POTS, Dysautonomia & Dizziness

Living with POTS? Why Neuroplasticity Might Be the Key to Getting Your Life Back

Dr Zimmerman on June 16, 2025

If you’ve been diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS), chances are you’ve spent years bouncing between specialists, wearing compression socks, increasing salt, and trying prescription after prescription. And despite doing “all the right things,” you’re still exhausted. Still dizzy. Still feeling like your body is out of sync.

Then, out of frustration and desperation, you started looking outside the box: chiropractic, supplements, upper cervical, acupuncture, and more; yet you still aren’t getting better.

You’re not alone. You’re not crazy. It’s not just in your head as a mental health disorder, even though you may have depression and anxiety, but who wouldn’t after struggling for years and being misunderstood.

The reason you haven’t gotten better isn’t because POTS is untreatable—it’s because POTS has been fundamentally misunderstood.

You’ve been told it’s a cardiovascular issue, which is why you keep seeing cardiology. But here’s the reality: POTS is not a cardiovascular disorder. The cardiovascular symptoms are manifestations of dysfunction within your autonomic nervous system. That distinction changes everything. And when you start approaching POTS from the lens of neuroplasticity, you open the door to real, lasting recovery.

What Is POTS…Really?

Let’s get the technical stuff out of the way.

POTS is diagnosed when your heart rate increases by more than 30 beats per minute (or 40 if you’re a teenager) within 10 minutes of standing up, without a significant drop in blood pressure.
POTS is diagnosed after multiple symptoms and vital sign changes have persisted for at least 3 months.
POTS is considered an appropriate diagnosis if there isn’t a better explanation for the symptoms and findings.

But let’s go deeper.

POTS lives under the umbrella of dysautonomia—dysfunction of the autonomic nervous system (ANS), which controls involuntary functions like heart rate, blood pressure, digestion, and temperature regulation.

So while your cardiologist may look at POTS as a heart rate problem, and your neurologist may say, “Not my lane,” the truth is: POTS is a nervous system issue that manifests as symptoms in your cardiovascular, respiratory, and gastrointestinal systems.

That’s why treatments like beta blockers, IV fluids, or Midodrine might reduce your heart rate or help you not feel faint, but they don’t fix the underlying issue. They’re managing symptoms, not creating healing.

What we’ve found in helping individuals for over 10 years and looking at the research, it’s clear that POTS is a nervous system issue that is influenced by impaired neurological and immune function.

Why Neuroplasticity Matters in POTS Recovery

Neuroplasticity is your brain’s ability to change, adapt, and form new connections based on the information it receives. And it can go one of two ways:

Positive neuroplasticity creates new, healthy patterns.
Negative neuroplasticity reinforces dysfunctional loops that keep your symptoms alive.

When you’re living with POTS, your brain and nervous system have learned to operate in a dysregulated state. You didn’t choose this, but the longer it goes on, the more deeply those patterns get wired in.

This is why surface-level treatments often fail. They don’t address the why. They don’t rewire the brain. And they don’t promote positive neuroplasticity, which is the only way real, long-term healing happens.

Understanding the Brainstem’s Role in POTS

To understand where POTS comes from, we need to look at the brainstem. The brainstem is the lower part of the brain with the lobes of the brain on top of it. When we look at the brainstem, there are 3 parts, but for simplicity, we are going to separate it into 2. The upper half, mesencephalon, is responsible for what’s known as the sympathetic nervous system. The lower half, the pons and medulla, is responsible for what’s known as the parasympathetic nervous system. This area is routinely called the pontomedullary region and is where we are going to focus. It’s the hub for the vagus nerve and integration of a variety of sensory inputs into the brainstem that will impact autonomic function.

The vagus nerve is crucial—it controls heart rate, digestion, blood pressure, and even inflammation. It’s been a hot topic in health circles lately, but we’ve been working with it long before it was trendy.

The vagus nerve is a two-way communication highway. It sends information from the body to the brain, and from the brain back to the body. If that feedback loop is disrupted, your body can’t regulate itself the way it’s supposed to.

For example, when you stand up, baroreceptors (pressure sensors in your arteries) should detect the drop in blood pressure, and this reduces the signals being sent to the brainstem and should result in increased sympathetic outflow to maintain blood pressure.

If this system isn’t working, blood pools in your lower body, your brain gets less oxygen, and you feel faint, dizzy, or like your heart is pounding out of your chest.

Why Treating the Vagus Nerve Alone Isn’t Enough

A lot of people get excited about vagus nerve stimulation, and there’s a place for that. We use tools that target it, and they can help.

But let’s be clear: stimulating the vagus nerve alone is like trying to fix a car by polishing the headlights.

POTS isn’t a “one-nerve” problem. The vagus nerve is just one player in a much larger system. Your brainstem, cortex, cranial nerves, cervical spine, and vestibular system all work together to regulate your autonomic function.

If you’re only targeting one piece of the puzzle, you’re going to keep missing the full picture and won’t get better.

The Vestibular System: The Overlooked Player in POTS

Your vestibular system, which controls balance and spatial orientation, is deeply intertwined with your autonomic function.

When you move your head, bend over, or shift positions, your vestibular system helps regulate blood pressure and heart rate through vestibulo-autonomic reflexes known as the vestibular sympathetic reflex.

If your vestibular system is out of sync, your blood pressure can crash when you move, and your heart rate can spike inappropriately. This is especially true if you have orthostatic hypotension, as impairments in the vestibular sympathetic reflex is the major contributor to this process.

Unfortunately, most with POTS, orthostatic hypotension, or other forms of dysautonomia will never have a vestibular evaluation. When people think of vestibular issues, they often think about issues with the inner ear resulting in vertigo.

