01/12/2026
Traditional Chinese Medicine (TCM) View on POTS
Postural Orthostatic Tachycardia Syndrome (POTS) is not recognized as a single disease entity in Traditional Chinese Medicine. Instead, it is understood as a complex pattern of imbalance involving Qi, Blood, Yin, and Yang, particularly affecting the Heart, Spleen, and Kidneys. Symptoms are viewed as the body’s inability to properly regulate circulation and stability when transitioning from lying or sitting to standing.
Core TCM Pathomechanisms
1. Heart Qi Deficiency (± Heart Blood Deficiency)
The Heart governs Blood and circulation and houses the Shen. When Heart Qi is deficient, Blood circulation becomes insufficient, especially when the body is upright. This can lead to palpitations, dizziness, anxiety, insomnia, and brain fog, all of which are commonly reported in POTS.
Common signs include palpitations on standing, shortness of breath, anxiety, poor sleep, and reduced concentration.
2. Spleen Qi Deficiency
Spleen Qi plays a central role in POTS. The Spleen governs transformation and transportation and is responsible for keeping Blood within the vessels. When Spleen Qi is weak, Blood may sink downward, resulting in inadequate nourishment of the brain upon standing.
Common signs include chronic fatigue, lightheadedness when standing, weak limbs, poor appetite, bloating, and loose stools.
3. Kidney Yang Deficiency
The Kidneys govern constitutional strength and support upright posture. Kidney Yang provides warmth and support to the Heart and Spleen. When Kidney Yang is deficient, the body struggles to anchor Qi and Blood upward, worsening orthostatic symptoms.
Common signs include cold intolerance, weak low back and knees, morning fatigue, worsening symptoms upon standing, and possible salt cravings.
4. Qi and Yin Deficiency (Post-Illness Patterns)
Many POTS patients present with combined Qi and Yin deficiency, particularly following viral illness, concussion, or prolonged stress. Qi deficiency leads to weak circulation, while Yin deficiency results in insufficient fluids to anchor Yang, causing tachycardia, heat sensations, and dizziness.
TCM Treatment Principles
Treatment in TCM focuses on pattern differentiation rather than symptom suppression. Core principles often include:
- Tonifying Heart and Spleen Qi
- Supporting Kidney Yang or Kidney Yin as indicated
- Raising clear Yang and preventing sinking of Qi
- Calming the Shen and regulating the autonomic response
Clinical Note
POTS often requires gentle, consistent treatment over time. Acupuncture, herbal medicine, dietary therapy, and lifestyle guidance are commonly combined to restore balance and improve quality of life.
PC: the POTS life
