This POTS case report presents a patient diagnosed with Postural Orthostatic Tachycardia Syndrome who experienced notable symptom relief following twelve acupuncture treatments combined with Chinese herbal medicine. The study highlights the benefits of integrating traditional Chinese medicine (TCM) into managing POTS and emphasizes the importance of a holistic approach in chronic conditions.
POTS Introduction
Postural orthostatic tachycardia syndrome (POTS) is a chronic autonomic nervous system disorder characterized by an excessive heart rate increase upon assuming an upright position. Other symptoms include lightheadedness, fainting, palpitations, fatigue, anxiety, and exercise intolerance. While there is no definitive cure for POTS, a multidisciplinary approach is often employed to alleviate symptoms and improve the patient’s quality of life.
POTS Case Presentation
Patient Information
- Age: 28
- Gender: Female
- Diagnosis: Postural Orthostatic Tachycardia Syndrome (POTS)
- Duration of Symptoms: 4 years
Presenting Complaints
The patient in this POTS case report initially presented with complaints of recurrent lightheadedness and fainting, palpitations, severe anxiety, and fatigue. She reported a significant decrease in her quality of life due to the limitations imposed by these symptoms. The condition had forced her to quit her job as a data analyst, and she had to stop playing tennis, a lifelong passion. She had tried several medications from her primary care physician, but none had helped. Furthermore, her blood work was normal, adding to the puzzle of her condition.
Treatment Protocol
The patient received twelve acupuncture treatments over three months, with sessions scheduled once a week. In conjunction with acupuncture, we prescribed a personalized herbal formula based on traditional Chinese medicine principles and adjusted it based on the patient’s progress and symptoms.
POTS Chinese Medicine Diagnosis
After assessing our patient’s symptoms, including examining her tongue and pulse, we determined her Chinese medicine pattern diagnosis to be Spleen and Heart Qi and Blood Deficiency. We commonly call this a Gui Pi pattern, named after a famous Chinese herbal medicine prescription.
Determining a Chinese medicine pattern diagnosis is critical for a successful treatment outcome. Five POTS patients may present with five unique pattern imbalances based on their signs and symptoms. Chinese medicine works by helping to restore the patient’s “imbalances”. Identifying their pattern is the first step in correcting the imbalances responsible for their health condition.
Acupuncture Protocol
We selected acupuncture points to address the symptoms and the underlying patterns identified in her TCM diagnosis. Points utilized in this POTS case report included:
Ren-4 (Guanyuan)
Ren-6 (Qihai)
St-36 (Zusanli)
Sp-6 (Sanyinjiao)
P-6 (Neiguan)
Sp-4 (Gongsun)
Si shen cong
GV-20 (Baihui)
These points act individually and together to strengthen Spleen and Heart Qi and to nourish and build blood. Qi collects in pools at specific locations on the body, each pool representing different organs and bodily functions. These pockets of Qi are designated as acupuncture points and given a specific name. For example, Sp-4 (Spleen 4) is located on in the medial side of the foot at the base of the big toe. Qi in this area affects stomach function, which in turn promotes the production of Qi from the food we eat.
Furthermore, when Sp-4 is needled in conjunction with P-6 (Pericardium 6), its positive effect on stomach function is significantly increased. Acupuncture includes many point combinations which enhance the power of individual acupoints.
Chinese Herbal Medicine for POTS
In addition, we prescribed Gui Pi Pian for our patient’s herbal supplement. Gui Pi is a 12-ingredient Chinese Medicine formula with Ginseng (Ren Shen), Milkvetch Roots (Huang Qi), Atractylodes Rhizomes (Bai Zhu) and Liquorice (Gan Cao) as principal ingredients. Invented in 1529 AD, it belongs to the category of formulas that tonify Qi and Blood. Its main actions are to strengthen and nourish Spleen and Heart Qi and Blood.
Chinese herbs work similarly to acupuncture points. Specific herbs target organ function, and combinations of herbs (formulas) enhance the positive effect of individual herbs. There are hundreds of Chinese herbal formulas, developed over thousands of years, that help restore balance and treat disease. They are a powerful supplement to acupuncture when treating “difficult-to-treat” conditions like POTS.
POTS Treatment Outcome and Follow-Up
After completing twelve treatments, our patient in this POTS case report saw significant improvements in her symptoms. The fainting stopped after two treatments. Additionally, the frequency and severity of lightheadedness and palpitations upon standing had notably decreased following the sixth session. She also reported increased energy levels and an improved ability to engage in daily activities. Furthermore, her anxiety dramatically decreased as her normal functioning returned. Ultimately, our patient was able to return to work part-time and started playing tennis again. She felt like herself again for the first time in years.
Discussion
This POTS case report demonstrates the benefits of an integrative approach to managing POTS using acupuncture and Chinese herbal medicine. Combining acupuncture and tailored herbal formulas based on TCM diagnosis addresses the symptoms and underlying patterns, promoting a holistic healing process.
While Western medicine does not fully understand the origins of POTS, Chinese medicine can distinguish clear pattern imbalances. By correcting these disharmonies, patients experience varying levels of relief. In this POTS case report, our patient improved by 70 percent, allowing her to return to work part-time and resume many of her usual activities.
Each POTS patient will present differently, and there is no guarantee how well they will respond. At Raleigh Acupuncture, we typically suggest patients receive four to six treatments once a week and then step back and assess progress. If the patient is responding to treatment, we continue. If they are not responding enough to warrant continued treatment, we stop treating them and help them determine other therapies to explore.
With complicated conditions like POTS, it often takes trying several different modalities or utilizing a combination of treatments before making significant progress. The key is to remain diligent and persistent.
Conclusion
This POTS case report demonstrates that acupuncture and Chinese herbal medicine provide a promising avenue for symptom relief and improved quality of life in affected individuals. Further research and larger-scale clinical trials are warranted to validate these findings and establish evidence-based guidelines for integrating traditional Chinese medicine into POTS management.
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Focus Keyphrase: POTS Case Report
Keywords: POTS, Postural Orthostatic Tachycardia Syndrome, acupuncture, Chinese herbal medicine, integrative medicine
Photo by Andrea Piacquadio: https://www.pexels.com/photo/woman-in-red-coat-holding-notebooks-and-coffee-cup-3755760/