In fact, many people with POTS don’t even have classic vertigo, but they still have vestibular dysfunction. That’s why dizziness, lightheadedness, neck pain, and motion sensitivity are so common.

We run computerized vestibular testing and eye movement tracking (video-oculography) on every patient, and over 75% show abnormalities. If your provider isn’t testing this, they’re missing one of the biggest drivers of your symptoms. In our experience, if this isn’t done, then you won’t get better if it was something that should have been treated.

The Cervical Spine, Vision, and Balance: Why It All Matters

Your neck (cervical spine) contains joints and muscles that feed into your vestibular system. When this information is good, it helps to stabilize the vestibular system, but when it’s bad, it can contribute to issues with the vestibular system. Problems here can mess with your balance, your blood pressure regulation, and your brain’s ability to orient in space.

But again, adjusting the neck alone won’t fix POTS. I’ve been in this field for over a decade. I’m a chiropractor and a nurse practitioner. I’ve seen neck adjustments help, but rarely do they solve the problem. I know you’ve likely heard in groups that some miracle happened with regular chiropractic, upper cervical, or yucca-based approach. Yes, some individuals do get better with it, but it’s not many, and we are about predictable results, which is why stopping with the cervical spine isn’t enough.

That’s because your visual system plays a role too. Your eyes work in tandem with your vestibular system to stabilize your vision and sense of movement. If your eye movements are off, even just slightly, it creates chaos for your brain and nervous system.

If scrolling your phone, driving, or being in crowds makes you feel “off,” that’s your oculomotor system screaming for help.

That’s why we test it. Every patient. Every time.

Immune and Inflammatory Triggers

Now, let’s discuss what exacerbates the situation: inflammation and immune dysfunction.

If you notice your POTS symptoms flare up during:

Menstrual cycles
Seasonal allergies
Illness or infections
After eating certain foods

…it’s likely because of neuroinflammation. Inflammation disrupts neuroplasticity and puts your nervous system on high alert. It changes how your brain processes signals, making symptoms feel more intense and harder to recover from.

This is where comprehensive lab testing becomes critical.

I’m not talking about basic panels, 3-5 vials, that come back “normal.” I’m talking about in-depth panels that look at gut health, nutrient deficiencies, autoimmune markers, and mitochondrial function.

Because if your body doesn’t have the fuel due to metabolic issues, or the immune system has shifted in the wrong direction, no amount of physical therapy or salt loading will move the needle.

The Mitochondrial and Hormonal Piece

There’s another layer most clinics skip: cellular energy.

Your nervous system runs on ATP—energy made by your mitochondria. If your mitochondria are sluggish (due to infections, toxins, stress, nutrient issues, or hormone imbalances), your brain can’t regulate itself. Did you know your brain uses 25% of the entire bodies energy supply when you are at rest?

Now, what happens when you have an unhealthy nervous system that is burning fuel inefficiently? Everything only gets worse. There are also a variety of factors that contribute to the energy capacity of the brain beyond neurological connections.

You may also have:

Thyroid issues (especially missed subclinical hypothyroidism)
Anemia
Adrenal dysregulation
Sex hormone imbalances

All of these affect how your brain functions—and whether your nervous system can rewire itself properly.

So… What Actually Works?

Here’s the framework we follow at Peak Brain and Body:

Comprehensive Evaluation

We run tests that others skip:

Computerized vestibular and balance testing
Video eye movement analysis
In-depth neurological examination
Expanded lab panels to identify immune and metabolic patterns

Multisystem Treatment Plan

We don’t throw darts in the dark. With the amount of data we gathered, we confidently tailor your treatment to what your body is telling us. That might include:

Neuroplasticity exercises targeting visual, vestibular, and motor systems
Brainstem and cerebellar retraining
Vagus nerve modulation
Cervical spine rehabilitation (if appropriate)
Mitochondrial and hormone support
Immune modulation and gut healing

Pattern-Based Progress

We don’t chase symptoms—we follow patterns. The more patterns we identify, the more accurately we can target treatment. It’s like studying the whole textbook before the test, not just one chapter.

This is where patience has to come in, just because we find something, it doesn’t mean it’s the first thing we have to address. If we address the wrong thing at the wrong time, you won’t get the results you want. We’ll guide you based on the patterns and testing to identify what should be addressed when.

Why You’re Still Stuck (And How to Change That)

If you’ve tried supplements, hyperbaric therapy, IVs, chiropractic, or functional medicine, but never got real traction, it’s not because you’re broken.

It’s because your care has been fragmented.

You’ve done bits and pieces. But this is like trying to bake a cake by only using flour. You need all the ingredients, and you need them in the right order.

When we bring all the systems together—neurology, cardiology, immunology, endocrinology, and gut health—we see people get their lives back.

Most of our POTS patients improve by 70-80% or more. The time to achieve those results is dependent on the underlying reasons why POTS is an issue for you. Some need additional support beyond the initial plan. But when you work through this framework systematically, the body starts to heal.

Final Thoughts: You’re Not Crazy. You’re Just Misunderstood.

If you’re reading this and thinking, “Why hasn’t anyone explained this to me before?”—that’s exactly why I created this blog.

Most providers weren’t trained to think this way. But this is the future of care for complex neurological conditions like POTS.

At Peak Brain and Body, we see patients from all over the country—people who’ve seen 10+ doctors and still didn’t have answers. But when you finally look at the full picture, things start to make sense.

Post-Concussion Symptoms Treatment: The Missing Link in Your Recovery

Dr Zimmerman on March 22, 2025

If you’re reading this, there’s a good chance you’re still living with the effects of a concussion—whether it happened recently or years ago. Maybe you’ve been struggling with concussion symptoms like brain fog, fatigue in concussion, dizziness, concussion headache, or mood changes. Maybe you’ve tried physical therapy, chiropractic, medications, or supplements, and yet… something still feels off.

