55 - HMN - Transcript - POTS and Migraines - Are They Connected
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Dr. Leslie: You are listening to the Healing Migraines Naturally podcast. I'm your host, Dr. Leslie Caesar, and I'm helping women all over the country rediscover a migraine free life. Today I am talking to Mary, who runs our awesome Facebook community about pots and migraines. Are they connected? Welcome, Mary. How are you?
Mari: Hey guys, how's everybody?
Dr. Leslie: Good, good. How?
Mari: Actually, it's fairly mild for the middle of, you know, almost well here, almost to July. So for Utah it's been pretty mild. We've had a lot more rain and overcast than normal, so not too bad.
Dr. Leslie: Yeah, that's not too bad. Does it get real hot there in the summer, like, uh, like Phoenix does, or
Mari: well, not quite that bad of course. But yeah, it does get pretty toasty. Quite
Dr. Leslie: It's hot and dry There.
Mari: Yeah. Yep. But so I always hear pots and pans, but [00:01:00] I've never heard pots and migraines together, so
Dr. Leslie: Yeah. Yeah, yeah, yeah, yeah. Well, this is, I wanted to talk about this because, um, when, uh, when we're prone to migraines, what I have discovered in my work is that there's, um, other health conditions that people also tend to be prone to along with the migraines. And so POTS is definitely one of those other conditions that kind of rides along with migraines.
Mari: Right.
Dr. Leslie: Um, and so this question has come up, uh, you know, Many, many times over the years in my free Facebook group, you know, does anyone have pots too? You know, I have pot. I just got diagnosed with POTS after many years of, you know, searching for answers and I have migraines. Are they connected? You know, this is a question that [00:02:00] comes up pretty frequently.
Dr. Leslie: And then with my clients, uh, this is a very, very frequent, if people don't have an actual diagnosis of pots, they have the symptoms of POTS sort of undiagnosed that they struggle with. Um, and it's, gosh, I mean, I haven't done it, uh, an audit, but, uh, the symptoms, like I say, not necessarily people formally diagnosed, but people having the symptoms of pods.
Mari: Mm-hmm.
Dr. Leslie: put that around 25% of my clients,
Mari: Well, and I'm just looking at you. I told you I was gonna have Google apps so I could understand,
Dr. Leslie: of course.
Mari: this page with you, but it looks like a lot of the symptoms also can be mistaken for other things like this sounds, this sounds like a typical anxiety attack in some ways, so,
Dr. Leslie: Mm-hmm.
Mari: Interesting.
Mari: So let's go backwards a minute. Can you explain what POTS is? And I want you to do the [00:03:00] big words that go.
Dr. Leslie: You want me to do the big words, right? So, um, so POTS is an acronym for Postural Orthostatic Tachycardia Syndrome. Okay. So, in medicine there are many diagnoses where the, the diagnosis, the name used to diagnose the condition is simply medical language to describe the symptoms that people experience. Okay.
Mari: Like, like tachycardia. Is your heartbeat beating fast?
Dr. Leslie: Mm-hmm. Exactly. So if we go through the words and, and look at the definition of these medical terms, it becomes sort of clear what the condition actually is. Okay. [00:04:00] Um, so the first word we have, um, postural. Okay. So postural refers to our position. Okay. The position of our body. It specifically refers to the position of your head.
Dr. Leslie: Okay? So our, if we're kind of, or, or you could say our head, relative to our body. Um, so if we're laying down, our head is in line with the rest of our body. If we're standing up, our head is at the top of our body. Right furthest from furthest from the ground. Right? So the postural in pots refers to body position.
Dr. Leslie: And so we have symptoms that are kicked off when there's a change in body position or posture. Okay? This doesn't mean posture, like, you know, uh, you know, the old time grandmother's telling you to stand up straight. This [00:05:00] is more your body position, particularly your head relative to your body.
Mari: okay.
Dr. Leslie: Um, now orthostatic that refers to, um, movement of the blood.
Dr. Leslie: Okay? Um, and so, uh, orthostatic is usually used in the context of hypotension, okay? Or low blood pressure. Okay? So orthostatic. In this case means low blood pressure when there's a change in the posture.
Mari: Okay.
Dr. Leslie: Okay? Now the tachycardia, right? This is a medical term that a lot of people recognize. Tachycardia.
Dr. Leslie: Tachy means like fast cardia. That means like heart, right? So fast heartbeat. Okay? So we have on a [00:06:00] change of posture, we have a drop in the blood pressure and an increase in the heart rate.
Mari: Mm-hmm.
Dr. Leslie: Okay? And then we just have syndrome because they throw the syndrome on there to make it a diagnosis. Okay?
Mari: Right.
Dr. Leslie: But those, so those medical terms as part of the diagnosis, that kind of gives us a clue as to what's going on. So, um, when people. Uh, get up. Now again, I'm saying, you know, I'm saying, okay, this is a syndrome. This is a diagnosis, this is a medical condition. Now, let me ask people, have you ever, you know, gotten down on the floor to pick something up, you know, straighten up the toy bin and you've been kneeling on the floor, and then you get up and you feel a little woozy,
Mari: Oh yeah, regularly
Dr. Leslie: right?
Dr. Leslie: So,
Mari: like I stand up too fast and literally my, I start to black out and
Dr. Leslie: exactly right. Yeah. It's like, [00:07:00] oops, I got up too fast. How many times do people say that? Or like, if they're laying down on the couch watching TV and then, you know, they sit up real quick, it's like, woo. Right? So
Mari: yeah.
Dr. Leslie: that is a postural orthostatic. At a minimum, what you're experiencing when that happens is postural orthostatic hypotension.
