The Experience Miracles Podcast

Q&A Is POTS Genetic—Or Is Something Bigger at Play?

Aug 8, 2025

Is POTS Genetic? What Actually Causes POTS in Kids and Teens

Episode 128, Experience Miracles Podcast | Host: Dr. Tony Ebel, DC, CACCP, Pediatric Chiropractor & Founder of PX Docs | Published: August 8, 2024 | Duration: 8 min

Key Takeaways

  • POTS (Postural Orthostatic Tachycardia Syndrome) affects an estimated 1 in 100 teenagers and is far more common in females than males. The primary cause is not genetics, it is autonomic nervous system dysfunction, specifically involving the vagus nerve.
  • The vagus nerve acts as the body’s “brake pedal,” regulating heart rate, breathing, inflammation, and social-emotional health. When it is compromised by physical tension in the neck and shoulders, what chiropractors call subluxation, POTS symptoms emerge.
  • Modern stressors including emotional stress, physical injury, infections, and chemical toxins (especially from skincare and cosmetic products) overwhelm the nervous system and trigger the dysregulation that drives POTS.
  • Dysautonomia, dysfunction of the autonomic nervous system, is the medical term used alongside a POTS diagnosis, but conventional medicine has no clear physical explanation or solution. Neurologically-Focused Chiropractic Care addresses the root cause directly.
  • When subluxation is corrected and vagus nerve tone is restored through chiropractic care, the autonomic nervous system rebalances, and the body’s own healing can take over.

What Really Causes POTS in Children and Teens?

POTS (Postural Orthostatic Tachycardia Syndrome) is not primarily a genetic condition. According to Dr. Tony Ebel, DC, CACCP, the real driver is autonomic nervous system dysfunction, specifically an overactive sympathetic “fight-or-flight” response combined with an underperforming vagus nerve that fails to counterbalance it.

POTS now affects an estimated 1 in 100 teenagers and is significantly more prevalent in females than males. The classic symptoms, dizziness, fainting, rapid heartbeat, and persistent anxiety when standing, are not random. They trace directly to the vagus nerve’s failure to regulate blood pressure, heart rate, and orthostatic stability. The vagus nerve runs from the brainstem down through the neck and shoulders, which is why physical tension in those areas, known as subluxation, is a key, often-overlooked trigger.

For parents, this distinction matters enormously. Being told POTS “runs in the family” with no path forward is very different from understanding that the underlying nervous system dysfunction has physical, identifiable causes that can be directly addressed. Neurologically-Focused Chiropractic Care targets these root causes: releasing tension from the upper cervical spine and shoulders, restoring vagus nerve tone, and helping the autonomic nervous system return to balance.

POTS Symptoms and the Genetic Myth [00:01:00 – 00:02:00]

Dr. Tony Ebel, DC, CACCP: Watching your teenager or young adult child struggle with unexplained dizziness, fatigue, rapid heartbeat, frequent fainting, and near-constant anxiety can be terrifying and frustrating. Every time they stand up or shift positions, you hold your breath, wondering if they’ll feel faint or need to sit back down.

You’ve probably been told that POTS, Postural Orthostatic Tachycardia Syndrome, runs in the family and that genetics are to blame, or that they simply don’t know what’s causing it. But the truth is, the main cause or trigger of POTS is nervous system dysfunction and nervous system dysregulation, specifically within the autonomic nervous system and the nerve that helps control or regulate blood flow, blood pressure, and overall balance within the body.

Vagus nerve dysfunction, and something called subluxation, is often to blame for this neurological condition that now affects 1 in 100 teens and is far more common in females than males.

The real culprit throws your child’s heart rate up and down, throws their nervous system inside and out, and causes them not to trust where their body is in space. This underlying nervous system dysfunction can actually be the thing triggering that constant anxiety and “on edge” feeling that too many kids and adults struggling with POTS, and the loved ones around them, are experiencing all the time.

Modern Stressors and Why Girls Are More Affected [00:02:00 – 00:04:00]

The real culprit is an overstressed, dysregulated nervous system. We are living in the most highly stressful, chaotic, and toxic world we’ve ever seen. All of this stress, whether it’s mental and emotional, physical from an injury to the neck and shoulders (which is directly connected to POTS), or from an infection or immune system challenge that triggers inflammation and irritates the vagus nerve, drives this dysregulation.

Even chemical stress plays a role. Toxins are everywhere. One theory for why POTS is more common in girls involves the chemical load coming into a female’s system through skincare products, makeup, and perfumes. This isn’t limited to teenagers, it’s happening with grade schoolers too, in a world where chemicals are increasingly unavoidable.

“The vagus nerve is our counterbalance, it’s the brake pedal to the nervous system.”

When the nervous system is overwhelmed, it goes into an overactive sympathetic response, that’s the rapid heart rate and the anxiety. But the fainting, the collapse, the postural instability that defines POTS? That’s where the vagus nerve comes in.