You’re not alone—and it’s not in your head despite the likelihood you’ve been told multiple times it’s from anxiety, depression, or that a concussion can’t impact you for that long. Concussions are the most common type of traumatic brain injury and are often classified as mild traumatic brain injury.

In this post, I’m going to walk you through everything you need to know about post concussion syndrome treatment in Tampa—from how concussions are (often wrongly) diagnosed, to the most common concussion myths, and most importantly, what proper post concussion treatment should actually look like.

Because what most people are getting isn’t sufficient? It’s not the full picture. And that’s why Peak Brain and Body is a leader in post concussion recovery and post concussion clinic care in Tampa and beyond.

This is the information I wish someone had given my wife 15 years before we finally discovered the root cause of her daily symptoms. She shouldn’t have had to suffer with daily headaches amongst many other symptoms.

There is a video version here: https://youtube.com/live/zdA0fYzWMw4

Why I Care So Much About Concussions (And Why You Should Too)

This is personal for me.

My wife had three concussions in her younger years. For over a decade, she battled with brain fog, fatigue in concussion, dizziness, and mood swings. She went to a couple doctors and was told it was just hormones, puberty, or stress. Even if she brought it up to her parents, the reply was “you’ve already been to the doctor.” No one put the pieces together. No one ever said, “Hey—this might be from a brain injury.”

That changed when I was working in a brain injury clinic. She realized that the concussion symptoms that individuals were having resolved on a daily basis were part of her everyday life. They were so common that she didn’t even mention them, because weren’t those symptoms that most people had? We finally did the right evaluations, uncovered what was missed, and began treatment that actually addressed her brain function. It was the beginning of her healing—and it changed the trajectory of my career.

Since then, I’ve dedicated my life to helping people who’ve been struggling silently for far too long.

People like you.

People who know something’s wrong but can’t get clear answers or real solutions. People who’ve been dismissed or told “you’re fine” based on a 5-minute exam or a normal MRI. People who’ve been told to “just wait it out” or “it’s all anxiety.” People who’ve tried functional medicine and been told maybe it was their thyroid, hormones, or gut health when in reality it was an unresolved concussion. In my experience, nearly 90% of those still struggling with concussion symptoms have no clue that is the driving factor for the symptoms they have.

I see you—and I want you to know: there’s hope. And there’s help.

The Most Common Concussion Myths That Keep People From Healing

Let’s start with some hard truths—because these concussion myths are harming people every single day. You’ve been told these from family, friends, co-workers, and even worse other medical providers:

“You didn’t lose consciousness, so it can’t be a concussion.”

False. About 90% of concussions don’t involve loss of consciousness. That’s not a requirement.

“You didn’t hit your head.”

Also false. A whiplash injury—like in a car accident or fall—is more than enough to cause a concussion. You don’t need a visible bump or bruise on your head. In our experience, concussions are the most undiagnosed and untreated injuries that occur in a car accident.

“Your imaging came back normal.”

This one makes my blood boil. A normal CT or MRI just means there’s no bleed or fracture. It says nothing about brain function or about a possible concussion. Most concussions won’t show up on those scans as they aren’t made to detect it. That doesn’t mean you’re okay, even if a provider says your imaging looks good and you are fine. This isn’t true and don’t fall for it.

“You just need to rest and wait it out.”

Maybe that made sense 20 years ago based upon our limited understanding of the brain. But if you’re still being told to sit in a dark room and “wait it out,” you’re not being given current, science-backed guidance. In fact, that kind of advice has been shown to delay your recovery.

“You’re just anxious or depressed.”

Yes, concussions can affect mood—but brushing off your brain-based symptoms as “mental health” issues without evaluating your brain is a huge disservice. We know that it’s very common to develop depression or anxiety after a concussion. We also know that pre-existing depression prolongs concussion recovery and tends to worsen symptoms. That doesn’t mean it is all from depression, but the way these issues interact with concussion recovery.

Post-Concussion Syndrome Symptoms

Maybe you’ve had a concussion and were told you’d bounce back in a few weeks—but here you are, months or years later, still not feeling like yourself.

Here are some of the concussion symptoms we commonly see in people with undiagnosed or untreated post concussion syndrome:

Brain fog that makes it hard to think clearly or find words
Fatigue in concussion cases that worsens throughout the day and doesn’t improve with rest
Concussion headache or pressure in your head
Concussion neck pain or stiffness
Difficulty focusing or remembering things
Light and sound sensitivity
Dizziness, motion sensitivity, or nausea
Irritability, anxiety, or mood swings
Sleep issues—either insomnia or waking up unrefreshed

If two or more of these symptoms got worse after your injury—or even if they were already present but intensified—your brain may be struggling to function normally. And you deserve to know why.

How Is a Concussion Diagnosed

Here’s how we determine whether your concussion symptoms are linked to a past injury:

1. A Clear Mechanism of Injury of Concussion

This could be a car accident, fall, sports collision, or any event involving a blow to the head or body that jolts the brain.

2. Clinical Signs of Concussion

Clinical signs would be findings that occur at the time of the concussion. This includes vomiting, loss of consciousness, confusion, and gross motor instability. You do not need to have these to be diagnosed if you have parts 1, 3 and 4.

3. New or Worsened Symptoms of Concussion

According to clinical guidelines, having two or more new or aggravated symptoms is enough to raise a red flag.

4. Objective Clinical Findings of Concussion

This includes eye movement testing, computerized balance assessments, and vestibular evaluations. (More on that in a second.)

5. No Better Explanation

If your symptoms don’t line up with another condition, and testing reveals brain dysfunction, a concussion diagnosis makes clinical sense—even without imaging abnormalities.