Dr. Leslie: Okay. But when we have that hypotension occur, our heartbeat is going to increase. Okay? And we're gonna talk about why. Okay? So the increased heartbeat some people may not be aware of, cuz our heart has to start really pounding quite a bit for us to become consciously aware of it. So this phenomenon, right?
Dr. Leslie: I mean, if you were to actually question people whether or not they have this set of symptoms or not, you're gonna capture a lot of people in this net. [00:08:00] Okay? So let's, uh, go through, uh, so a little bit more on this. Any questions, Mary, for me before we dig a little deeper?
Mari: Well, I'm, I'm assuming you're gonna get there anyways, but I was just gonna say, let's, um, quickly talk about like what the symptoms are like. Um, For example, dizziness, lightheadedness, um, what else does that usually, what is our body actually experiencing symptom-wise?
Dr. Leslie: Yeah. So people will sort of the, uh, mildest set of symptoms that people are going to experience is that little bit of whew. Stood up too fast. Let me just, whew, let me just take a little pause here, right. If it's severe, then. Um, people are going to experience much, a much more severe sense of whoa, right?
Dr. Leslie: So they can be dizzy, lightheaded. They might actually [00:09:00] even sort of feel like a curtain is coming down on their visual field. Um, Worst case scenario, people would actually faint. Okay. Lose consciousness. And that can be very dangerous, right? We don't wanna be standing up and faint and then knock our head on something.
Dr. Leslie: Okay? Um, people can have, um, you know, they might feel foggy, they might feel tired. Um, this could definitely generate a headache for people. Um, and then the heart palpitations the tachycardia, right? If it's a little tachycardia, we're not gonna notice that, really. But if it's severe, then we feel that heart pounding in our chest.
Dr. Leslie: And this is where, like you said before, people can feel like I'm having a panic attack here. What's going on? Right? Because we don't like it when we feel our heart beating in our chest. You know, if we're having like a little skipped heartbeat or heart palpitations or our heart starts pounding, we [00:10:00] don't like that, right?
Dr. Leslie: That. Doesn't feel good. And so even that sense, even the ability to sense our heart beating can generate a lot of anxiety for people. You know, what's going on with my heart? You know, am I having a heart attack? I mean, obviously your heart is a critical organ, right? So
Mari: Most of
Dr. Leslie: are feeling something in there, then they might just feel anxious just from that,
Mari: I like. Yeah. Most of us tend to like our hearts and want them to feel good
Dr. Leslie: Exactly. Right. And I also don't wanna think about my heart. I just want it to do its job and me not be aware of it. Right.
Mari: Exactly. This also talks about shortness of breath and shaking and sweating.
Dr. Leslie: Yeah. So we will talk about why that would happen. Okay? Um, so the shortness of breath that can be due to the anxiety that somebody would naturally, you know, wouldn't be unreasonable if somebody felt anxiety, if they felt like they were gonna faint, or, you know, their heart starts beating their, their respiration might increase.
Dr. Leslie: Um, but there [00:11:00] are also some hormonal reasons why that could happen too. So let's dig in to what's going on physiologically in the body and biochemically in the body. Okay? So, um, I want you to think of, right, like you're laying on the couch watching TV and your body is horizontal, right? So gravity is pulling on your body equally on all parts of your body, right?
Dr. Leslie: Because you are horizontal.
Mari: Right.
Dr. Leslie: Now we humans, we're upright. Right? When we're awake, we're supposed to be up and about walking around. Okay? So actually when, when we are upright standing on our feet, gravity is pulling down on our body and pulling the blood out of our head all the [00:12:00] time,
Mari: Hmm.
Dr. Leslie: right? If we're laying down, then our blood, blood, right?
Dr. Leslie: If, if our heart were not pumping anything right, and we were laying down flat, our blood would be level. Right, because right. Just like you put like a level on a hard surface that, that, that water and the level, it, it flattens out, right? But if you put the level upright, that water is gonna come down and you're gonna have the bubble right at the top.
Dr. Leslie: So we're like that. When we're standing up, gravity is literally pulling the blood out of our head, towards our feet. Now we have to have blood in our brain to function,
Mari: Right.
Dr. Leslie: So our circulatory system, our heart, and our, our entire system of blood vessels is continuously maintaining a blood pressure so that [00:13:00] the blood is pumped into the brain and maintained at a consistent flow. So I want you to think about how amazing that is, right? So that you know the ability for that to take place for us and, you know, o other animals, right? As, as soon as we're not in the water, as soon as you know, the organisms left the water, we had to contend with this, okay?
Mari: Right,
Dr. Leslie: So this is an amazing feat that without any of our conscious awareness, our, uh, the circulatory system is maintaining a continuous and constant blood flow in the brain, despite gravity, continuously trying to pull the blood down.
Mari: Right.
Dr. Leslie: So when we get up, right? So if we're kind of down on the floor picking up those toys, or we're laying on the couch, we are very rapidly moving [00:14:00] from that horizontal position where gravity is not. A factor to going upright, and then suddenly you have gravity, just whoosh, right? Pooling all of that blood right down.
Mari: Right.
Dr. Leslie: So whenever we have that change in position,
Mari: Mm-hmm.
Dr. Leslie: the circulatory system has to increase the pressure within it to pump that blood into the brain. Now, how is it going to do that? Okay, this is where biochemistry comes in. Hormones come in, okay? So our adrenal glands, which are over our kidneys, so they're kind of like in the back.
Dr. Leslie: If you put your fists like on the small of your back, that's where your kidneys are, and then your adrenal glands are sitting on top of your kidneys. So the adrenal glands produce adrenaline and noradrenaline, or they, [00:15:00] these hormones are sometimes called epinephrine and no epinephrine. And these are commonly called like stress hormones, right?
