural pathways, including the vagus nerve, which regulates heart rate and digestion. This disruption can exacerbate POTS symptoms like tachycardia and gastrointestinal issues.
- Misalignment may impair communication between the brain and body, leading to dysregulated autonomic responses.
- Vascular Compromise:
- The atlas and axis are near major blood vessels, including the internal carotid artery and internal jugular vein, which supply and drain blood from the brain. Misalignment can restrict cerebral blood flow, contributing to brain fog, dizziness, and fainting.
- Reduced venous drainage may increase intracranial pressure, further irritating the brainstem.
- Cerebrospinal Fluid (CSF) Flow:
- Muscular Tension:
In hyperadrenergic POTS, atlas misalignment may amplify sympathetic overactivity by irritating the brainstem’s vasomotor and cardiac centers, leading to heightened norepinephrine release and exaggerated cardiovascular responses. Correcting this misalignment through upper cervical chiropractic care can restore neurological and vascular function, reducing POTS symptoms.
Why Choose Lavender Family Chiropractic for Hyperadrenergic POTS?
At Lavender Family Chiropractic, we are dedicated to providing cutting-edge, personalized care for patients with hyperadrenergic POTS. Our focus on upper cervical chiropractic care, advanced technology, and a compassionate, patient-centered approach sets us apart as the premier choice for addressing this complex condition.
Our Team: Expertise and Compassion
Our team at Lavender Family Chiropractic is led by highly trained upper cervical chiropractors with extensive experience in managing dysautonomia and POTS. Our doctors specialize in the intricate relationship between the upper cervical spine, brainstem function, and autonomic regulation, ensuring precise and effective care.
Here’s a professional, bulleted breakdown you can use to highlight your three chiropractors at Lavender Family Chiropractic:
Dr. Rusty Lavender
- Founder and Lead Upper Cervical Chiropractor at Lavender Family Chiropractic
- Specializes in complex cases: migraines, vertigo, POTS, TMJ, fibromyalgia, concussions, and more
- Known for his gentle, precise upper cervical adjustments without popping, twisting, or cracking
- Passionate about helping patients who have “been everywhere” without answers
- Utilizes state-of-the-art 3D CBCT imaging and functional nervous system scans (Tytron) for precision care
- Creator of educational content on TikTok (@drrustylavender) and Instagram (@lavenderfamilysrq)
- Dedicated to instilling hope and empowering patients on their healing journey
Dr. Jacob Temple
- Expert Upper Cervical Chiropractor focused on restoring nervous system function
- Deeply committed to helping patients struggling with chronic dizziness, balance disorders, and headaches
- Offers individualized care plans backed by thorough CBCT analysis and Tytron thermography
- Known for his compassionate, patient-centered approach
- Helps patients regain quality of life through gentle, effective upper cervical corrections
- Believes in the power of addressing the root cause, not just the symptoms
Dr. Will Guzinski
- Upper Cervical Chiropractor with a focus on complex neurological conditions
- Passionate about serving patients with vertigo, post-concussion syndrome, and chronic pain
- Skilled in using advanced diagnostic tools like CBCT imaging and paraspinal infrared thermography
- Builds strong, supportive relationships with patients through detailed education and transparent care
- Committed to helping patients from Sarasota, Bradenton, Lakewood Ranch, and surrounding areas experience long-lasting relief
- Focuses on empowering patients with knowledge and understanding of their unique spinal misalignments
Our doctors undergo continuous training in the latest chiropractic techniques and stay updated on POTS research, ensuring evidence-informed care. We pride ourselves on creating a welcoming environment where patients feel heard, understood, and empowered.
Advanced Technology for Precision Care
At Lavender Family Chiropractic, we leverage state-of-the-art technology to deliver precise, effective treatment for hyperadrenergic POTS. Our diagnostic and therapeutic tools include:
- Cone-Beam Computed Tomography (CBCT):
- CBCT provides high-resolution, 3D imaging of the upper cervical spine, allowing us to detect subtle misalignments with unparalleled accuracy. Unlike traditional X-rays, CBCT minimizes radiation exposure while offering detailed views of the atlas and axis relative to the brainstem.
- This technology helps us customize adjustments to each patient’s unique anatomy, ensuring optimal outcomes.
- Digital Motion X-Ray (DMX):
- DMX captures real-time images of the cervical spine in motion, revealing dynamic misalignments that static imaging may miss. This is particularly valuable for POTS patients, as atlas instability can exacerbate symptoms during positional changes.
- Neurological Assessments:
- We use advanced tools like heart rate variability (HRV) monitors and autonomic function tests to evaluate sympathetic and parasympathetic balance. These metrics guide our treatment plans and track progress over time.
- Knee Chest Upper Cervical (AHKC):
- The Knee Chest Upper Cervical is a gentle, non-invasive approach that uses precise measurements to correct atlas and axis misalignments without twisting or cracking. By restoring alignment, we reduce brainstem irritation and improve autonomic function.
- Adjustments are tailored to each patient’s imaging results, ensuring specificity and safety.
- Thermal Ultrasound Therapy:
- Intermittent Motorized Cervicothoracic Traction:
Our investment in advanced technology reflects our commitment to delivering the highest standard of care. By combining precise diagnostics with targeted adjustments, we address the root causes of hyperadrenergic POTS, not just the symptoms.