Here is a graphic from the American Congress of Physical Medicine and Rehabilitation for diagnostic criteria for MTBI.

The American Congress of Rehabilitation Medicine Diagnostic Criteria for Mild Traumatic Brain Injury
Silverberg, Noah D. et al.
Archives of Physical Medicine and Rehabilitation, Volume 104, Issue 8, 1343 – 1355

Why Most People Aren’t Diagnosed Properly For Concussion

Too often, people are told, “Your scans are normal. You’re fine.” They might get a quick check of reflexes and be sent on their way. It’s unfortunate that this happens, but most providers receive little to no training on concussions.

Here’s what’s missing, objective testing:

Computerized Balance Testing

This shows how well your brain integrates signals from your eyes, vestibular system, and body. The platform measures how much you move on a firm and perturbed surface with eyes open and closed. Beyond this, evaluating tandem stance and one legged stance is also important.

Eye Movement Testing (Video Oculography)

We use specialized goggles to record your eye movements. Why? Because your eye movements are directly connected to brain function. It is important to measure gaze fixation, pursuits, saccades, anti-saccades, optokinetics, and spontaneous nystagmus. If you can’t smoothly follow a target, your brain isn’t processing information correctly and this will routinely cause a variety of symptoms.

QEEG Brain Mapping

This measures your brainwave activity. While not diagnostic on its own, it’s a powerful way to measure progress and see how your brain is functioning. In the future, this testing will likely be more important as research will be able to correlate certain brainwave patterns with concussions.

Why Most Treatments Fail (And What You Actually Need)

Many try one therapy at a time—vision therapy, vestibular rehab, neurofeedback—yet still don’t recover. That’s because concussions affect multiple systems.

You need an integrated plan addressing:

Neurological dysfunction
Brain energy production
Vestibular & visual processing (concussion Oculomotor therapy, concussion Vestibular therapy)
Inflammatory & immune factors
Pre-existing health

Think of it like trying to play your favorite song—but each instrument is playing solo. You need them all working together in harmony as that is the only way you get the results you want.

Post-Concussion Syndrome Treatment in Tampa at Peak Brain and Body

At our clinic, we go beyond checklists and guesswork. Every treatment plan is custom-built based on detailed testing. And instead of treating one system in isolation, we stack therapies together in a sequence that makes sense for your brain.

Our Treatment Toolbox Includes:

Oculomotor therapy is based on improving the brain’s ability to perform a variety of functions.
Vestibular therapy to integrate the function of vestibular, visual, and cervical spine.
Postural and neck retraining
Photobiomodulation (laser therapy) to reduce inflammation and support cellular energy
Brain-based cognitive training and hand-eye coordination drills
Targeted supplementation and peptide therapy
Functional medicine to address root issues like gut health, hormones, autoimmunity, or mold exposure

We do all of this in a way that’s dynamic—just like your brain. And it works.

Real Recovery Is Possible

If you’ve been told there’s nothing else you can do, I want to tell you this: That’s not true.

I’ve seen people who’ve been struggling for 5, 10, even 15 years start to recover—because someone finally asked the right questions and ran the right tests.

I’ve seen people go from canceling plans and calling off work… to being present with their families again. Getting their careers back. Enjoying life again.

And the best part? Most people don’t need lifetime care. They need the right care at the right time—tailored to their brain. The brain can change fast when it’s provided the right information and supported.

You’re Not Broken. You’re Just Misunderstood.

If you’ve been told your symptoms are all in your head, or that you should have recovered by now—let me say this loud and clear:

You’re not crazy. You’re not lazy. And you’re not broken.

You’re dealing with a brain that hasn’t fully recovered. And once we understand where the disconnects are—we can start fixing them.

It doesn’t matter what you’ve tried in the past, our clinic is full of individuals who tried numerous other therapies before they finally came in and found answers and solutions.

Ready to Take the Next Step?

If you’re in the Tampa area or are willing to fly in and you’re ready for real answers—and real progress—we’re here for you.

Peak Brain and Body, located in Wesley Chapel, FL, offers the most advanced post-concussion syndrome treatment in the Tampa metro area. It’s led by Dr. Zimmerman who is a best selling author and the only dual-licensed nurse practitioner and chiropractor integrating advanced neurological diagnostics, functional neurology, functional medicine, and peptide therapy in the state of Florida and one of a few in the entire United States.

Click below to schedule your comprehensive brain health evaluation and take the first step toward feeling like you again.

Can post-concussion syndrome symptoms come and go over time?

Yes. People with post-concussion syndrome symptoms timeline often notice that dizziness, headaches, or trouble concentrating may improve for a while and then return, especially if they overexert physically or mentally. Tracking your symptoms over weeks and months can help guide recovery strategies.

Is vestibular rehab only for severe post-concussion dizziness?

No. Vestibular rehab for post concussion dizziness can help even in mild cases. The therapy aims to retrain your brain and inner ear to work together, reducing imbalance and improving stability, regardless of symptom severity.

How does oculomotor therapy help after a concussion?

Oculomotor therapy after concussion focuses on restoring normal eye movement control, which is often disrupted. This can help reduce blurred vision, improve reading ability, and ease headaches linked to visual strain.

What role does neurotherapy play in concussion recovery?

Neurotherapy for concussion recovery uses brainwave training to support cognitive function, mood regulation, and energy levels. It can be combined with physical therapy for a more comprehensive healing plan.

Why is sleep hygiene important in concussion recovery?

Good sleep hygiene concussion recovery tips—such as setting a regular sleep schedule, limiting screen time before bed, and creating a calm environment—are critical because the brain heals most effectively during deep rest.