Dr. Leslie: Like people think of adrenaline, you know, fight or flight. You know, I'm in a car accident and the adrenaline, uh, came out and now my heart's pounding and I'm sweating and I'm woozy and everything else, right?
Mari: Which sounds exactly like the symptoms of pot, really. Pots, I should say pot, not pot. The S actually is important in this case.
Dr. Leslie: Exactly right. So yes, you can see where we're going here, right? So the, when we change the position, the adrenals have to, Squirt out that adrenaline and noradrenaline into the bloodstream. Those molecules have to find receptors [00:16:00] within our blood vessels and within our heart to activate a sort of like a squeezing, right?
Dr. Leslie: If you wanna increase the pressure inside of a tube, you squeeze the tube, You have to contract the blood vessels a little bit, and then you have to get the heart rate pumping a little bit more rigorously, right? So if we want a little bit more pressure in that tube, we can squeeze the tube and then we can put more force behind the pumping, and that's what those two hormones do.
Mari: Mm-hmm.
Dr. Leslie: So that is, An amazing cascade of events that take place within an instant of us changing our position.
Mari: Right. I think it's really cool too that our body knows that our vital organ is the brain and the heart, and so it automatically does whatever it takes to make those [00:17:00] two things. Okay. Right.
Dr. Leslie: Correct? Yes. And our body is going to do whatever it takes to keep us conscious,
Mari: Mm-hmm.
Dr. Leslie: right? Because if we fall unconscious, we've got a big problem on our hands, right? So that is so, so when this is all hap, when this all happens smoothly, okay, we are laying on the couch. One second, the phone rings and the next, and we are up and at him.
Dr. Leslie: Okay? And we don't have any symptoms. We're just living our life. We're not even thinking twice.
Mari: Mm-hmm.
Dr. Leslie: Okay. Maybe if we were to take our blood pressure, if we were to take our pulse a little bit, we would see some changes, but it really wouldn't be noticeable to us. We would have to kind of measure that with equipment to even know that anything was changing.
Mari: Right.
Dr. Leslie: And you know, you can see this with, uh, kids, kids are up and down all the time, right?
Mari: Mm-hmm.[00:18:00]
Dr. Leslie: Right. Most children, they're not kind of going, oh, whoa, I better stop doing these cartwheels. Right. They're just going at it.
Mari: Right,
Dr. Leslie: This is something that starts to happen as people get older. Okay.
Mari: I can't tell you the last time I did a cartwheel.
Dr. Leslie: Yeah. I could never do cartwheels. I'm, I was never a big, uh, physical athletic type person. I was more of a science nerd.
Mari: Yeah.
Dr. Leslie: So, um, so that's what's supposed to happen. Okay. So let's talk about what happens in pots or what happens to people who don't have the diagnosis but are having the symptoms.
Mari: Mm-hmm.
Dr. Leslie: So, um, let's say that, uh, well, so, so let me just walk through what is generating the symptoms first.
Dr. Leslie: Okay. So we're laying down on the couch, our cell [00:19:00] phone dings a notification and we wanna get up and check it. And so we pop up off the couch and then we feel like we're gonna faint. The room is spinning, our heart's pounding. We're, you know, we're sweating, right? What's going on here? So, what has happened is the posture has changed, okay?
Dr. Leslie: And either our adrenal glands are so worn out. And so fatigued that they're like, oh man, she's getting off the couch. I don't know.
Mari: once I feel the same way.
Dr. Leslie: Right? Uh, can't she just lay there another five minutes? Right? And so they're real slow creating those hormones. Okay? So then our heart in our circulatory system is not getting the message, Hey, tighten up here, pound a little harder.
Dr. Leslie: We gotta get, keep the blood in here,
Mari: Hmm.
Dr. Leslie: right? And so [00:20:00] then what happens is it's like, whoa, where's the blood? Right? It's like, I feel, I can see that curtain coming down. My vision. I'm like, I'm not in my body anymore. I'm, I'm woozy, I'm, the room is spinning. I can't think, right? Because there is an adequate blood in the brain.
Dr. Leslie: Gravity is pulling it out of there.
Mari: Interesting. I was just going to ask you like, I guess a normal body should be able to do that without any issues or whatever, right? So what?
Dr. Leslie: we are in a state of health, then that is just gonna happen. Just like boom, boom, boom. I'm up, I'm checking my phone, I'm onto the next.
Mari: Right, but something has gone wrong, so now our adrenals are not working properly,
Dr. Leslie: exactly, exactly. So let me go through what is sort of the second pattern, and then we'll talk about why this happens because that's, that's really [00:21:00] right. You're, you're like, okay, why is this happening? Right.
Mari: right?
Dr. Leslie: So the second picture would be a situation where I'm on the couch, my phone dings, I pop up, and my adrenals are completely overstressed.
Dr. Leslie: What's she gonna do next? I'm on high alert here. Oh my goodness. She got up the, and the adrenal said, I better just blast her. Right? We gotta get the, we gotta keep that blood in the brain and the adrenals just blast the body with the adrenaline and the noradrenaline, right? So then we have this flood of stress hormones, fight or flight hormones.
Mari: So they kinda go on overdrive to make up for the sluggishness in a
Dr. Leslie: Exactly. They go into overdrive, and so then you're gonna get all those symptoms that you would get if you were in a car accident. My heart is [00:22:00] pounding, I'm sweating, I'm chic, I'm jittery, you know? Oh my goodness, my stomach. What? When we are in a fight or flight mode, right? The body says, well, if I have to run, I can't be lugging around food in my stomach.
