Dr. Spencer Zimmerman

09/06/2026

Five things I wish every medical provider understood about POTS, dysautonomia, Long COVID, ME/CFS, and EDS.

1. Stop judging patients by how they look.

People are routinely dismissed because they look healthy, are overweight, or seem “too young” to be this sick. These conditions affect every age, size, and appearance. The evaluation should determine the diagnosis—not a visual impression.

2. Normal testing does not mean nothing is wrong.

Ruling out serious pathology matters. But nervous-system and immune-system dysfunction can be profoundly disabling without appearing on standard imaging or bloodwork. “We didn’t find pathology” and “you’re fine” are not the same conclusion.

3. Stop ignoring labs that are only slightly abnormal.

Low ferritin. Low vitamin D. Elevated fasting insulin. Low C-peptide. Thyroid, cortisol, estrogen, progesterone, or testosterone sitting at the edge of the range.

Individually, these findings may not look dramatic. Together, they can matter significantly. They are often inexpensive, actionable opportunities to help someone feel and function better.

4. There is more available than what you personally offer.

Medications and standard recommendations may help, but they are not the entire landscape. Functional neurology, vestibular rehabilitation, functional medicine, and targeted neurological rehabilitation can all have a role.

Referring beyond your own toolkit is not failure. It is good care.

5. Communicate with other providers.

These patients are already exhausted. They should not also be forced to quarterback a fragmented medical team and repeatedly explain what every provider is doing.

These are not extraordinary requests. They are the minimum people with complex chronic illness deserve.

The dismissal, gaslighting, and siloed care have real consequences for people who could be doing significantly better with the right approach.

What has your experience with the medical system actually been?

09/05/2026

For POTS, what are the top two diagnoses that come together with it?

Most of you initially are going to think about the trifecta: POTS plus hypermobile Ehlers-Danlos syndrome and mast cell activation syndrome (MCAS), but this isn't exactly correct.
When we look at a recent review published in August 2026, the top two things, with one leading the pack, are migraines and irritable bowel syndrome. Hypermobile Ehlers-Danlos syndrome is fairly close, and mast cell activation syndrome is much further down the list. It was number 6, which means let's talk about why migraines and irritable bowel syndrome matter.

1. When we look at migraines, migraines are a neurological issue. You can have migraines driven by inflammation, hormones, vascular changes, concussions, or post-infectious-related issues. Every single one of those things just listed also can contribute to the development of POTS or the persistence of POTS. When someone is getting their migraine treated, if you are doing more of a root-cause or what-keeps-the-migraine-going process, it's very hard to improve the migraine without impacting the rest of the POTS symptoms.

The only time you tend to improve migraines on its own is when you're using medications. It doesn't matter if it's sumatriptan, Nurtec, or people who do Botox for migraines. If you can understand the mechanism driving the migraines, you can once again improve that and improve your POTS.

2. When we look at irritable bowel syndrome, it's fairly common for people with POTS to have gastrointestinal symptoms. You may have constipation, diarrhea, heartburn, bloating, nausea. You feel full pretty fast. What's interesting is that when we look at irritable bowel syndrome, it's long been considered a functional disorder so there's not a gross pathology that impacts it.

We know altered nervous system functionality is a driver for some of those with irritable bowel syndrome and this is very much true also when we look at POTS. POTS is a neurological condition but there's no gross pathology here either. There is altered functionality and for some of you, you notice as your digestive symptoms get worse or improve, your POTS symptoms also follow suit. That's where it fits.

When we look at both these things, migraines plus irritable bowel syndrome, migraines probably gives us more actionable things from identifying what keeps it going but also don't sleep on irritable bowel syndrome. It matters as well.

Do you have either of these issues along with your POTS? Let me know and if so what's helped you the most?

09/04/2026

Mast cell activation syndrome is rapidly being talked about, but do you actually have it or just something that's similar?

09/04/2026

"the brain’s age was the top predictor of overall mortality. People with extremely aged brains (> 1.5 SD from average or about 7% of people studied) had a 182% increased risk for death over 15 years compared to people with normal aging."

The brain continues to be the most important organ, but it's also the one least likely to be evaluated and improved.

That's what makes what we do here differently. While we care about what's happening in the body, we also take into account the brain. Offering an integrative approach.

Epigenetic clocks can give ‘a vague concept of aging,’ but researchers are progressing to organ-specific techniques that provide actionable, medically meaningful data.

09/03/2026

Blood pooling is one of the explanations for why individuals have POTS and other types of dysautonomia, but what actually causes this when you make a positional change?

That's what this video is about.

09/02/2026

Is POTS actually worse than orthostatic hypotension or neurocardiogenic syncope?

Plus, what are the current treatment recommendations?

09/02/2026

"I can't try something else that doesn't work"

This is something that many of our POTS, Long Covid, other Dysautonomia, and Concussion patients tell us.

It's something that we take to heart.

While we don't help everyone and can't guarantee results.

We don't give up, we are continuously learning and progressing, and we're always bringing in the latest equipment and therapies to give individuals the highest likelihood of success.

09/01/2026

How do you know if you actually have POTS?

Here's what should happen with the vitals, symptoms, and what's not actually required to happen.

08/31/2026

08/30/2026

Have you been diagnosed with POTS or another type of dysautonomia and have found that, over time, your body just seems overreactive to everything?

If so, this video is for you.