What Causes Dizziness

Dr Zimmerman on February 20, 2025

What Causes Dizziness: Causes, Types, and How to Get Relief

Dizziness is a common yet frustrating symptom that can disrupt daily life, making it difficult to function at work, engage in activities, and even complete simple tasks. Many people are constantly searching for what causes dizziness or even the causes of dizziness in women, since hormonal changes, pregnancy, and menopause can all play a role. Dr. Zimmerman at Peak Brain and Body in Wesley Chapel, Tampa area, has helped many complex dizziness cases using an integrative medicine approach that combines both functional medicine and functional neurology.

Many people struggle for months or even years to get answers because they don’t know where to look or what questions to ask. If that sounds like you, keep reading—we’re going to break down everything you need to know about dizziness, the symptoms of dizziness and vertigo, and how you can take steps toward recovery. This will help you understand why some people do well with one treatment, but others don’t respond at all.

What is Dizziness?

“Dizziness” is a broad term that can mean different things to different people. Some describe it as feeling lightheaded, off-balance, or like the world is shifting around them. Others experience a sensation of spinning, known as vertigo. Understanding the difference is critical because using the wrong terminology could lead to misdiagnosis and ineffective treatment.

Vertigo: A rotational sensation where either you feel like you are spinning or the world around you is spinning.
Dizziness: A general feeling of unsteadiness, lightheadedness, or imbalance without a spinning sensation.

This distinction matters because the underlying causes of vertigo in women may differ from the broader causes of vertigo and dizziness found in men or the general population. The right diagnosis ensures the right treatment.

The 5 Key Causes of Dizziness

In this section, we are going to discuss in detail what causes dizziness and set a framework for finding answers. Dizziness is a brain-based issue, meaning that if your brain isn’t processing signals correctly, you’re going to feel off balance.

Mind map showing major causes of dizziness and vertigo, including neurological, metabolic, musculoskeletal, inflammatory, and vascular factors.

Visual overview of the key causes of vertigo and dizziness, such as neurological issues, inflammation, vascular problems, metabolic imbalances, and musculoskeletal dysfunctions.

1. Inflammation

Inflammation in the brain or body can impact your nervous system, leading to dizziness. Food sensitivities, infections, and allergies are common triggers. Some people may experience dizziness and nausea simultaneously, particularly when inflammation disrupts the balance systems in the ear and brain. Common sources include:

Food sensitivities: Gluten, dairy, and ultra-processed foods can cause systemic inflammation.
Infections: Viral, bacterial, or fungal infections, including mold exposure, can contribute to dizziness.
Allergies: Seasonal allergies can create congestion in the eustachian tubes, impacting balance and stability.

2. Metabolic Issues

Metabolic problems like anemia, thyroid dysfunction, and blood sugar imbalances are common causes of dizziness in women, particularly during pregnancy or menopause. Low iron, thyroid fluctuations, and poor blood sugar control can all lead to dizziness, fatigue, and confusion. Key metabolic causes of dizziness include:

Anemia: Low iron levels reduce oxygen delivery to the brain, leading to dizziness. A complete iron panel (including ferritin and iron saturation) is essential for proper diagnosis. Many will only have a CBC and be told things are normal, but this will miss many individuals who have an iron deficiency.
Thyroid Dysfunction: Hypothyroidism or hyperthyroidism can contribute to dizziness. Proper thyroid testing should include TSH, T4, T3, free T3, free T4, and thyroid antibodies.
Blood Sugar Imbalances: Both high and low blood sugar levels can cause dizziness. Symptoms of dysregulated blood sugar include energy crashes after meals or sudden surges in energy.

3. Musculoskeletal Issues

Your neck and spinal alignment play a significant role in balance. Poor posture, cervical spine dysfunction, or muscle imbalances can all contribute to instability. For some people, this dizziness is worse after waking or when they are dizzy after standing up, because positional changes stress the cervical spine.

Cervical Spine Dysfunction: Poor posture, injuries, or surgeries in the neck can lead to dizziness.
Muscle Imbalances: If the muscles around your neck send incorrect signals to your brain, it can create instability, as it creates confusion within the brain.

For some of these individuals, they do well with chiropractic or physical therapy, but others will be made worse.

4. Vascular Issues

Proper blood flow is critical for brain function. When blood flow is disrupted, dizziness can occur.

Blood Pressure: Sudden drops can cause lightheadedness or dizziness after standing.
Dehydration: A lack of fluids can cause imbalance and faintness.
Vascular Dementia: Many wonder, does vascular dementia cause dizziness? Yes—poor circulation to the brain can lead to dizziness and vascular dementia symptoms overlapping. Research shows a connection between vascular dementia and dizziness, especially when blood flow is compromised.

5. Neurological Causes

Dizziness is ultimately a neurological issue, meaning that problems within the nervous system can be a major cause.

Dysautonomia/POTS: A condition where the autonomic nervous system fails to regulate blood pressure and heart rate properly, leading to dizziness upon standing.
Vestibular Dysfunction: The inner ear plays a crucial role in balance. If the vestibular system is impaired, dizziness and vertigo can result.
Concussions and Brain Injuries: Even mild concussions can lead to dizziness for months or years if left untreated.
Stroke & Multiple Sclerosis: More severe neurological conditions, such as stroke and MS, can impact balance and coordination.

As you are probably gathering by now, when someone wants to know what causes dizziness, the answer isn’t black and white. Some individuals only have one of the components from above, but many others will have overlapping components that have to be addressed as a complete unit.