Dr. Leslie: I gotta empty the digestive tract, right? This is why when people have have a fright, they're vomiting, they're having a loose stool, because the body is like, okay, if I gotta do whatever it takes to survive, I can't have this food in my gut.
Mari: Right.
Dr. Leslie: So then people are nauseous, right? So, um, like I'm on the, uh, John Hopkins, uh, Medi Medical, uh, web page that describes pots.
Dr. Leslie: So if you go down the symptoms here, right, you can see, right? Cuz some of the symptoms, it's like, well, okay, um, I'm real lightheaded or I'm shaky, right? It's like, kind of like, what, how would I have both? You're not necessarily going to have [00:23:00] all of this at once. You're going to have a different sort of subset of symptoms depending on if your adrenals are underreacting or overreacting. Now that is a symptom too. Okay. So either pattern is a symptom that our adrenal glands are not in a state of health. Okay? So let's talk about why that happens. Unless you have any more questions for me, and I, and I, I hope you do. If, if you do,
Mari: Um, no, I, I had gotten back to the part about the stomach digesting and I was just thinking about, um, learning with adrenaline and all of that. Like, the number one thing it does is like divert energy to parts of your body that your body needs. So if your body is in fight or flight, you don't need to be digesting food, right?
Mari: So it shuts your [00:24:00] digestion down, which is, I feel like why we get the butterflies in our stomach kind of feeling like nauseous or, you know, nervous feeling in your stomach. So I wasn't really having a question as much as contemplating that process.
Dr. Leslie: Yeah, you're exactly correct. You are exactly correct. Right? Because it's like if I'm in a life or death situation here, I don't really care if I'm breaking down this food two hours from now. Like I have to stay alive in the next 15 minutes,
Mari: Right, exactly.
Dr. Leslie: right? And so it's like, get this, get this outta here, right? And in a most extreme reaction, we're gonna have that loose stool, or we're gonna be vomiting it up out of our stomach.
Dr. Leslie: But yeah, in a lesser situation, right? We've got, oh yeah, my stomach, right, there's something and I'm a little nauseous, or you know, I have those butterflies or there's something going, going on there. It starts rumbling, you know, different digestive symptoms. Absolutely. You're [00:25:00] gonna have, um, That going on Absolutely.
Mari: I just don't understand why that has to happen when you're like going to a job or interview or the first day. So like really?
Dr. Leslie: Right? Well, let's, uh, I, I mean, I'll digress a little bit. How many people have digestive symptoms?
Mari: Oh, probably all of us. I would assume.
Dr. Leslie: Right. So it's like a lot of people are in that lower stress level a lot of the time, right? But when we're in that lower stress level, we're still releasing adrenaline. Also, cortisol is another hormone that, uh, IM, you know, implements this fight or flight response.
Dr. Leslie: So you can see, right, when you understand what these hormones are designed to do, you can see how they can be affecting you more on a day-to-day basis, even [00:26:00] at a lower level.
Mari: That's so true. Yep. But that, yeah, that was the, not my question, but just my contemplation.
Dr. Leslie: absolutely. Yeah. No, it's, it's a great point. So how does this happen? Okay, so when you go on the John Hopkins Medicine website, and John Hopkins, probably one of the most famous medical systems in the world, right? When you go on their website and read their, uh, writeup on pots,
Mari: Mm-hmm.
Dr. Leslie: it is a complete medical mystery to them. They really have no idea what, what causes this.
Mari: So no idea why some people get such an extreme response to their body positioning change versus, like, most of us can do [00:27:00] it pretty good 99.9% of the time. We don't necessarily have any reaction. I mean, I like, I do get, I black out occasionally, but it's like once a year, you know, like, Most of us don't deal with that very often.
Dr. Leslie: Yeah. Yeah. So they have no idea why this happens, which is a mystery to me because I just described to you the known physiology and biochemistry
Mari: Mm-hmm.
Dr. Leslie: of the circulatory system as it relates to the, to us moving around and changing our posture, which you can find in any medical physiology, textbook or medical biochemistry textbook.
Mari: Right.
Dr. Leslie: All right. Now, why would the adrenals not be generating their hormones [00:28:00] correctly? Again, it comes back to what I call the three principles that are required to restore and maintain our health.
Mari: Mm-hmm.
Dr. Leslie: And I have come to these three principles via my knowledge of medical physiology and biochemistry. And so there are three things that we have to do to restore our health and maintain our health.
Dr. Leslie: And these three principles apply at a cellular level, at an organ level, and at a whole body level. So, Our adrenal glands. In order to make adrenaline, they have to have certain nutrients to make the hormone. And this is what I call the first principle to restoring and maintaining our health. We have to get the nutrients that our cells need to the [00:29:00] cells.
Dr. Leslie: Otherwise, how would they have the fuel to do what they're supposed to do? You know, we don't just make adrenaline outta Starbucks, frappuccinos and unicorn dust,
Mari: Uh, maybe it's a Dorito dust though.
Dr. Leslie: right? Maybe it's a chee, right? A Cheeto dust. Right? So our adrenal gland, and again, I'm not just like making this up. You can open up a biochemistry textbook and read about all the nutrients that are required to make adrenaline so. Okay. So if a little cell within that adrenal gland is supposed to make that adrenaline when we get up off the couch and it doesn't have the nutrients that it needs to make the adrenaline, guess what does not happen?
Mari: Mm-hmm.
Dr. Leslie: Right? And then you look at that not just from like a one little cell, but what if like 80% of the cells in your adrenal glands don't have the nutrients that they need to make the adrenaline when you get off the couch, you're not gonna have the adrenaline you need when you get off the couch.[00:30:00]
Mari: Right.
