Episode #31
Ep 31. POTS 2.0: What to Do When Salt and Water Aren’t Enough w Cardiologist Dr Alexis Cutchins
POTS is often introduced with the same advice: drink more water and eat more salt. What happens when that isn’t enough? In this episode, we welcome back cardiologist Dr Alexis Cutchins for a practical deep dive into diagnosing and managing POTS. We talk through what can be done in primary care, when further cardiac investigation is useful, how to make salt, fluid and compression actually work, and how to approach exercise without triggering a crash. Then we go beyond the basics, covering medications including midodrine, fludrocortisone, desmopressin, ivabradine and beta blockers, how blood pressure can help guide treatment, and why finding the right combination often takes some trial and error. We also discuss orthostatic intolerance that doesn’t quite meet the textbook POTS criteria, the importance of early treatment, and why people shouldn’t have to wait a year for specialist review before anyone starts helping them feel better. A practical episode for people living with POTS, the people who care about them, and health professionals wanting more confidence about what to do next.