How to Get Relief from Dizziness

If you’re experiencing dizziness, the key to relief is identifying and addressing the root cause. Here are some steps you can take:

1. Get Proper Testing: Functional Medicine Labs in Wesley Chapel | Tampa, FL

Most traditional doctors only check basic bloodwork, but you may need more comprehensive testing, including:

Iron panel (Ferritin, TIBC, Iron Saturation, Serum Iron)
Thyroid panel (TSH, Free T3, Free T4, Thyroid Antibodies)
Comprehensive Metabolic Panel (CMP)
Inflammatory Markers (CRP, Homocysteine, ESR)
Functional Neurological Evaluation

A functional neurological evaluation for dizziness includes videooculography, computerized balance posturography, and a comprehensive physical examination that reveals what MRI and CT scans don’t. It’s why we see so many individuals finally get answers after they’ve been told nothing is wrong or the provider didn’t know what could be done.

2. Address Inflammation

Eliminate inflammatory foods (processed foods, gluten, dairy, excess sugar).
Reduce exposure to mold, allergens, and environmental toxins.
Consider anti-inflammatory supplements such as omega-3s and curcumin.

3. Support Your Metabolism

Ensure adequate iron, B vitamins, and thyroid support based on lab values.
Balance blood sugar by eating protein-rich, fiber-dense meals.
Stay hydrated with adequate electrolytes.

4. Improve Neck and Postural Health

Seek chiropractic care, physical therapy, or massage if musculoskeletal issues are contributing to dizziness. If this helps you, then fantastic, and keep going. If it’s not helping you or makes you feel worse, then know there is more to the story, and a more in-depth evaluation and treatment are necessary.
Work on neck exercises and posture correction to optimize brain-body communication.

5. Strengthen Brain & Nervous System Function Utilizing Functional Neurology

Perform eye and vestibular exercises under professional guidance.
Targeted neurological therapy integrates cognition, hand-eye coordination, reaction time, and balance.
Avoid excessive caffeine or stimulants that could worsen symptoms.

Final Thoughts: Taking Control of Your Health

If you’ve been struggling with dizziness for months or even years without answers, it’s time to take a different approach. Whether your dizziness comes with nausea, happens after standing, or is even related to conditions like vascular dementia and dizziness, solutions exist.

At Peak Brain and Body, Dr. Spencer Zimmerman and his team specialize in uncovering what other providers have missed. From causes of vertigo to brain-based balance rehabilitation, our goal is to get to the root of your symptoms. You don’t have to keep suffering—answers are available, and recovery is possible.

Request a Discovery Consult with our team today to finally find relief.

Dysautonomia and POTS Syndrome – Why You Have Dizziness, Headaches, and Chronic Fatigue

Dr Zimmerman on February 9, 2025

Dysautonomia and POTS Treatment| Peak Brain and Body | Tampa and Wesley Chapel, FL

Dysautonomia, POTS, and Chronic Fatigue – Why You Have Dizziness, Headaches, and Other Common Symptoms

This may be the first time you’ve heard the phrase Postural Orthostatic Tachycardia Syndrome (POTS Syndrome), or you’ve been battling this condition for years and are struggling to find answers. Dr. Zimmerman at Peak Brain and Body has helped many in Tampa, FL, and beyond get their lives back through advanced testing and treatment for POTS and autonomic dysautonomia.

This blog is going to provide insight into not only what POTS and chronic fatigue are but also what dysautonomia is, why treating it as a cardiovascular-based condition fails so many, and what real solutions look like.

There is also a YouTube version of this: watch here

What Is POTS?

POTS is a form of dysautonomia, meaning it involves dysfunction in the autonomic nervous system—the system responsible for controlling involuntary functions like heart rate, blood pressure, digestion, and temperature regulation. It primarily affects women, with an estimated 80% of cases occurring in females.

The defining characteristic of POTS is an excessive increase in heart rate (by 30 beats per minute for adults, or 40 beats per minute for teens) within 10 minutes of standing, without a significant drop in blood pressure. If blood pressure does drop significantly, then it falls under broader dysautonomia causes rather than POTS specifically.

POTS vs. Dysautonomia: What’s the Difference?

Dysautonomia is a broader term referring to dysfunction in the autonomic nervous system. POTS is a specific subtype of dysautonomia, characterized by increased heart rate upon standing without major blood pressure drops. If blood pressure does drop significantly, then the condition falls under categories like orthostatic hypotension rather than POTS.

While all POTS patients have dysautonomia, not all dysautonomia patients have POTS. Think of it like this: If dysautonomia were a car brand, POTS would be one specific model. Understanding this distinction is crucial because treatment approaches will differ when you see a traditional medical provider. It doesn’t matter as much when we look at non-traditional approaches, which you’ll understand a lot more as you progress through this article.

Who Gets POTS and Why?

Over 3 million Americans are estimated to have dysautonomia POTS, and cases have skyrocketed, especially following COVID-19. It is important to note that it existed before COVID-19, but it wasn’t a routinely accepted diagnosis. This led to many individuals who’ve dealt with it in the past not receiving a diagnosis. While COVID-19 infection is known to cause POTS or dysautonomia, it’s not the only thing. Other known triggers include:

Viral infections (including flu and COVID-19)
Concussions and brain injuries (including mild concussions that were dismissed)
Autoimmune conditions (POTS can be an autoimmune-driven disorder)
Chronic migraines (which can be both a cause and an effect of POTS)
Surgery and prolonged bed rest
Mast cell activation syndrome (MCAS)
Vaccine side effects
Hormonal shifts (such as menstruation and perimenopause)
Genetic disorders like Ehlers-Danlos Syndrome (EDS) (particularly hypermobile EDS)

Symptoms of POTS: More Than Just Dizziness

POTS affects multiple body systems, making it difficult to diagnose and manage. Common symptoms include:

Cardiovascular: Palpitations, fainting, feeling lightheaded, Raynaud’s syndrome (cold, discolored hands and feet)
Neurological: Brain fog, headaches, dizziness, blurry vision, vertigo, ADHD-like symptoms, anxiety
Gastrointestinal: Nausea, bloating, constipation, diarrhea, irritable bowel syndrome (IBS)
Musculoskeletal: Weakness, joint pain, hypermobility, muscle fatigue
Endocrine: Menstrual cycle irregularities, extreme fatigue, heat intolerance

Many POTS patients find themselves visiting multiple specialists—cardiologists, neurologists, endocrinologists—who only focus on one system. The issue? POTS impacts multiple systems at once. The symptoms above may be associated with the system above, but this is not the underlying reason for the array of symptoms that individuals have. Without a whole-body approach, treatment often falls short, and many are left frustrated.

