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POTS Pro Tips - Weather, Altitude, Flying & Barometric Pressure Changes with POTS


Pro-Tips Managing Pressure with POTS

While most people casually discuss that the weatherperson says it's going to rain tomorrow, people with Postural Orthostatic Tachycardia Syndrome (POTS) have bodies that are like human barometers. Things that might seem like simple small talk events to some can make a big difference in the daily lives of people with POTS.

To be fair, feeling the storm coming in some contexts before the development of modern day meteorology may have been an advantage. In modern society however, not only is it not very useful, but it can be pretty inconvenient. People with POTS can have a wide variety of symptoms that come with the weather change including headaches, dizziness, swelling, brain fog, and muscle/joint soreness to name a few.

There is a general consensus amongst people with POTS and other dysautonomia conditions that things like weather changes, altitude and airplane rides affect their symptoms. Unfortunately, finding answers to questions like: "Why does the weather change affect me?" and the even more important question "What can I do about it?" Have gotten very little attention and research funding.

For those who need to understand the "why" let's take a look at the available evidence and delve into some possible explanations.

We suspect that the barometric pressure on the outside of your body effects the pressure on the inside. While POTS specific research isn't available yet, there are studies that suggest that the barometric pressure impacts some other conditions like arthritis and fibromyalgia. (1, 2)

There are many functions in our bodies that depend on pressure. Your lungs use negative pressure to suck air inward when you inhale. You also have a blood pressure of the force of your blood pressing against your veins and arteries. Then there is what we call "interstitial pressure", or the pressure of the blood that has moved out into your body's tissues to supply them with oxygen and nutrients.

There has to be balance between this interstitial pressure and the pressure in your veins to control how long the blood stays out in your tissues before being transported back to the heart and lungs in your veins to pick up more nutrients again.

When the mechanisms your body uses to control these pressures aren't working properly for a person with POTS, their symptoms start to appear. If the pressure against the skin on your legs decreases because of a weather change outside, it can allow the blood to sit in your tissues, rather than being pushed back into circulation in your veins. That's how swelling happens.

If the pressure in your legs isn't doing what it should, then your blood pressure might not be high enough to force the blood all the way up to your brain. Gravity will always pull blood down, so our bodies have to work to get it up higher when we're standing.

If we think about how blood works in our bodies, the reason weather changes affect us may not be such a mystery after all (See POTS University). As the barometric pressure drops around us with the changing weather, suddenly the external pressure against our bodies decreases. That means that internally, your body has to be able to adjust to the change in order to continue moving the blood in your tissues back into circulation. If it can't do that effectively, you may start to experience swelling in your arms and legs as well as other POTS symptoms.

The barometric pressure changes with storms, but altitude can have a similar effect. When you ride in an airplane, they attempt to control the cabin pressure. Your ears are very sensitive to pressure too. Most people will chew gum or yawn to "pop their ears" and allow for the pressure in their ears to adjust. For infants and small children that haven't figured out how to do this yet, they often cry and are uncomfortable of flights.

Living in a body that has POTS, can be uncomfortable like that too. The difference is, POTS isn't something that everyone grows out of. We are still learning the best ways to treat it.

Unfortunately, when it comes to flying in a plane, or long car rides, there are a couple of other factors that make things worse.

First, the dry air can dehydrate you. As the car or airplane attempts to maintain a consistent temperature within the heating and cooling system has to circulate the air. If the air is not humidified in the process (which it generally isn't) then your body has to add moisture to the air as it moves into your lungs. This uses up extra fluid. If your body doesn't have enough fluid to go around, it may not be making as much blood as it should. If there is less blood to go around, then it can aggravate your POTS symptoms.

Second, when you are flying on a plane or sitting for a long car ride, you aren't moving much. When we move around, our bodies naturally increase our heart rates and try to circulate blood more quickly to supply our muscles with oxygen and nutrients. At the same time, as you contract your muscles, you compress the interstitial fluid and veins that run into those muscles which helps to pump the blood.

Now that we better understand the problem, we are able to start coming up with solutions. The big question everyone asks is: "So what can I do about it?" As promised here are some tips and tricks for navigating weather changes, plane rides, and managing pressure changes with POTS


8 Pro-Tips Managing Pressure with POTS

  1. Wear your compression garments. If the atmosphere is not going to accommodate you by providing barometric pressure on your tissues, you can add some extra of your own. (See product recommendations for ideas on compression wear)

  2. Manage fluid and electrolyte intake. Make sure that your body has enough building blocks to keep your blood volume up. The more blood you have to go around, the less it will affect you that the pressure isn't helping the blood move where it needs to be as efficiently. This is important both before you travel and after you arrive.

  3. Cross your legs or squat on your seat. This restricts blood flow down to your legs and keeps it up closer to your heart and brain (See The POTS Squat)

  4. Take breaks from driving if you're able to get up and move.

  5. If you're flying, exercise in your seat or get up and move if possible. As you do, you help your body pump the blood in your system.

  6. Exercise regularly. Regular aerobic exercise helps encourage your body to store more blood volume. Doing it in a pool, or consulting your POTS specializing physical therapist can help if you're having a hard time exercising. They can teach you targeted exercises that are specifically for people with POTS.

  7. Wear cool clothing. If you're overheated, your body will sent blood to the surface of your skin to get rid of the heat.

  8. Talk to your doctor about medication. There are pharmacological treatments available that can help manage POTS.


As always, this article is intended for educational purposes and is not a replacement for individual medical advice. If you are interested in seeking personalized recommendations for managing POTS or other conditions with physical therapy, call or Book Online to schedule your consultation.


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