08/14/2026
Craniosacral Therapy snd Homeopathy can be very beneficial for people with POTS!
Most people with POTS think about physical exertion as their main trigger. Standing too long, doing too much, being on their feet. But a lot of you have noticed something that doesn't fit that narrative. You crash from a work meeting. You're wiped out after a phone call. You try to read something for twenty minutes and it feels like you ran a mile. And you were sitting the entire time.
This study published in the Journal of the American Heart Association explains exactly why that happens. ðŸ§
Researchers tested cerebral blood flow and cognitive performance in POTS patients during sustained cognitive tasks. What they found was clear. During cognitive demand, POTS patients had reduced cerebral blood flow compared to healthy controls. As the task continued and the demand was sustained over time, that reduction got worse. And cognitive performance declined right along with it.
Here's the important context for why this matters so much. Your brain uses 20% of your body's total energy just to keep you alive at rest, doing nothing. When you ask it to do something cognitively demanding, it needs more. But in POTS, the blood flow and oxygen delivery to the brain are already compromised. So when the cognitive demand goes up, the system can't keep up. It burns through what little reserve is there even faster, and blood flow regulation breaks down even sooner.
The brain fog, the word finding difficulties, the inability to follow a conversation, the exhaustion after mental work. These are not vague or unexplained symptoms. They have a measurable physiological mechanism behind them. The brain isn't getting what it needs, and cognitive work accelerates how quickly that deficit becomes a problem.
This also directly explains post-exertional malaise from cognitive activity. It's the same mechanism as physical exertion, just triggered through a different demand on the same struggling system.
What the paper doesn't fully address, and what I always push on, is why cerebral perfusion is impaired in the first place. The study measures what's happening at the cardiovascular level, but the root of the problem goes back to the vestibular autonomic reflexes and baroreceptor responses that are supposed to be maintaining adequate blood flow to the brain in the first place. When those systems are off, everything downstream is off with them.
This is also why slowing the heart rate down with beta blockers doesn't restore cognitive function for most people. Treating the heart rate is treating the compensation. It's not treating the impaired perfusion that made the compensation necessary.
Have you noticed cognitive tasks hitting you just as hard as physical ones, if not harder?
Research:
Lau DH, et al. (2020). Cerebral blood flow and cognitive performance in postural tachycardia syndrome: insights from sustained cognitive stress test. Journal of the American Heart Association, 9, e017861. DOI: 10.1161/JAHA.120.017861
