The Experts: Dr. Santa Maria on Saline Therapy for POTS Patients

Dysautonomia is the kind of illness that comes unique to every patient. When the autonomic nervous system misfires and dysfunctions, it can leave a200423583-001 patient with a host of perplexing symptoms that affect nearly every major organ system in the body. From heart-pounding Postural Orthostatic Tachycardia to painful gastroparesis and disorienting migraines—this is an illness that is difficult to diagnose, and even more difficult to treat.

One of the treatments I prescribe for my patients with Postural Orthostatic Tachycardia Syndrome is Intravenous Saline Therapy. Although Dysautonomia is treated with a variety of symptom-based prescriptions, cardiac rehab, and other therapies–simple IV fluids can begin to calm many symptoms of and provide instant relief to a suffering patient.

What is POTS?

Postural – Dependent on posture.

Orthostatic- Referring to the upright or vertical.

Tachycardia- Accelerated heart rate (fast heartbeat.)


Put it all together and it refers to a syndrome characterized by an increase in heart rate by 20-30 beats per minute or more when the person stands up.

This fast heart rate is abnormal and can lead to dizziness, weakness or even fainting. The normal person will respond to standing up with NO noticeable change in heart rate. The heart and blood vessel system has an automatic compensation system which seems to fail for some unknown reason in the person who develops POTS.

The increase in heart rate can be associated with a drop in blood pressure, no change in blood pressure or an increase in blood pressure, depending on the patient.

It is important to realize that this condition can occur suddenly or gradually in a person who was completely fine previously and never had anything like it before.

How does IV Saline Therapy improve POTS Symptoms?

IV Saline is an isotonic solution used to maintain adequate hydration in many clinical settings. The term “isotonic” suggests that it has the same density as normal blood and contains the same amounts sodium and chloride concentrations as normal blood so that electrolyte balance will not be affected. We all know instinctively that we cannot drink sea water because it is “hypertonic” and would cause our brain to shrink up and we would die from the excess amount of sodium and chloride per unit volume of water. What is less well appreciated is that we would also become very sick from drinking excessive amounts of “free water”  i.e. water with NO sodium or chloride in it. This would profoundly dilute the concentrations of sodium and chloride in the bloodstream and would not be good for heart and brain function.

By using one liter of IV saline we safely expand the circulating blood volume without affecting the sodium and chloride (“electrolyte”) concentrations. The circulating blood volume of a normal sized individual is approximately 5 liters so we are increasing it by about 20%. This can significantly help with supporting upright blood pressure and slowing the reflex tachycardia.

I also find that due to gastroparesis and malabsorption associated with dysautonomia, many patients experience a Vitamin B deficiency and greatly benefit from a dose of liquid Vitamin B complex injected into their saline solution.

Patients have reported that IV therapy has lessened their fatigued, improved gastric motility, migraines, joint pain, can often assist with calming tachycardia.­­­­

How Can Patients Access Saline IV Therapy?

I’ve rarely come across fellow physicians who offer IV’s in their office, as I do. It is such a simple therapy to provide for patients, but many doctors do not have the time or resources to establish infusion centers within their daily practice. Patients can find assistance at walk-in clinics or emergency rooms. They may also be able to work with their physician to schedule IV’s on a weekly basis at a local infusion center. This is usually covered by insurance. It is best to give saline preemptively on a regular schedule instead of on an emergency basis when a patient is already in the depths of their worst symptoms. Regular hydration can provide a sense of stabilization and normalcy for patients, allowing them to have more control over their bodies, health and ultimately—their lives.

DSCN0120About the Expert 

Dr. Santa Maria is a concierge physician working in Boca Raton, FL. He works with all types of patients and specializes in cardiovascular disease treatment and prevention, nutrition, lipid management, weight control and chronic illness.For more information on receiving saline therapy through Santa Maria Medicine please visit or call 561-338-0737