Dysautonomia · POTS After COVID
The Invisible Illness Women Are Told Is All in Their Heads
POTS — Postural Orthostatic Tachycardia Syndrome — is a form of dysautonomia that disrupts everyday life and disproportionately affects young women. Cases have surged since COVID-19, yet the condition is still routinely misdiagnosed or dismissed as stress or anxiety. At The Fascia Institute and Treatment Center, we take these symptoms seriously — and we build whole-body treatment plans that help.
· Autonomic dysfunction · Post-viral · Whole-body care · Metairie · New Orleans
By Jacques Courseault, MD, CAQSM, FAAPMR · The Fascia Institute and Treatment Center®
01 · Understanding the Condition
What Is POTS?
POTS stands for Postural Orthostatic Tachycardia Syndrome, a condition that affects the autonomic nervous system — the system that quietly runs the functions you never have to think about: heart rate, blood pressure, breathing, digestion, and temperature regulation.
In people with POTS, the body struggles to regulate these functions properly — especially when changing position, such as standing up from lying down. The result is a cluster of symptoms that can vary from day to day and are easy to trace to the wrong cause:
· Dizziness or lightheadedness
· Rapid heart rate
· Brain fog and difficulty concentrating
· Extreme fatigue
· Nausea
· Shaking or tremors
· Anxiety or panic-like episodes
· Numbness or tingling in the limbs
02 · The Post-COVID Surge
How COVID-19 Changed the Picture
POTS is not new, but the number of people living with it has climbed sharply. Clinicians across the country have reported roughly a five-fold increase in POTS diagnoses since the onset of COVID-19. Some patients had a pre-existing vulnerability to autonomic dysfunction, but viral infections — COVID-19, Epstein-Barr, and Lyme disease among them — can act as a trigger, unmasking or worsening symptoms that had been simmering quietly.
WWL-TV’s Meg Farris featured this growing health crisis in her report, Invisible Illness: Unmasking the Health Condition Women Are Told Is All in Their Heads — a look at how POTS is so often dismissed, especially among women, and how the pandemic has pushed the condition into sharper focus.
For many women, the road to a diagnosis is long and frustrating. Routine labs and imaging usually come back normal, which too often leaves patients feeling brushed aside. The overlap of hormone sensitivity, immune activation, and post-viral inflammation can create a perfect storm for dysautonomia to emerge or escalate.
03 · What We’ve Found in Our Own Clinic
POTS Rarely Travels Alone
Persistent, treatment-resistant symptoms are often a clue that something deeper is going on. In our own peer-reviewed research published in PM&R, we found that stubborn long-COVID symptoms can point to an underlying, previously undiagnosed connective tissue condition.
Of five long-COVID patients evaluated in our Ehlers-Danlos Syndrome clinic, four were subsequently diagnosed with hypermobile Ehlers-Danlos syndrome (hEDS) and one with hypermobility spectrum disorder (HSD).
This matters because dysautonomia and POTS frequently overlap with hypermobility and mast cell activation — a pattern many clinicians see cluster together, even as researchers continue to work out exactly why. When we treat POTS, we look at the whole picture rather than a single symptom in isolation. It doesn’t matter where you land on the spectrum: a body that isn’t regulating itself well is worth taking seriously, and there is a great deal we can do to help.
04 · Why Women Are Hit Harder
Common Triggers in Women
Several factors help explain why POTS shows up more often in women:
· Hormonal fluctuations across the menstrual cycle, pregnancy, and menopause
· Post-viral dysregulation after COVID-19, mononucleosis, or Epstein-Barr
· Connective tissue differences such as Ehlers-Danlos Syndrome and hypermobility
· Genetic or autoimmune predispositions
05 · A Patient’s Story
From Nurse to Patient Advocate
In the WWL-TV feature, registered nurse Nikki Wiggins, 32, describes symptoms that began while she was working in oncology research — a sudden wave of panic and dizziness in a meeting, followed by months of fatigue, numbness, and visits to specialist after specialist without an answer.
“Getting the diagnosis was the turning point — it meant what I was feeling was real.”
She was eventually diagnosed with POTS after a tilt-table test performed by a cardiologist. While there is no FDA-approved cure for POTS, the diagnosis itself was a turning point. Today Nikki is back at work as a patient case manager and channels her experience into raising awareness for others walking the same path.
06 · The System Behind the Symptoms
The Autonomic Nervous System & Dysautonomia
To understand POTS, it helps to understand the autonomic nervous system. Often described as the body’s “cruise control,” it regulates vital functions automatically — heart rate, blood pressure, sweating, and digestion — without any conscious effort on your part.
When that system falls out of balance — a state called dysautonomia — it can affect nearly every part of the body. That is exactly why the symptoms shift from day to day and are so hard to trace back to a single cause. It is also why the answer is rarely one pill; it is a coordinated plan that helps the whole system settle.
07 · How We Treat It
A Multidisciplinary Approach
There is no single cure for POTS, but a tailored, multi-faceted care plan can meaningfully improve quality of life. At The Fascia Institute and Treatment Center, we combine medical and physical therapies to treat the whole person — not a scattered list of symptoms. Evidence-based strategies we may use include:
Treatment plans are individualized and evolve over time. The goal is to stabilize the nervous system, improve blood flow, reduce symptoms, and support your overall recovery — not just quiet one complaint while another flares.
08 · You Deserve to Be Heard
You Are Not Alone
If you are living with symptoms that don’t seem to have an explanation — or you have been told “it’s just anxiety” — you are not alone. Thousands of women are facing the same thing, and real help is available. We believe our patients. We listen. And we build treatment plans that support your body, your life, and your healing.
Ready When You Are
Let’s Get to the Root of It
If you’re struggling with unexplained symptoms or have been told it’s “all in your head,” we’re here to help. We understand the complexities of POTS and dysautonomia, and we’ll work with you toward a personalized, whole-body plan.
Existing patients: Schedule directly through the FIT PHR app — on the Apple App Store and Google Play.
New to FIT? Call (504) 704-1254 or request an appointment online to schedule your consultation.
References & Media
Farris, M. (WWL-TV). Invisible Illness: Unmasking the Health Condition Women Are Told Is All in Their Heads. wwltv.com
Five-fold increase in POTS diagnoses since COVID-19. European Heart Journal – Quality of Care & Clinical Outcomes. academic.oup.com
Courseault, J., et al. Long COVID and undiagnosed connective tissue disease. PM&R. doi.org/10.1002/pmrj.13120
