What Vitamins Should People with POTS Take?

October 16, 2025 •

4 min read

Many people with Postural Orthostatic Tachycardia Syndrome (POTS) experience nutrient deficiencies that can worsen their symptoms. Knowing what vitamins should people with POTS take can be a critical part of a comprehensive management strategy to address fatigue, brain fog, and other autonomic issues.

Quick Summary

This guide covers vitamins and supplements often recommended for POTS patients, including B vitamins, Vitamin D, and iron, to help address deficiencies. It also details the importance of electrolytes like magnesium and potassium, explains how nutrients impact POTS symptoms, and provides practical advice for incorporating supplements into a daily routine. Note that any supplementation should be discussed with a healthcare professional first.

Key Points

Identify Deficiencies: Many POTS patients have nutrient deficiencies that exacerbate symptoms like fatigue and brain fog, and blood testing can help identify specific needs.
Prioritize Electrolytes: Increasing sodium, potassium, and magnesium intake is crucial for POTS, as these minerals help regulate blood volume and nerve function.
Address B Vitamin Levels: Deficiencies in B vitamins like B1 and B12 can affect energy and nerve function; supplementation, particularly with a B-complex, may help.
Correct Vitamin D Insufficiency: Low vitamin D is common in POTS and can impact energy and immune health, suggesting that supplementation may be beneficial.
Check Iron and Ferritin: Anemia caused by iron deficiency can mimic or worsen POTS symptoms, so iron levels should be tested and corrected if low.
Support Cellular Energy: Supplements like CoQ10 and L-Carnitine may help combat the severe fatigue associated with POTS by supporting energy production at a cellular level.
Combine with Hydration: For supplements to be most effective, they must be paired with sufficient fluid intake, as many POTS symptoms are linked to low blood volume.

Essential Vitamins and Minerals for POTS Management

For individuals with Postural Orthostatic Tachycardia Syndrome (POTS), nutrient deficiencies are common due to issues with digestion, malabsorption, and the body's overactive stress response. Supporting the body with specific vitamins and minerals can help mitigate symptoms and improve overall function. Electrolytes like sodium, potassium, and magnesium are especially critical for fluid balance and blood volume, which are often dysregulated in POTS.

B Vitamins for Energy and Nerve Function

B vitamins play a vital role in energy metabolism and nervous system health. For POTS patients struggling with chronic fatigue and brain fog, a comprehensive B-complex supplement can be beneficial.

Vitamin B1 (Thiamine): Though rare, thiamine deficiency can mimic POTS symptoms like fatigue and blood pressure issues. Some studies suggest that a subset of POTS patients may have a subclinical B1 deficiency that responds well to supplementation.
Vitamin B12 (Cobalamin): A higher prevalence of B12 deficiency has been observed in adolescents with fainting disorders and POTS compared to healthy controls. Since B12 is essential for nerve health and red blood cell production, correcting a deficiency can help improve fatigue and nerve-related symptoms. Vegans are particularly at risk and must supplement.
Vitamin B6 (Pyridoxine): Important for nerve function and energy production, B6 is often included in comprehensive B-complex supplements. However, excessive supplemental B6 can cause peripheral neuropathy, so it is important to monitor intake.
Folate (Vitamin B9): Crucial for cellular function and red blood cell formation, folate is often low alongside B12 and iron deficiencies in POTS patients. Some practitioners recommend methylated folate, especially for those with MTHFR gene variants.

Vitamin D for Autonomic and Immune Support

Low vitamin D levels are common in the general population but are particularly noted in POTS patients, where deficiencies can impact energy levels, bone health, and immune function. Vitamin D also plays a role in nervous system regulation and may help modulate the autonomic nervous system. A case study even reported that supplementing with calcitriol, the active form of vitamin D, led to a patient’s POTS remission. However, larger studies show conflicting results on a strong correlation, and deficiency should be confirmed with testing.

Iron for Addressing Anemia

Iron deficiency and anemia are frequent comorbidities in POTS, especially in menstruating women. Iron plays a key role in oxygen transport throughout the body. Anemia can cause a rapid heart rate and fatigue, mimicking or worsening POTS symptoms. Improving iron stores can lead to a significant reduction in symptoms for some patients. However, it is crucial to test iron and ferritin levels before supplementing, as excess iron can be harmful.

CoQ10 and L-Carnitine for Cellular Energy

Coenzyme Q10 (CoQ10) and L-Carnitine are mitochondrial boosters that can aid in cellular energy production. Fatigue is a hallmark symptom of POTS, and these supplements may help address the energy drain at a cellular level.

