Case Study.

POTS functional medicine.

Meet Chelsea, a patient since 2022.

When Chelsea (female, 20’s) joined Index Health, she was struggling with POTS, chronic fatigue, and Fibromyalgia. Her goals were to improve her focus, reduce her use of medications, and enhance her exercise tolerance.
While this patient’s name and photo have been changed to protect her anonymity, she agreed to share her results here so that future clients can see what to expect from working with Index Health.

Results After 8 Months.

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Medical Data.

Time to outcome

Pepcid + Midodrine



Amitriptyline + 5-HTP + Venlafaxine

Discontinued + Dose Halved

7 Weeks

OCPs + Venlafaxine + Pregabalin​

Discontinued + Weaning

~3.5 Months​

Pyridostigmine + Corlanor + Pregabalin​

Discontinued + Doses Halved

5 Months

Welchol + Corlanor

Doses halved

8 Months

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Results Summary.

  • Slow and steady reduction in multiple medications.
  • Improved focus and reduced fatigue
  • Resolution of dysautonomic symptoms
  • Improved exercise tolerance. Acheived goal to run one mile without stopping.

Initial Diagnosis.

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  • POTS
  • Fibromyalgia
  • Chronic Fatigue Syndrome
  • GERD
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Meds & Supplements.

  • Meds: Adderall, Midodrine, Amitriptyline, Pregabalin, Pepcid, Escitalopram, Pyridostigmine, Promethazine, OCPs
  • Supplements: Fibro Formula, Digestive Enzymes, Adrenal Cortex, Salt tabs5-HTPMelatonin
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Health Goals.

  • Health optimization
  • Improve energy
  • Deprescribe medications

Treatment & Personalized Plan.

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Lab Results.

  • Nutritional insufficiencies: Folate + RBC Zinc*, CoQ10 + Vitamin D*, Iron (low ferritin 31)
  • Very high B12 and SHBG
  • GI-Effects: high sIgA, low SCFAs, borderline EPI, low Akkermansia spp.
  • Mycotoxin panels (GPL+RTL): Ochratoxin + Enniatin B, Gliotoxin + Zearalenones
  • Gut Health testing shows low elastase, high sIgA, presence of heavy growth of a potential pathogen (Klebsiella oxytoca), also lesser growth of Citrobacter and Klebsiella pneumoniae
  • Genomics insights: VDR +/+, PAI-1 +/+ (4G/4G), Absent GSTM-1, CYP1A1 +/- (hyperinduction, caution PAHs/HCAs)
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Meds & Supplement Changes.

  • Methyl folate
  • GABAergic natural agent for anxiety
  • Paleofiber + RestorFlora
  • Mycotoxin regimen: Glutathione, Medi-Clay, Floramyces, Welchol (Rx)
  • Added alternative antiemetic: low-dose haloperidol
  • Psych changed her SSRI to Venlafaxine
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Lifestyle Changes.

  • Minimal intensity with exercise.
  • Akkermansia-promoting diet strategies.
  • Stopping OCPs as tolerated.
  • Vagus Nerve Stimulation (TENS)
  • Limbic retraining (Unlearn Your Pain)
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Nutrition Plan.

  • Addition of apple cider vinegar pre-meals
  • Akkermansia-promoting foods: deep red fruits, bitter greens, walnuts, and fatty fish​
  • Resistant starches (larch arabinogalactans, plantains, etc) and soluble fiber (to increase SCFAs)
  • Seed cycling for promoting hormone balance
  • Mitochondrial-focused nutrition plan
  • Food focus: sources of zinc, vitamin D, iron, folate

Ready to begin your better health journey?

After reading the above POTS Functional Medicine case study, you can see this patient’s phenomenal health improvements, which greatly benefitted her quality of life. The experts at Index Health can also help you to relieve your symptoms and improve your health.

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Ready to diagnose and treat the root cause of your symptoms?

Index Health offers telehealth appointments with functional medicine specialists to get to the root cause of your symptoms from the convenience of your couch. Interested in POTS functional medicine options? Contact Us for a free consultation.