Why Standard Medical Approaches Fall Short

Most POTS patients are given five main recommendations:

Increase salt intake
Wear compression stockings
Take beta-blockers (like propranolol) to lower heart rate
If there is a blood pressure drop, which, as we noted this wouldn’t be true POTS, then individuals are given a medication to increase blood pressure.
Cardiology and neurology often try to work together to send the individual to do physical therapy with a focus on building back up strength and endurance.

While these can help some symptoms, they fail to address the root cause. Many patients feel frustrated when medications like propranolol leave them with brain fog and fatigue, but don’t actually fix what’s causing their POTS in the first place.

Physical therapy, in our experience, often makes these individuals worse as it’s not done at the right time. It’s not as simple as just building up physical endurance; you must identify what is driving the POTS to begin with. After that is treated, then physical therapy or simply going to a gym and working up can go well.

A Smarter Approach to Treating POTS

To understand what to look for in treatment, it’s important to understand that even though it’s often treated as a cardiovascular condition, it’s not for many. It is a neurological and immune-based issue that manifests with a variety of symptoms, with the hallmark feature being heart rate.

To truly improve, you need a comprehensive plan that evaluates:

Neurological function – Brain imbalances can lead to autonomic dysfunction. Testing eye movements and balance can provide crucial insights into nervous system health.
Immune system health – Autoimmune issues and chronic inflammation are major drivers of POTS.
Gut health – IBS and leaky gut can worsen POTS symptoms due to their connection with the nervous and immune systems.
Mast cell activation & histamine response – Many POTS patients also experience extreme reactions to foods, environmental triggers, and stress.
Hormonal balance – Menstrual cycles, adrenal dysfunction, and thyroid disorders all influence POTS symptoms.

We will briefly discuss how to evaluate the nervous and immune system in POTS and dysautonomia.

Many people will naturally think they need an MRI or a CT scan due to the headaches, dizziness, and nausea. They are routinely disappointed if they do get one, as this does not provide any information for someone with POTS and chronic fatigue. It should be done if there is a worry of something like a tumor or a brain bleed. It is essential to look at nervous system function.

The eyes are known as the windows into the health of the brain. A comprehensive eye movement assessment should be done using computerized technology known as videooculography. This allows for the highest level of evaluation and is very educational, as it allows you to see where you did well and did not. Components of an eye movement examination should include: vergence, fixation, pursuits, saccades, and optokinetics.

The other side of the neurological evaluation is balance. Balance testing is routinely off with many POTS patients. What we’ve found is that if it’s only balance, then it’s not necessarily something that is treated. If both eye movements and balance are off, then neurological rehab does really well. You may be wondering why it’s not necessarily appropriate to treat poor balance. As you’ve experienced, you notice fatigue, weakness, and an inability to be on your feet too long. When balance is off, it could be due to neurological dysfunction or simply related to the fatigue and weakness many have.

The immune system is initially evaluated by looking at triggers that impact symptoms. What happens when you get stressed, sick, have menses, make food choices, or experience sleep changes? Based on this, it gives the provider a good idea of where to start. Beyond this, it is often beneficial to evaluate immune system markers, gut health, and reactions to mycotoxins from molds.

How We Help People with POTS Recover and Feel Better

At Peak Brain and Body, we take a root-cause approach to POTS and chronic fatigue treatment, using advanced neurological testing, brain function assessments, immune system evaluations, and metabolic panels to uncover hidden triggers. This isn’t just another evaluation or brief visit; this is the most in-depth evaluation most of our patients have ever had.

Here’s what makes our approach different:

We connect the dots between your brain, nervous system, and immune function.
We perform in-depth testing beyond standard labs to find hidden infections, gut imbalances, or underlying concussions that may be contributing to your symptoms.
We use targeted therapies like eye movement therapy, balance retraining, cognitive therapy, low-level laser, hyperbaric oxygen therapy, and functional medicine interventions to restore nervous system balance.

Based on your testing, a customized care plan is created. It’s not just about finding out what is wrong, but knowing the order things should be addressed.

The Path to Healing From POTS and Dysautonomia

Healing from POTS isn’t about finding a magic pill—it’s about finding the right roadmap for your unique body. While no two POTS cases are identical, addressing neurological health, immune balance, and gut function can make a world of difference.

If you’re tired of bouncing from doctor to doctor without answers, it’s time for a different approach. You deserve to work with someone who understands the bigger picture and has the tools to help you get your life back.

At the end of the day, knowledge is power. You don’t have to live with POTS controlling your life. With the right approach, individuals routinely find healing is possible even if they’ve been told nothing else can be done.

Next Steps

Looking for answers? Schedule a consultation with Peak Brain and Body to start uncovering the root cause of your symptoms.

Understanding POTS Syndrome and Its Symptoms

Webmaster on December 12, 2024

What Is POTS Syndrome? Tampa | Wesley Chapel FL

Could you have Postural Orthostatic Tachycardia Syndrome (POTS)?

Do you or someone you know often feel dizzy, especially when standing up?
Have you experienced a foggy feeling in your brain, making it hard to think or concentrate?
Are you dealing with constant fatigue, no matter how much you rest?
Do these symptoms seem to come and go, without any clear reason?
Are you wondering if these could be signs of a condition like POTS syndrome?
Do you know someone who’s struggling with similar symptoms and looking for answers?