CoQ10: This antioxidant is involved in producing ATP, the body's main energy source. Many patients report that CoQ10 reduces fatigue and brain fog, though more research is needed.
L-Carnitine: This amino acid is essential for transporting fatty acids into the mitochondria for energy production. Supplementation has been suggested to support exercise tolerance and endurance in POTS patients.

The Critical Role of Electrolytes and Hydration

While not vitamins, electrolytes are arguably the most important supplements for POTS due to their direct impact on blood volume and fluid balance.

Sodium: Increased sodium intake is a cornerstone of POTS management for most patients, as it helps the body retain water, increase blood volume, and improve circulation. Daily recommendations vary widely depending on individual needs and medical advice.
Potassium and Magnesium: These minerals work in concert with sodium to regulate fluid balance, nerve signals, and heart rhythm. Magnesium, in particular, may help calm the nervous system and reduce muscle cramps and palpitations. Many patients with POTS have low intracellular magnesium, even with normal blood levels.

Comparison of Key Supplements for POTS


Supplement	Primary Benefit for POTS	Evidence Level	Foods Rich in Nutrient
B-Complex	Supports energy and nervous system function	Moderate (especially B1, B12)	Whole grains, eggs, meat, legumes
Vitamin D	Regulates nervous system, immunity, and bone health	Moderate to High (with confirmed deficiency)	Fatty fish, fortified dairy, sunlight
Iron	Addresses anemia and related fatigue	High (with confirmed deficiency)	Red meat, lentils, spinach, fortified cereals
Magnesium	Calms nervous system, regulates heart rhythm	High (anecdotal, some studies)	Dark chocolate, leafy greens, nuts, seeds
CoQ10	Aids cellular energy production, reduces fatigue	Moderate (anecdotal)	Meat, poultry, fatty fish, spinach, soy

Conclusion

While there is no single vitamin to cure POTS, targeted supplementation can play a powerful role in managing symptoms by addressing common nutrient deficiencies. B vitamins, Vitamin D, iron, and cellular energy aids like CoQ10 and L-Carnitine can all help combat the debilitating fatigue and brain fog often experienced by those with the condition. Furthermore, focusing on electrolytes like sodium, potassium, and magnesium is essential for regulating blood volume and nervous system function. Always consult with a healthcare professional before starting any new supplement regimen to ensure it is safe and appropriate for your specific needs. An individualized approach, guided by lab testing and symptom tracking, will yield the best results for managing POTS and improving quality of life. For more in-depth information, the non-profit organization Standing Up to POTS offers extensive resources on nutritional strategies.

Disclaimer: This information is for educational purposes only and should not be considered medical advice. Always consult a healthcare professional for diagnosis and treatment.

Frequently Asked Questions

While vitamin B12 deficiency does not directly cause POTS, there is an association between the two conditions. Low B12 levels may contribute to autonomic nervous system dysfunction and can exacerbate POTS-like symptoms, particularly fatigue. Testing for and correcting a deficiency is often recommended.

Yes, many people with POTS find magnesium helpful. It plays a crucial role in nerve and muscle function, including regulating heart rhythm, and can help calm the nervous system. Some studies have found low intracellular magnesium in POTS patients despite normal blood levels.

Electrolytes, particularly sodium, help the body retain fluid, which increases blood volume. For people with POTS who experience low blood volume (hypovolemia), this can significantly alleviate symptoms such as dizziness and rapid heart rate. Potassium and magnesium also work to maintain fluid balance and support heart function.

Many POTS patients increase their sodium intake with salt tablets, electrolyte drinks, or by adding salt to their food. This is often recommended to increase blood volume. However, it is essential to consult with your doctor before drastically increasing your sodium intake, especially if you have other health conditions like high blood pressure.

Coenzyme Q10 (CoQ10) is a vitamin-like substance that helps produce energy in the body's cells. Anecdotal reports and some research suggest it may help reduce the severe fatigue and brain fog commonly associated with POTS, though its effectiveness can vary.

While a good quality multivitamin can provide a general nutritional baseline, it is often not enough to address the specific deficiencies and high electrolyte needs of many POTS patients. Specialized supplementation of specific nutrients like B-complex, vitamin D, magnesium, and iron is often required, based on individual needs and lab results.

Yes, it is crucial to consult with a healthcare professional before starting any new supplement regimen for POTS. They can help identify specific deficiencies through blood tests and provide personalized recommendations and dosages, ensuring supplements are safe and don't interfere with other medications.