Dr. Leslie: Right? Um, the second principle to restoring and maintaining our health is clearing metabolic waste material. So when our, when that little cell in the adrenal takes those little nutrients and makes that adrenaline waste material is generated, everything that our cells do, they, they make a little, a little, uh, protein, they make a little molecule.
Dr. Leslie: Waste material is generated at the same time. That has to be removed from the cell, uh, and then put into the bloodstream where our organs of detoxification process that molecule so that it can get out of the body. Okay? So in order to get things in and out of the cell, so even to get the nutrients that the cells need into the cell and to get the waste material that the cells make out of the cell, we need other nutrients.
Dr. Leslie: Okay? Things are not just [00:31:00] kind of floating around and randomly happening. Everything in our body is dictated by little receptors on cell membranes. There's pumps that pump things in and outta cells, uh, that are fueled by things like sodium and potassium. Okay? So tons and tons of nutrients are needed just to get things in and out of our cells.
Dr. Leslie: So we may not need the sodium and potassium to make the hormone, but we need the sodium potassium to operate the pump, to pump the nutrients in and pump the waste material out. Okay. So that second principle, we've gotta get the waste material out of the cell for the, you know, the cell's not gonna function properly if it's like on an episode of hoarders.
Dr. Leslie: Okay.
Mari: Sorry, the visual
Dr. Leslie: Right. I mean, a lot of our cells are like, they're got a lot of stuff in there that shouldn't be in there. [00:32:00] Okay. And then the third principle to restoring and maintaining our health is restoring our vitality. Okay. And when I talk about that, I mean at a cellular level, what I'm talking about is the actual cellular voltage.
Dr. Leslie: Okay. So there has to be a voltage difference between the inside of the cell and the outside of the cell in order for the cell to function properly. And they've actually measured that a healthy cell is functioning at negative 40 milliamps. Okay. So we have to have that vitality in the cell, the voltage in the cell.
Dr. Leslie: We also have vitality at a whole body level, at the level of our consciousness, okay? When we're getting into that aspect of the body, some people might call it the vital force or the life force, the animating force. Okay? But at the cellular level, there's literally a voltage that has to be there within the cell. [00:33:00] So if the cell, so what they have also measured is as cells become, quote unquote, less healthy, as the cell starts to function less and less efficiently, the voltage changes. So if we don't have that correct voltage differential, the cell is not gonna function optimally. Okay? Okay. So you can see with this, right?
Dr. Leslie: These three principles that I talk about all the time in this podcast, you know, these apply everywhere to every cell in the body. And if these conditions are not met, our cells are not gonna be functioning optimally, and then the organ is not gonna be functioning optimally. And in this case, if the adrenals are not functioning optimally, the circulatory system cannot do what it is supposed to do, right?
Dr. Leslie: You go into a cardiologist, they're not talking to you about your adrenal glands,[00:34:00]
Mari: Mm-hmm.
Dr. Leslie: but the heart is not just pumping without any other feedback from the body.
Mari: Right.
Dr. Leslie: Right. So your circulatory system, your heart rate, your blood pressure, right, is tremendously affected by your adrenal glands. How many cardiologists, how many of you have gone into a cardiologist and talked about adrenals?
Mari: Mm-hmm.
Dr. Leslie: All right. Now, this obviously explains why you would have the phenomenon where you're not making enough adrenaline. What about this overexcited state? Okay. So for many things within the body before things sort of, you know, kind of fall through, you know, decline and kind of fall into the basement, things get overactive so many times, not all the time, but many times, the first stage of decline [00:35:00] is going to be combated by the cell with overactivity.
Dr. Leslie: And this is extremely prominent with the adrenal glands. So as these three conditions start to decline, the cells go, okay, wait a minute, here, I'm, I'm, I'm running out. I better, you know, kind of make hay while the sun shines kind of a thing, right? Let me just get as much as I can out here. And they be, start to become hyper sensitive to things. The other factor that I see over and over again is that when we have an accumulation of metabolic waste material, we also become hypersensitive. And so I think that is probably playing a role in this as well. So as the trash starts to pile up within those cells, the cells are getting a little irritated and they're on kind of like a hair trigger.
Dr. Leslie: Oh, she moved, poof. Right? I've gotta punch a punch. A whole bunch of stuff out.[00:36:00]
Mari: That makes sense.
Dr. Leslie: So the correction for this is to, I first identify where there are blockers or missing pieces specifically for the individual within these three principles. We know they're there because they have pots. But what are they specifically for this particular person? And then work to address those deficiencies or blockers or missing pieces.
Dr. Leslie: And then you're gonna see this turnaround, and I see this over and over and over again with my clients. Like I say, around 25% of my clients when we start working together, have this list of symptoms to some degree. And the most common is when I bend over and stand up, I'm, I'm dizzy,
Mari: Hmm.
Dr. Leslie: I'm Woo. Okay, let me pause a minute.
Dr. Leslie: Right? That's gonna be kind of the first stage of this. And then as the deficiencies in [00:37:00] the blockers continue to pile up and the adrenal glands continue to decline, then you're gonna get more and more of these symptoms.
Mari: Interesting. I don't know that I would've connected the two. Like you said, how often do you talk about your heart and your adrenals in the same sentence? So
Dr. Leslie: Yeah.
Mari: makes, makes total sense.
Dr. Leslie: So, you know, um, I don't, when I, when I have clients with this symptom picture, we are naturally, I, I mean, we are going to automatically be addressing the pots along with their migraines because the deficiencies within these three principles are generating all of the symptoms that the person has. They're generating the migraines, they're generating the pot symptoms, they're generating the heartburn, you know, whatever [00:38:00] complete symptom picture that she has. Ultimately it's because of blockers or deficiencies or missing pieces. Within these three principles, we've identified those. We get to work on those, and then the rising tide lifts the boats of all of the symptoms, right?
