Post-COVID POTS
WHY STANDING UP FEELS SO HARD & HOW ACUPUNCTURE CAN HELP
Welcome back to Dr. Ark’s Healing Tribe.
One of the more challenging post-COVID conditions I am seeing with increasing frequency at Arkadiy Sarkisov Acupuncture (SAY Acupuncture) is Postural Orthostatic Tachycardia Syndrome, commonly known as POTS.
Over the past several years, and especially since COVID, a growing number of patients have come into my clinic here in West Michigan describing the same unsettling pattern: they feel relatively stable while lying down, yet experience a sudden racing heart, dizziness, lightheadedness, shortness of breath, weakness, or near-fainting as soon as they stand.
For many, these symptoms emerge weeks or months after a COVID infection and begin to dominate daily life, making even simple activities like showering, cooking, walking short distances, or returning to work feel overwhelming.
DEFINING P.O.T.S.
From a biomedical perspective, POTS is a form of autonomic nervous system dysfunction. Normally, when a person stands, the nervous system automatically adjusts heart rate, blood pressure, and blood vessel tone to maintain steady blood flow to the brain.
In post-COVID patients, this regulation often becomes unreliable. Ongoing inflammation, immune activation, vascular changes, and disrupted autonomic signaling can prevent the body from adapting smoothly to upright posture.
The result is an exaggerated heart rate response, inefficient circulation, and symptoms such as palpitations, dizziness, brain fog, fatigue, and exercise intolerance.
Treating P.O.T.S.
At SAY Acupuncture, in collaboration with the Born Clinic, we focus on treating nervous system dysregulation and post-COVID conditions by addressing underlying imbalances rather than just managing symptoms.
I now regularly work with patients who have been formally diagnosed with POTS, as well as many who are experiencing post-viral dysautonomia without a clear label yet. Most arrive after months of specialist visits and extensive testing that often come back “normal,” leaving them frustrated, discouraged, and unsure where to turn next.
What stands out clinically is how consistent the nervous system patterns are across these patients, even though their test results and timelines may differ. Many describe a constant sense of vigilance in the body, difficulty recovering after minimal exertion, disrupted sleep, and a growing fear of standing, walking, or triggering another flare.
With consistent acupuncture and visceral massage care, I often see early shifts that signal improved nervous system regulation before significant physical changes occur. Patients frequently report more profound, restorative sleep, fewer sudden heart rate spikes when standing, reduced dizziness, and a calmer baseline state.
As care continues, many experience improved tolerance to upright posture, smoother energy throughout the day, fewer crashes, and a gradual return of confidence in movement.
Progress is rarely linear, but these steady changes can be deeply reassuring for patients who have felt stuck or misunderstood for a long time.
T.C.M.’s Take on P.O.T.S.
From a Traditional Chinese Medicine (TCM) perspective, post-COVID POTS reflects a deeper disruption of internal balance rather than an isolated heart condition.
COVID commonly weakens the Lung Qi, which affects overall vitality and resilience.
With prolonged recovery, the Liver’s ability to regulate the smooth flow of Qi often becomes impaired. The Liver plays a central role in adaptability, stress response, and autonomic regulation.
When this function is disrupted, the body struggles to adjust smoothly to positional changes, closely mirroring the autonomic instability seen in POTS.
Among the many of the patients I see at my clinic, this pattern is compounded by Spleen Qi deficiency and Kidney Yin depletion. A weakened Spleen reduces the body’s ability to generate adequate Qi and Blood, leading to fatigue, heaviness, and poor stamina.
Depleted Kidney Yin fails to anchor Heart and Liver Yang, allowing energy to rise upward and manifest as rapid heart rate, dizziness upon standing, internal heat, anxiety, and agitation. Many patients describe this state as feeling wired but exhausted — mentally alert yet physically unstable — and significantly worse with standing, stress, or exertion.
How Acupuncture Helps P.O.T.S.
Acupuncture offers a comprehensive and integrative approach by addressing both autonomic nervous system regulation and the underlying TCM imbalances we consistently observe in clinical practice.
Treatment is focused on calming the nervous system, restoring smooth Liver Qi flow, nourishing Kidney Yin, strengthening Spleen Qi, and calming the Heart and Shen. Clinically, this often corresponds with a steadier heart rate, reduced dizziness, clearer thinking, improved sleep, better tolerance to activity, and more stable energy throughout the day.
Stages of P.O.T.S. Recovery with Acupuncture
Recovery from post-COVID POTS through clinical TCM Acupuncture typically unfolds in stages:
Stage 1:
nervous system stabilization
gradual reduction in symptom intensity
Stage 2:
improved circulation
improved energy regulation
improved stress tolerance
While timelines vary and no two recoveries are the same, Acupuncture offers a gentle, non-invasive therapy that works with the body’s natural healing, capacity rather than overriding it.
If you are experiencing rapid heart rate when standing, dizziness, fatigue, brain fog, or exercise intolerance after COVID, you may be dealing with POTS or a related form of dysautonomia.
These symptoms are real, increasingly common, and often misunderstood. Acupuncture provides a holistic approach to calming the nervous system, restoring internal balance, and supporting long-term recovery.
Ready to explore how Acupuncture can help your own challenging symptoms? My clinic is just a phone call away.
From my hands to your healing,
— Dr. Arkadiy
