Make Visible: Chronic Illness Explored #31 POTS: Symptoms, understanding, and management with Dr Tae Chung
Apr 3, 2026
Dr Tae Chung, Director of the POTS Program at Johns Hopkins and autonomic specialist. He explains what POTS looks like, how it is diagnosed, and why personalized, multidisciplinary care matters. They cover practical testing at home, lifestyle strategies like hydration and salt, exercise risks and rehab, and new research into post-COVID POTS and biomarkers.
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Target Volume Expansion To Reduce Symptoms
- Aim therapies at increasing venous return and blood volume: hydrate, increase salt, use volume-retaining meds and supervised exercise as volume-expansion therapy.
- Tae Chung emphasizes combining medical drugs and tailored physiotherapy rather than unsupervised gym programs.
Supervise Gradual Cardio To Avoid Setbacks
- Introduce cardiovascular training gradually under a therapist who understands POTS and pair it with medications when needed.
- Overdoing cardio causes setbacks; coordinated PT and meds (e.g., midodrine) improve tolerance and progression.
Match Medication To Mechanism
- Use medications targeted to physiology: midodrine for vasoconstriction, fludrocortisone for volume retention, beta blockers or ivabradine for excessive tachycardia.
- Choose drugs based on whether you need volume expansion or heart-rate control and monitor effects with wearables.