Postural orthostatic tachycardia syndrome (POTS) is a disorder that affects blood flow and can cause symptoms like dizziness, fainting, and heart palpitations after standing up. Some people with POTS have reported issues with memory and concentration. In this article, we’ll explore whether POTS can affect short-term memory.
What is POTS?
POTS is a form of dysautonomia, meaning it affects the autonomic nervous system. This system controls involuntary functions like heart rate, blood pressure, digestion, and more.
In people with POTS, the autonomic system doesn’t properly regulate blood flow when transitioning from lying down to standing up. This causes an abnormally large increase in heart rate, leading to symptoms like:
- Dizziness or lightheadedness
- Heart palpitations
- Shakiness
- Brain fog
- Fatigue
- Headache
- Blurred vision
- Weakness
- Fainting
These signs typically develop within 10 minutes of standing and are relieved by sitting or lying back down. POTS predominantly affects women between the ages of 15-50 years old.
What causes POTS?
The exact cause of POTS is unknown, but several mechanisms may be at play:
- Partial autonomic neuropathy: Damage to the small nerve fibers that help control blood vessel constriction and heart rate.
- Hypovolemia: Lower than normal blood volume.
- Deconditioning: Being less active can cause blood vessels to be less effective at constricting and returning blood to the heart.
- Hyperadrenergic state: Higher levels of adrenaline can increase heart rate and cardiovascualr responses.
- Autoimmunity: POTS may sometimes be associated with autoimmune disorders like lupus or Sjogren’s syndrome.
- Genetics: Variants in certain genes may predispose someone to developing POTS.
Often, POTS arises due to a combination of these factors that disrupt normal blood flow regulation.
Common POTS symptoms
The hallmark symptom of POTS is a rapid increase in heart rate of 30+ beats per minute when moving from lying down to standing up. This is accompanied by symptoms like:
- Dizziness
- Fainting
- Weakness
- Fatigue
- Tremors
- Heart palpitations
- Chest pain
- Shortness of breath
- Headache
- Brain fog
- Blurry vision
- Nausea
- Stomach pain or discomfort
- Temperature dysregulation
- Sleep disturbances
- Anxiety
Many of these are related to the abrupt drop in blood supply to the brain when standing up. Lying back down typically relieves symptoms within a few minutes.
Is brain fog a symptom of POTS?
Yes, brain fog is a very common symptom of POTS. An estimated 80% of people with POTS experience problems with memory, concentration, and mental clarity.
Brain fog refers to difficulty thinking clearly, finding the right words, focusing, recalling information, and completing mental tasks. It may feel like your mind is full of cobwebs.
Brain fog occurs because the rapid heartbeat and drop in blood pressure in POTS reduces blood flow to the brain. This transiently impairs cognitive function.
Can POTS cause short-term memory loss?
Yes, many studies have found that people with POTS demonstrate impaired short-term and working memory compared to healthy controls. Some research suggests up to 80% of POTS patients have memory difficulties.
Short-term memory involves recalling information over a brief timeframe, like a phone number you just heard or details from earlier in your day. Working memory is the active manipulation of information, like mental math or following recipes.
In one study, adults with POTS showed deficits in both auditory and visual working memory compared to controls. Their reaction times were also slower on memory tasks.
Multiple brain imaging studies reveal reduced blood flow and oxygenation in areas involved in memory when people with POTS stand up. This ischemia temporarily affects cognition.
Fatigue and brain fog related to constantly dealing with POTS symptoms can also interfere with memory formation and recall.
Memory issues reported in POTS
Some specific short-term memory problems reported by those with POTS include:
- Forgetting conversations and instructions shortly after they occur
- Losing one’s train of thought or forgetting what one was saying mid-sentence
- Forgetting to run errands or complete tasks
- Difficulty recalling words and vocabulary when speaking or writing
- Forgetting details about one’s daily schedule or recent events
- Struggling to remember facts, appointments, deadlines, birthdays, etc.
- Having to re-read paragraphs multiple times to retain the information
These issues primarily arise from impaired working memory and concentration, rather than a permanent loss of long-term memories.
Tips to improve memory with POTS
The memory problems associated with POTS are generally temporary and reversible if you can improve your symptoms. Some tips include:
- Stay hydrated – Drink 2-3 liters of electrolyte-rich fluids daily.
- Increase salt intake – Help retain fluids and support blood volume.
- Wear compression garments – Help push blood back to the upper body.
- Exercise – Helps grow new blood vessels and improve conditioning.
- Raise the head of your bed – Improves symptoms at night.
- Take brain-boosting supplements like B vitamins, ginseng, ginkgo biloba.
- Reduce stress through yoga, meditation, counseling, and good sleep habits.
- Use memory aids like calendars, journals, sticky notes, alarms, apps.
- Stay organized and keep items in assigned places.
- Minimize multitasking and distractions when concentrating.
Treating any underlying factors like anemia, thyroid disorders, sleep apnea, or depression may also help.
POTS-related memory issues are usually mild. But if they begin severely impacting daily function, talk to your doctor about referral to a neuropsychologist for evaluation and management.
Does POTS get worse over time?
POTS does not directly cause progressive cognitive decline or dementia. The memory issues arise from temporary blood flow changes.
However, the severity of POTS symptoms can fluctuate over time. Periods of greater fainting spells, brain fog, and fatigue may impair short-term memory more than periods with milder symptoms.
How POTS progresses depends on the underlying cause and management approach:
- If POTS is due to deconditioning, exercise and building up activity tolerance often improves it.
- POTS triggered by a viral illness may resolve over time.
- Effectively treating secondary factors like migraine, poor sleep, or depression can reduce POTS severity.
- Conditions like neuropathy or hyperadrenergic POTS may worsen if the underlying disease progresses.
- POTS tends to follow a relapsing-remitting course, with symptom fluctuations.
While POTS itself does not cause dementia, experiencing recurrent fainting can increase future risk of dementia. Seeking treatment to prevent fainting episodes is important.
When to see a doctor
See your doctor if you experience persistent issues with memory, concentration, or thinking that affect your quality of life. Some signs that warrant medical evaluation include:
- Brain fog and confusion that is getting worse over weeks/months
- Memory problems are impacting relationships, work, or school performance
- Others notice your memory seems impaired
- Friends/family say your personality seems different
- You feel constantly distracted and unable to focus
- You struggle with comprehension or completing familiar tasks
- You feel lost, disoriented, or unsure of recent events
- Symptoms are significantly worsening over time
A doctor can check for issues like nutritional deficiencies, thyroid disorders, side effects of medications, sleep apnea, and other causes of cognitive dysfunction. They may recommend neuropsychological testing for further evaluation.
Conclusion
Many people with POTS experience transient short-term memory loss and brain fog, especially when standing up. This is caused by temporary decreases in blood flow to the brain.
Managing POTS symptoms and maintaining adequate blood volume, nutrition, and activity levels can help improve temporary cognitive deficits. While POTS may fluctuate over time, it does not directly worsen into dementia or permanent impairment.
Seeking treatment for recurrent fainting episodes and addressing any secondary factors contributing to POTS severity is important to help minimize impacts on memory.
