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How Can Upper Cervical Care Help POTS Patients?

Describes three POTS subtypes and how craniocervical alignment supports autonomic regulation.

Dr. Ethan Surprenant
Upper Cervical Chiropractor
August 22, 2025 · 7 min read

Brain Communication and POTS

Postural Orthostatic Tachycardia Syndrome (POTS) represents a misunderstood nervous system condition within the dysautonomia disorder category, where autonomic nervous system dysfunction disrupts automatic body processes including heart rate, blood pressure, digestion, and temperature regulation.

Common POTS symptoms include:

  • Fast heart rate when standing
  • Dizziness or fainting
  • Brain fog
  • Fatigue
  • Temperature regulation issues
  • Shaky or anxious feelings

Patients frequently receive dismissals attributing symptoms to anxiety, without proper diagnosis or explanation of the underlying physiological dysfunction.

The Three Subtypes of POTS

Hyperadrenergic POTS involves excessive adrenaline, creating a persistent fight-or-flight state with rapid heartbeat, elevated blood pressure, sweating, and panic-like sensations upon standing.

Neuropathic POTS stems from compromised nerve function, particularly in the legs, where blood vessel control deteriorates, causing blood pooling and reduced cerebral circulation manifesting as dizziness and visual disturbances.

Hypovolemic POTS results from insufficient blood volume due to fluid retention, electrolyte imbalance, or kidney dysfunction, producing lightheadedness, weakness, and heat intolerance.

Many patients experience combined subtypes, necessitating individualized treatment approaches.

Where Upper Cervical Care Comes In

The craniocervical junction (CCJ)—where the skull meets the atlas and axis vertebrae—surrounds the brainstem, which regulates:

  • Blood pressure
  • Heart rate
  • Breathing rhythm
  • Vagal tone (rest-and-digest)
  • Adrenal and kidney signaling
  • Blood vessel control

Even millimeter-level misalignments can distort neurologic signaling and blood flow to the brainstem. Upper cervical corrections may restore nervous system regulation, potentially reducing dizzy episodes, stabilizing heart rate, and improving mental clarity.

Subtype Support: A Functional Comparison

MechanismHyperadrenergicNeuropathicHypovolemicSymptoms When Dysfunctional
↓ Brainstem irritationLightheadedness, poor temperature regulation, dizziness, fatigue
↑ Vagal toneDigestive issues, rapid heart rate, poor sleep, anxiety
↑ Baroreceptor functionBlood pressure instability, fainting, heart rate spikes
↑ Blood vessel tone🟡🟡Blood pooling in legs, cold hands/feet, dizziness when standing
↑ Blood volume regulation🟡🟡Weakness, low exercise tolerance, low BP, frequent urination
↓ Sympathetic overflow🟡🟡Racing heart, tremors, chest discomfort, restlessness

✅ = Strong link · 🟡 = Potential link

This Isn’t About "Fixing" POTS

Upper cervical care does not cure POTS. Rather, it may address overlooked brainstem irritation sources. When this region stabilizes, patients often respond better to medication, hydration, exercise, and dietary interventions—establishing foundational nervous system support.

Real Answers Start at the Top

Most patients have consulted multiple specialists without resolution. A comprehensive assessment beginning from the top down may identify previously overlooked interference patterns.

Your body possesses innate healing capacity. Restoring communication at critical anatomical junctures facilitates this process.

About the Author
Dr. Ethan Surprenant, DC
Upper Cervical Chiropractor

Dr. Surprenant specializes in innovative, non-invasive Upper Cervical Chiropractic Care, uniquely addressing complex neurological conditions like dysautonomia, migraines, headaches, and cranio-cervical syndrome, to restore lasting neurological health.

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