CEREBRALOf Tampa Bay
(727) 677-0001Schedule
HomePractice AreasAboutTestimonialsEventsBlogWhite PapersIn the MediaContactSchedule an Appointment
From Our Doctors

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.

More from the JournalView all ›

Our Doctors

Experts in spinal and neurological care

Get Started

Request an Initial Appointment

Expert care starts with discovery. Schedule a consultation with one of our doctors to see if you may be a candidate for care. Let’s get down to the root cause of the problem — fill out the form and we’ll get back to you to schedule your initial consultation.

Who is this appointment for?
Were you referred by another doctor or provider?
Are you experiencing any of these symptoms?
These are conditions we commonly see, but they’re not the only ones we help. Please be as thorough as possible about what’s going on so we can get you to the right person to help.
HeadachesMigrainesDizzinessVertigoBalance issuesP.O.T.S.Pressure in the headBrain fogMénière’s diseaseTrigeminal neuralgiaOccipital neuralgiaConcussionMTBINeck painWhiplashBack painAnxietyOther
What are you noticing with your child?
These are things we commonly see, but they’re not the only ones we help. Please be as thorough as possible about what’s going on so we can get you to the right person to help.
Posture issuesADHD / ADDAnxietyAsthmaAutismBirth TraumaConstipationCyclic Vomiting SyndromeEar infectionsPANDAS / PANSSeizuresSensory ProcessingSleepSpeech DelaysOther
Do you have a preferred doctor?
Which days work best for your first appointment?
We do our best to accommodate and get you in at our first available appointment.
MonTueWedThuFri
Something went wrong — please call us at (727) 677-0001.
Thank you — we’ve received your form
A confirmation is on its way to your inbox, and someone from our team will personally reach out to schedule your initial consultation.