QUESTION: How do you treat POTS? Does it have something to do with thyroid?
ANSWER: Underlying stuff is adrenal regulation and in POTS it sucks and can take 1-2 years to work on. Also if added DM or insulin resistance or “pre-diabetes” it will never be fixed. Circadian disruption feeds in, and in POTS autonomic disruption is 100% so that doesn’t help. All that leads to an increased rT3, which is testable, and receptor resistance [not testable] and thyroid dysfunction.
I use the two step approach of
(a) start to Tx the underlying stuff
(b) low to moderate T3 rx until metabolism responds.
If Tx’ing everything, what you see is that as the adrenocortico related issues resolve the need for T3 drops and they either need no thyroid (resistance fixed) or they need a more traditional T4 or T4-T3 Tx.