The Vagus Nerve: The Body’s Brake Pedal [00:04:00 – 00:05:00]

Dr. Tony Ebel: The vagus nerve is our counterbalance, it’s the brake pedal to the nervous system. It leaves from the brainstem, runs down through the neck and through the shoulders (which is why there’s such a strong physical, postural component to POTS), and then it’s in charge of calming the heart rate.

The vagus nerve also calms breathing rate and respiration. We now know it controls social-emotional and mental health regulation. And it controls inflammation, which is why POTS symptoms can be initially triggered by illness, and why they reliably worsen when a child is sick.

“The vagus nerve controls our social-emotional and mental health regulation, and when it’s compromised, inflammation, heart rate, and anxiety all spiral together.”

Supporting vagal nerve tone, essentially, how charged and functional that nerve is, is essential to addressing POTS at its root. This is not about symptom management. It’s about restoring the nerve that controls nearly every regulatory function involved in POTS.

The Missing Physical Component: Subluxation [00:05:00 – 00:07:00]

It’s worth pausing on the word “postural” in POTS. Conventional medicine doesn’t look at POTS from a physical construct. That’s the missing link.

What’s found again and again with POTS patients is a severe level of physical neuromechanical tension. The chiropractic term for this is subluxation, in the neck, shoulders, and thorax. This causes not only visibly poor posture, but constant tension, irritation, and interference with vagus nerve function.

The vagus nerve is literally a wire that needs to run from the brain and brainstem down to the respiratory system, to heart rate regulation, and then to the eyes, the vestibular system, and the inner ear, where it regulates orthostatic, up-against-gravity balance.

“POTS is perhaps the most common medical condition where they will bring up dysautonomia, but that doesn’t mean they know what to do about it.”

When there’s too much sympathetic fight-or-flight and too little parasympathetic vagal nerve tone, that’s dysautonomia. POTS is one of the most common conditions where medicine uses that term, but acknowledging dysautonomia isn’t the same as knowing how to address its physical cause.

Neurologically-Focused Chiropractic Care and Natural Recovery [00:07:00 – 00:08:00]

Dr. Tony Ebel: This is where Neurologically-Focused Chiropractic Care comes in.

Chiropractors trained in this approach know how to get physical pressure and stress off the neck, off the shoulders, and in turn off the vagus nerve. They know how to release stuck tension within the sympathetic nervous system. And they know how to stimulate and activate the vagus nerve, restoring balance and regulation to the entire autonomic nervous system.

When that happens, the body begins making its way back into balance. The teenager or young adult who couldn’t stand up without near-fainting can now handle positional changes, handle stress, and move through daily life, because the vagus nerve and autonomic nervous system are doing their job again.

That’s why the body can get better on its own, because the real root cause of POTS and its related challenges has been addressed.

Frequently Asked Questions

Is POTS genetic, or is it caused by something else?

While POTS often appears to run in families, Dr. Tony Ebel explains that the primary driver is autonomic nervous system dysfunction, not inherited genetics. POTS affects an estimated 1 in 100 teens. The real trigger is an overactive sympathetic nervous system combined with poor vagus nerve tone, a physical, addressable condition, not a genetic sentence.

What actually causes POTS symptoms like dizziness and fainting?

POTS symptoms stem from the vagus nerve’s inability to regulate heart rate, blood pressure, and orthostatic stability. When physical tension (subluxation) in the neck and upper spine compresses the vagus nerve, the body loses its ability to rebalance when moving from sitting or lying to standing, producing dizziness, rapid heartbeat, and fainting.

Why is POTS more common in girls and young women?

Beyond differences in postural stress patterns, females are exposed to a significantly higher chemical load through skincare products, makeup, and perfumes. Dr. Tony Ebel identifies these chemical stressors as contributing to nervous system dysregulation, particularly disrupting vagus nerve function in ways that make POTS symptoms more likely to develop.

What is the connection between POTS and dysautonomia?

Dysautonomia refers to dysfunction of the autonomic nervous system and is often the term used alongside a POTS diagnosis. POTS is one of the most common presentations of dysautonomia. However, conventional medicine’s use of the term doesn’t translate into treatment for the physical cause, the subluxation and vagus nerve compression that drives the dysfunction.

Can chiropractic care help children and teenagers with POTS?

Yes. Neurologically-Focused Chiropractic Care addresses the physical root cause of POTS by removing tension and subluxation from the neck and upper spine, reducing interference with the vagus nerve, and restoring balance to the autonomic nervous system. As vagal nerve tone improves, the body’s ability to self-regulate heart rate, blood pressure, and positional changes returns naturally.

How do I find a chiropractor who treats POTS and dysautonomia in children?

The PX Docs directory lists chiropractors trained in Neurologically-Focused Chiropractic Care across the country. These practitioners are equipped to assess nervous system function using INSiGHT Scans and apply targeted care for conditions like POTS and dysautonomia.

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