Is There a Link Between Nasal Obstruction and POTS?

If you have POTS (Postural Orthostatic Tachycardia Syndrome), you're already familiar with dizziness, a racing heart, and crushing fatigue. You might also have a constantly stuffy nose and assume it's just allergies or bad sinuses.

But what if that stuffy nose is actually making your POTS symptoms worse? It sounds strange, but new research suggests these two problems might be connected. This blog breaks down the link in simple terms.

What is POTS?

Think of your autonomic nervous system as your body's "autopilot." It automatically controls things like your heart rate, blood pressure, and digestion without you having to think about it.

In POTS, this autopilot system is malfunctioning. When you stand up, instead of keeping your heart rate steady, it goes into overdrive. This causes:

• Rapid heart rate (increase of 30+ BPM upon standing)
• Dizziness or lightheadedness
• Fatigue and "brain fog"
• Blood pooling in extremities (which can cause reddish-purple discoloration in legs)

POTS affects an estimated 1–3 million Americans, primarily women of childbearing age.

What Causes Nasal Obstruction (Stuffy Nose)?

Nasal obstruction occurs when airflow through the nose is blocked due to various reasons. The most common causes include:

• Allergies or chronic sinusitis (swelling and mucus buildup)
• Deviated septum (structural misalignment)
• Autonomic dysfunction (abnormal blood vessel dilation in nasal passages)

 The Surprising Connection: How Nasal Issues May Worsen POTS

Since your body's "autopilot" system (the ANS) controls both your heart rate and the blood vessels in your nose, a problem in one area can cause a problem in the other.

1. Autonomic Nervous System Dysfunction

If your autopilot system is misfiring and making your heart race when you stand up, it can also misfire and tell the blood vessels in your nose to swell shut. This means the same root cause can trigger both POTS and a stuffy nose.

Research Insight: Studies show that ANS imbalances can trigger both nasal obstruction and POTS symptoms simultaneously 

2. Overactive Immune Cells (MCAS)

Many people with POTS also have a condition where their immune cells overreact and release too much histamine (the same chemical that causes allergy symptoms). This can cause:

• Stuffy, congested nose
• Expanded blood vessels, which makes POTS dizziness worse

3. Reduced Oxygen and Blood Flow

Chronic nasal obstruction can lead to:

• Poor sleep (due to mouth breathing), which worsens POTS fatigue
• Lower oxygen intake, causing the heart to compensate by increasing the heartrate, exacerbating POTS symptoms

Can Treating Nasal Obstruction Help POTS?

Yes, it might! While treating your nose won't cure POTS, it can remove an extra burden from your body and help you feel significantly better. Here’s how:

1. Non-Medication Approaches

• Saline rinses: Flush out irritants and calm inflammation.
• Nasal dilators: Small stickers or inserts that hold your nostrils open atnight.
• Elevating the head while sleeping: Reduces nasal congestion and helps with breathing.

2. Medications (Talk to Your Doctor First):

• Antihistamines: Helpful if MCAS is contributing to your symptoms.
• Nasal corticosteroids: Used to manage chronic sinusitis and inflammation.

3. Addressing Underlying POTS

In addition to managing nasal obstruction, addressing POTS symptoms may also help you feel better:

• Increase salt and water intake: Boosts blood volume and improves circulation
• Compression stockings: Prevents blood pooling in legs
• Graded exercise: Improves circulation and overall cardiovascular health

When to See a Doctor

If you’re dealing with any of the following, it’s a good idea to consult an ear, nose, and throat (ENT) specialist or an autonomic specialist:

• Chronic nasal congestion combined with dizziness or fatigue
• Worsening POTS symptoms when sinus issues flare up
• Signs of MCAS, such as flushing, itching, or gastrointestinal problems

Sinus Specialist in Schaumburg and Rockford, Illinois

At Exhale Sinus, TMJ, Headache & Sleep, our specialists understand the POTS-nasal connection. We offer:

• Advanced diagnostics (sinus CT, autonomic testing)
• Personalized treatment plans
• Cutting-edge therapies

Take the next step and schedule online or call to book an appointment.

Exhale Sinus, TMJ, Headache, & Sleep serves Schaumburg, Rockford, and surrounding communities.  

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