Dr. Leslie: So this is something when somebody has these symptoms, I'm asking them every week when we meet, have you had a dizzy? You know, many people will be dizzy, multiple, you know, multiple times a week or, or daily, right? So, okay, this week was the dizziness. A little bit better, little bit worse. Exactly the same, right?
Dr. Leslie: Many times this will improve even before the migraines improve.
Mari: I was gonna ask you, like, now that you brought up dizziness again, like, you know, I do get vertigo, migraines, right?
Dr. Leslie: Mm-hmm. Mm-hmm.
Mari: does that have more to do with this, um, this situation? Or is it more like just the regular migraine, do you know what I mean? Or, or is it, or is it both?[00:39:00]
Dr. Leslie: Great. Great question. So we are, we have our own innate susceptibility to different symptoms. So some people are very susceptible to getting dizzy.
Mari: Right.
Dr. Leslie: And so, um, other people are very susceptible to, uh, like problems with the lungs, you know, oh, anytime I get a cold, I'm probably gonna get pneumonia.
Dr. Leslie: Or, you know, this, like here in Chicago right now, we have the, uh, Canadian wildfire smoke. We had the worst air quality in the world a couple days ago, right? And so, you know, if people have a tendency towards lung symptoms or their lung as a system is sort of a weak si uh, uh, system, right? They're going to Oh, right.
Dr. Leslie: Any little thing, I'm getting a lung symptom,
Mari: Mm.
Dr. Leslie: right? And so, um, women [00:40:00] who have vestibular migraines, right, they're usually going to be prone to dizziness, right? So what's very typical, like when women have. P you know, common migraines where the main symptom is the head pain. Right. It's very common for them to say, yeah, when I was a kid, I had a tendency towards headaches. Right? And then as these deficiencies and these three principles continue to accumulate as they get older, well the, you know, now they're prone to head pain, now they have migraines. Right. Traditional migraine and with vestibular migraines, right. It's like, I've never been somebody to go on a rollercoaster.
Dr. Leslie: I'm never gonna go on that. You know, fiddler's, flinging ride at, you know, at at a fair. I'm never gonna go on the tilter whirl. Right. It's like they're a little, they're prone to that symptom.
Mari: Right.
Dr. Leslie: Do you, does is that, I, I don't mean to, you know, you [00:41:00] don't have to answer this. We can cut this,
Mari: Yeah, no. You know, I'm pretty open and I have, I don't have any shame, so we're fine. No, I, I actually don't really remember having any sort of headaches or anything as a child. I mean, I don't remember getting dizzy. I don't, I don't know. So it, but then on, on the other hand, I have so, such a vague memory of my childhood in general.
Mari: So I, if that's cuz I didn't have them, or I just don't remember, you know,
Dr. Leslie: Yeah.
Mari: I remember being dit as a. Yeah,
Dr. Leslie: So, yeah, so, so we have tendencies towards symptom clusters or symptom pictures that are largely inherited, largely genetic, right? Um, but that doesn't mean we're doomed to that. It, it just means that when we [00:42:00] fall out of a state of health, when we have blockers or deficiencies or missing pieces within these three principles, those are the particular symptoms that we are going to express.
Mari: Mm-hmm. That makes sense.
Dr. Leslie: Right. So, um, so yeah, I think, uh, again, I haven't done a case review on this. I think you raised a very interesting question and just kind of thinking back over the years, uh, yeah. People with these symptoms, are they gonna be more prone to dizziness with their migraines even? I'd have to do like a full review, but, you know, many people have, uh, common migraines where the main fixture is pain, but they also feel dizzy and it's not technically a vestibular migraine.
Dr. Leslie: Right. But there can be a lot of dizziness with, uh, you know, common migraine, regular migraine.
Mari: Yeah, I think we, especially in the Facebook group, [00:43:00] um, there's often questions of, you know, do you get this symptom or that symptom with migraines? And it seems like dizziness does come up quite frequently.
Dr. Leslie: Mm-hmm. Yeah. So, um, like I say, when I'm working with my clients, we're looking at all of their symptoms and I'm assessing, okay, where are all of the symptoms heading? Right? And not every symp, you know, not all symptoms get better at the same rate, but we should see movement in the symptoms, right? I, if we're moving towards health and we're gonna see improvements, symptoms are going to get a little bit better, a little bit better, a little bit better.
Dr. Leslie: And so when people have this cluster of symptoms, it's a really, really useful symptom to me because it's easy for people to assess. Right. If people have hypertension, high blood pressure, well, you have to check that with a machine for us to know whether or not it's changing. Because [00:44:00] unless your blood pressure is extraordinarily high, you're you, you don't experience symptoms.
Dr. Leslie: Right. But you sure know when you're dizzy. You sure know when you're out gardening and then you get up from pulling weeds and you're like, whoa. Right? Like that's very obvious to people. So I like it when people have symptoms like this because it makes it easier to, to track and make sure that we're on the right track.
Dr. Leslie: Right, right. Path with people because it's pretty easy for people to notice a difference.
Mari: Yeah. That's interesting. I wonder, I mean, not that you can catch that at the exact moment it's happening, but it would be interesting to have someone, um, hooked up to a blood pressure monitor to measure like that. I'm sure they've done studies, but it would be interesting to see it in action. You know what I mean?
Dr. Leslie: Yeah, so that's actually one of the diagnostic criteria for
Mari: Mm-hmm.
Dr. Leslie: um, where you lay on a table and you can kind of do this in a low tech way, [00:45:00] or you can do it in a high tech way. But the low tech way is you kind of lay on the exam table and you get rested. You know, you're kind of like, okay, I've laid on the exam table, maybe five minutes.