If these questions sound familiar, then it’s important to learn about POTS as it may be impacting you. We will discuss the connection between brain fog, dizziness, chronic fatigue, and POTS syndrome.

WHAT IS POTS SYNDROME?

POTS, or Postural Orthostatic Tachycardia Syndrome, is a condition related to the autonomic nervous system, which controls functions like heart rate and blood pressure. The hallmark feature of POTS is an increase of heart rate >30 bpm in adults and >40 in children when going from a sitting to standing position without having a notable drop in blood pressure. POTS affects a range of systems in the body including: immune, nervous, cardiovascular, and gastrointestinal. This leads to a wide rage of symptoms that individuals will experience.

CAN POTS SYNDROME CAUSE BRAIN FOG, DIZZINESS, AND CHRONIC FATIGUE?

Yes, it can. Here’s why:

Blood Flow Issues: POTS affects how blood flows in the body, which can lead to dizziness when standing.
Brain Fog: Due to blood flow irregularities, the brain might not get enough oxygen, leading to a feeling of mental cloudiness or brain fog.
Chronic Fatigue: Constant strain on the body from trying to manage blood flow can result in ongoing tiredness.

WHAT ARE SYMPTOMS OF POTS SYNDROME?

There are many symptoms that an individual may experience with POTS, but you don’t have to have all of them.

HOW DO THESE SYMPTOMS MANIFEST IN POTS SYNDROME?

The symptoms of brain fog, dizziness, and fatigue in POTS syndrome are very common. This usually manifests in certain ways for individuals:

Feeling lightheaded or dizzy when initially standing up or being on your feet for even 5-10 minutes.
Difficulty concentrating or remembering things. This may be an ongoing issue or you may notice it gets worse as the day goes on.
Constant tiredness, even after getting enough sleep. You may feel the need for naps even if you get great sleep at night. Going through life is draining and most have pulled back substantially from what they’d normally do as a result.

WHO GETS POTS SYNDROME?

POTS is estimated to impact nearly 3 million Americans, but which ones are more likely:

Nearly 80% of those diagnosed with POTS syndrome are female.
Predominantly impacts teenagers and adults.
Those with hypermobility, specifically with Ehlers-Danlos Syndrome are at higher rate.
May develop after an infection including flu and covid-19
May develop after a vaccine
May develop after exposure to mold
May develop after a concussion

MANAGING SYMPTOMS OF POTS SYNDROME

While battling symptoms of POTS is frustrating, it doesn’t have to be. We’ll first cover what traditional medicine does for POTS before talking about how we approach it. Traditional medical approaches are about managing the symptoms of POTS.

Initial evaluation: Will include a tilt table test or doing orthostatic testing. Basically this involves having an individual go from lying to standing and measuring the changes in blood pressure and heart rate.
Medication Management: As long as blood pressure isn’t too low many are prescribed a beta blocker to control the heart rate. Some are even trying different corticosteroids to try and reduce inflammation, but this isn’t a widely accepted approach at this time.
Lifestyle Adjustments: Increase salt intake or take salt tablets. Wear compression stockings to help promote blood flow.
Physical Therapy: In some cases individuals are sent to physical therapy to help build up strength and endurance.

PEAK BRAIN AND BODY TREATMENT FOR POTS SYNDROME

We believe in a holistic approach to managing POTS syndrome. As noted previously, POTS impacts multiple systems of the body. We’ve found that the two things that matter most in POTS recovery are the nervous and immune systems. We evaluate and treat both the nervous and immune system.

How We Evaluate Nervous System Function For POTS Syndrome

The nervous system is best evaluated by looking at function, not through imaging. If you’ve had imaging and were told it’s normal that is okay, but it doesn’t mean everything is fine. It just means the imaging can’t pick up what is needed. That is where testing that evaluates nervous system function comes in. There are 3 ways we evaluate the nervous system:

Videooculography (Eye Movement): Eyes are considered the windows into the health of the brain. With this testing we are able to map out which parts of the brain are healthy or not. This testing provides tremendous insights and answers.
Computerized Balance Posturography: Dizziness is a common symptom with POTS and can be due to impairment in vestibular function as a result. When balance testing is used as part of an evaluation we can distinguish between vestibular issues or weakness that impacts balance.
QEEG Brainmapping: This allows us to evaluate brain waves including delta, theta, alpha, beta, and gamma waves. Imbalances in these could help explain brain fog, concentration, memory, and anxiety based symptoms.

How We Evaluate the Immune Symptoms in POTS Syndrome

Most are frustrated when they get their labs done. They get a basic CBC, CMP, and maybe a little more; but they are routinely told their labs are normal. Most labs will not pick up immune system dysfunction. If you know what to look for there are clues along the way. We look for patterns of symptoms increasing due to: stress, menses, infection, poor sleep, and nutrition choices.

We can also perform labs that looks at inflammation, iron deficiency, immune system dysfunction, and even stool testing. When it comes to evaluating immune system dysfunction we are able to do an in-depth panel that goes far beyond what a CBC provides.

It is worth mentioning that we are finding a group of individuals who are dealing with issues related to mycotoxins which are produced by mold. There is specific testing that we do to evaluate for that.

NEED HELP OR MORE INFORMATION?

If you or someone you know is experiencing symptoms like brain fog, dizziness, and chronic fatigue and suspect it could be related to POTS syndrome then it’s time for a full evaluation. It doesn’t matter if you’ve been diagnosed or have had symptoms for 6 months or 5 years.

At Peak Brain and Body we’ve helped individuals who’ve tried numerous other treatments and didn’t see progress until taking an approach that focuses on both nervous and immune system function.

Request a Free Discovery Consult with our team today.