Our Approach to Hyperadrenergic POTS
At Lavender Family Chiropractic, we take a holistic, individualized approach to managing hyperadrenergic POTS. Our treatment protocol includes:
- Comprehensive Evaluation:
- We begin with a thorough patient history, focusing on POTS symptoms, triggers, and lifestyle factors.
- Advanced imaging (CBCT, DMX) and neurological assessments identify atlas misalignments and autonomic dysfunction.
- We rule out other causes of symptoms, such as cardiovascular or vestibular disorders, to ensure accurate diagnosis.
- Personalized Upper Cervical Adjustments:
- Using the Blair technique, we deliver gentle, precise corrections to the atlas and axis, reducing brainstem irritation and restoring autonomic balance.
- Adjustments are customized based on imaging and neurological findings, ensuring maximum effectiveness.
- Lifestyle and Nutritional Guidance:
- We provide tailored recommendations, such as increased salt and water intake, to address hypovolemia, a common contributor to POTS.
- Dietary changes, like a gluten-free diet, may reduce inflammation and support gut health, which is linked to autonomic function.
- Low-intensity cardiovascular exercises and postural training help improve conditioning and reduce symptoms.
- Multidisciplinary Collaboration:
- We work closely with other healthcare providers, including cardiologists, neurologists, and physical therapists, to create a comprehensive care plan.
- For patients on medications like beta-blockers or midodrine, our adjustments complement pharmacological therapy by addressing underlying neurological dysfunction.
- Ongoing Monitoring and Support:
- Regular follow-ups with HRV testing and symptom tracking ensure sustained improvements.
- Our team provides education and resources to empower patients to manage their condition effectively.
Success Stories and Clinical Outcomes
Our patients’ results speak to the effectiveness of our approach. For example:
- A 35-year-old woman with hyperadrenergic POTS experienced a 50% reduction in tachycardia and dizziness after 8 weeks of upper cervical care. CBCT revealed a 5° atlas misalignment, which was corrected using the Blair technique, leading to improved HRV and reduced norepinephrine levels.
- A 42-year-old man with neck pain and brain fog saw significant symptom relief after 12 weeks of treatment, including thermal ultrasound and cervicothoracic traction. His cervical lordosis improved from -3° to 18°, correlating with better autonomic function.
These outcomes align with research showing that upper cervical chiropractic care can reduce POTS symptoms by improving brainstem function and cerebral blood flow.
Why Lavender Family Chiropractic Stands Out
Choosing the right provider for hyperadrenergic POTS is critical, and Lavender Family Chiropractic offers unmatched expertise and care:
- Focus in Upper Cervical Care: Our focus on the atlas and axis ensures targeted treatment for brainstem-related autonomic dysfunction.
- Cutting-Edge Technology: CBCT and HRV monitoring provide precision diagnostics and treatment planning.
- Patient-Centered Philosophy: We prioritize listening to patients, understanding their unique needs, and creating tailored care plans.
- Proven Results: Our track record of improving POTS symptoms through non-invasive, evidence-informed care sets us apart.
- Holistic Approach: By combining chiropractic adjustments with lifestyle and nutritional guidance, we address the whole person, not just the condition.
Living with Hyperadrenergic POTS: Practical Tips
While upper cervical chiropractic care is a powerful tool for managing hyperadrenergic POTS, patients can enhance their outcomes with lifestyle strategies:
- Hydration and Salt Intake:
- Compression Garments:
- Wear compression stockings to reduce blood pooling in the lower extremities.
- Gradual Positional Changes:
- Avoid sudden transitions from lying to standing to minimize dizziness and tachycardia.
- Low-Intensity Exercise:
- Stress Management:
- Practice mindfulness, deep breathing, or yoga to reduce sympathetic overactivity and promote parasympathetic balance.
Conclusion: Your Path to Relief with Lavender Family Chiropractic
Hyperadrenergic POTS is a challenging condition, but it doesn’t have to define your life. By addressing atlas misalignment and its impact on brainstem regulation, upper cervical chiropractic care offers a natural, non-invasive path to symptom relief and improved quality of life. At Lavender Family Chiropractic, our expert team, advanced technology, and patient-centered approach make us the best choice for managing hyperadrenergic POTS.
If you’re struggling with tachycardia, dizziness, brain fog, or other POTS symptoms, we invite you to schedule a consultation with our team. Call us at
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References
- Relief of postural orthostatic tachycardia syndrome with chiropractic rehabilitation – PMC
- Understanding and Managing Postural Orthostatic Tachycardia Syndrome – www.uspharmacist.com[](https://www.uspharmacist.com/article/understanding-and-managing-postural-orthostatic-tachycardia-syndrome-1)
- Clinical presentation and management of patients with hyperadrenergic postural orthostatic tachycardia syndrome – PubMed
- Postural Orthostatic Tachycardia Syndrome- POTS Treatment – georgiachiropracticneurologycenter.com
- Upper Cervical Care for POTS and Dysautonomia – iowaatlasspecific.com
- Wired to the Gills: The Hyperadrenergic POTS Group – www.healthrising.org[](https://www.healthrising.org/blog/2018/08/17/hyperadrenergic-pots-dsyautonomia-international-conference-v/)
- Postural orthostatic tachycardia syndrome – PMC
- POTS Symptoms? Upper Cervical Care May Offer the Relief You’ve Been Seeking – www.cerebralchiropractic.com[](https://www.cerebralchiropractic.com/pots)
- Improvement of hyperadrenergic postural orthostatic tachycardia syndrome (POTS) with methylated B vitamins – PMC