Dr. Leslie: You know, your heart rate goes down, your respiration goes down to normal, and then gravity is pulling on you equally cuz you're horizontal. And then they put a blood pressure cuff on you and then they have you sit up and then they press the button and then they take your blood pressure, right? And so the, you know, and that machine will take your pulse too.
Dr. Leslie: So they're looking for a decrease in your blood pressure and an increase in your heart rate.
Mari: Mm-hmm.
Dr. Leslie: Um, they, the high tech way is something called a tilt table. So you're laying on a table that kind of tilts, you kind of press a lever and then it kind of put, tilts you up, moves your head up, um, automatically, and then they take your blood pressure.
Dr. Leslie: But you can do it [00:46:00] in a, you know, you can do it in a low tech way.
Dr. Leslie: Um, so, you know, me personally, I mean, definitely there have been times in my life where, uh, oh yeah, get up too fast, I'm in trouble. Right? Um, so this is, this is something that's really, really common for people and, you know, I've never been diagnosed with pots. I never, uh, I never suffered from it enough to pursue a diagnosis.
Dr. Leslie: But you can imagine if somebody was plagued by this every day, every time they're moving around, they're having some sort of symptoms. Uh, you can imagine. Um, just how debilitating and frustrating and anxiety provoking it can be.
Mari: Right. Especially when like, I don't know, I think I, like you said, anytime it involves your heart, I think it does tend to increase the anxiety and you know, [00:47:00] you experience something weird with your heart. It's definitely like a major rate red flag. Whether it's just something little and you don't know it, it still feels big, like what's going on, you know?
Dr. Leslie: Mm-hmm. For sure. For sure. I think another one, like, I've had the experience where it's like a black curtain coming down on my vision. That's not, that's not fun either. That's pretty anxiety provoking. So, you know, something like that. And then the heart, yeah, people are gonna freak out. Why wouldn't they?
Mari: I get that black curtain probably more than any other symptom when I stand up too fast. What, what exactly. I mean, I, and I understand that the blood's drained from your brain, but like why does it feel like there's a black curtain going in front of your eyes?
Dr. Leslie: Well, yeah, because we really don't see with our eyes, right? We see in the back of our brain. So as the blood is draining out, the visual cortex where we're, we are actually [00:48:00] seeing things that isn't, uh, doesn't have fuel anymore, doesn't have oxygen and nutrients anymore, and so it's like, okay, the curtain's going down, lights are going off.
Mari: Yeah. That's not a pleasant feeling at all. I don't not enjoy that. Yeah.
Dr. Leslie: so very good. So, uh, any other questions for me? Do you think we covered it? What, what do you think?
Mari: I think we did. I, I think I'm out of question. So it's been interesting. Like I said before, I, I've never really made the connection between this POTS syndrome and migraines, so.
Dr. Leslie: Mm-hmm. Mm-hmm. And let me, let me actually touch on the, maybe the last point here, which is one of the symptoms of POTS is headaches, right? So if we're prone to headaches,
Mari: Mm-hmm.
Dr. Leslie: a great way to get a headache or a migraine is to have a [00:49:00] fight or flight response.
Mari: Mm. Actually, I was going to men ask and mention that y like a little bit ago was, um, kind of like how we keep talking about the stressors on the body and when you have stressors, like the hormones can be a stressor, right? So that increases your chance of having a migraine, right?
Dr. Leslie: Mm-hmm. Yes. So, yes. So, uh, for listeners, we're talking about, um, the stressors are what a lot of migraine sufferers call triggers, right? That kind of knock us out of balance and tip us over into a migraine. So yes, you are absolutely correct, Mary, when we have that fight or flight response, that is a tremendous physical stressor on the body.
Dr. Leslie: Absolutely.
Mari: Okay. So yeah, I mean, it kind of, it makes complete sense if you have this pot situation where you stand up [00:50:00] really fast, all of your hormones kick on, your body goes into a stress situation, and then you end up with a migraine later on. It makes total sense. So
Dr. Leslie: Yep.
Mari: unfortunately we don't enjoy it, but it does add up.
Dr. Leslie: Right. And this is the point, I guess, well now I'm gonna make one more point, Mary.
Mari: That.
Dr. Leslie: but th this is, you know, another, uh, thing that I wanna get across. Okay. When you go on the esteemed John Hopkins Medicine website and they act like, ah, so just a mystery why this happens. We don't know. You know, it's just something that happens. It sends a message to people that their body is broken and defective and kind of like weird, you know, like, why am I getting this weird stuff that nobody knows why this is happening?
Mari: Mm-hmm.
Dr. Leslie: Right. And what is the, you know, number one thing that women [00:51:00] with chronic migraines say, my body hates me, my gene are defective.
Dr. Leslie: Right? We just have this whole, you know, I've had clients where their neurologist said their brain had faulty wiring and that's why they got migraines. Okay? So again, we have, within conventional medicine, there's this constant attitude that we're having these symptoms because, oh, well, we don't know. Just something, you know, you're, you're the weirdo.
Dr. Leslie: We don't know why this is happening. Something's wrong with you.
Mari: Right.
Dr. Leslie: When if they just simply reopened their physiology textbooks, the physiology textbooks and biochemistry textbooks that are behind me on my bookshelf that I had to memorize in naturopathic medical school are the same medical textbooks that all medical schools use. I'm not going through some kind of woowoo naturopathic physiology and biochemistry here. This is [00:52:00] in the medical textbooks, why this is happening. So they go through the same, uh, scientific training that I went through, and yet they, once they close the book, when the class is over, it's never referenced again.
Mari: Right?
Dr. Leslie: they tell you, you are defective. This, whoa, we don't know why this happened. Just kind of fell out of the sky, ho, ho, you know, hope you can deal with it.
Mari: Mm
Dr. Leslie: When you know the physiology of the body and the biochemistry of the body, it's very obvious why this is happening. You are not doomed or defective.
Dr. Leslie: You simply have some correctable blockers or deficiencies or missing pieces. That's it.
Mari: mm-hmm.
Dr. Leslie: Once we know what they are, let's get 'em fixed and then you feel better.
Mari: From the medical standpoint, is there really anything they can do to.
Dr. Leslie: [00:53:00] Well, uh, that is, so we're gonna cut this out. Let me see what the, I would imagine like something like maybe prednisone is a common, um, yeah. Okay. So, uh, so great question Mary. What are the conventional treatments? Okay.
Mari: I'm, I'm not, I'm okay that you don't know off the top of your head. I'm just like, huh.
Dr. Leslie: Yeah, no, we'll, we'll cut right to here cuz I just scrolled down the page here.
Mari: Cool.
Dr. Leslie: So the medications that they give you, okay. Uh, they will, uh, give you, um, steroid hormones. Okay. So, uh, you cannot be on synthetic steroid hormones your whole life. Okay? Um, there are tremendous side effects from steroid hormones,
Mari: Mm-hmm.
Dr. Leslie: Um, and particularly for women, they, um, lower your bone [00:54:00] density. It's a great way to gain weight being on synthetic, uh, steroids. So, you know, not a long-term solution, but they're giving those synthetic steroids because it's a synthetic cortisol, a synthetic stress hormone, okay? To try to get that, squeeze those pipes a little bit more to keep the pressure up within the pipe, okay?
Mari: Yeah, you don't wanna be on that long term.
Dr. Leslie: you don't. Um, or they'll give you beta blockers, okay? Like propranolol or metoprolol. These are also common migraine preventative medication. This prevents your heart from beating too quickly.
Mari: Mm-hmm.
Dr. Leslie: So this would be given if somebody has the, the picture where their heart's racing a lot, where they're kind of the adrenals are overproducing the, um, adrenaline.
Dr. Leslie: Well, okay, then we'll give you a drug where we're suppressing your heart rate. So your heart can't beat so fast. Well, guess what? You can't do [00:55:00] very well if you're on beta blockers, go up a flight of stairs, cuz you know your heart has to beat a little faster to go up a flight of stairs,
Mari: Right.
Dr. Leslie: right? So beta blockers many times are not tolerated well by people because of the side effects where, you know, I, I have no stamina, I have no endurance, I can't walk up a hill, you know, on my walk.
Dr. Leslie: And then because of their effect, they're gonna lower the blood pressure as well. Most people with pots, most women with migraines too, they have low blood pressure.
Mari: Mm.
Dr. Leslie: so then we're gonna take a beta blocker or a heart, uh, uh, blood pressure medicine that further lowers our blood pressure. Well, uh, we're not gonna feel very good all the time then.
Mari: Right.
Dr. Leslie: Okay. So the conventional treatments are trying to sort of play God [00:56:00] with your body, right. Suppressing the symptoms.
Mari: Mm-hmm. Okay. Makes sense.
Dr. Leslie: So, yeah, great question. Great question. And I can't, I can't tell you right, when I'm working with my clients with these symptoms, usually the POTS symptoms improve before the migraines.
Mari: Interesting.
Dr. Leslie: Right. Like, and they may not be a hundred percent gone when by the time the migraines start to improve, but usually one of the first symptoms that starts to improve are these POTS type symptoms.
Mari: I find it really interesting that the migraines are often the last symptom. That's better.
Dr. Leslie: Mm-hmm. Mm-hmm. The migraine migraines are a very complex symptom phenomenon that are affecting [00:57:00] multiple organ systems.
Mari: Right.
Dr. Leslie: You know, with this we just have the adrenals. You know, if the adrenals are acting appropriately, then everything works great. Right versus a migraine. We've got the vasculature involved, we've got, um, neurotransmitters and brain chemistry involved.
Dr. Leslie: Then we've got, uh, might, you know, that might impact the vestibular system. It impacts the digestive symptom, uh, system. Um, uh, you know, we can have the visual cortex involved if people have an aura. I mean, it's multiple, multiple, uh, systems that are involved with a migraine. So, yeah, it, it, uh, it can take a little longer, you know, to kind of fill up those buckets that are deficient versus getting your, getting one organ filled up that might be a little quicker.
Mari: right. Very interesting. [00:58:00] I mean, we don't celebrate the fact that people are having migraines by any means, but I do appreciate the attitude of like, what is this teaching our body or teaching us about our bodies? You
Dr. Leslie: Yeah. Yeah. And, uh, you know, really what you know, because everybody does the Dr. Google
Mari: Yes.
Dr. Leslie: And I'm sure, you know, people see the, the title of the podcast and what do they do? Pots Dr. Google, what is this? Right? And they re know, they go on a prestigious website like John Hopkins medicine.org and they read about this syndrome, and then they ha get, they get this attitude from John Hopkins that it's just a mystery.
Dr. Leslie: Who knows? You know, we have to be so careful with the messages that we tell ourselves.
Mari: Yeah. I'm not the whole helpless point of view, like, oh, it's just how [00:59:00] it is. I'm nothing I can do about it. But I don't think that that's helpful to anyone.
Dr. Leslie: Right. I mean, do you wanna go out for coffee with a friend that's always telling you, well, you know, you know, Leslie, I really don't think you should do too much. You know, you're not the kind of person that should really be, you know, you really wanna do that. I don't know. Um, I, I really think you should stay in a, in a room because, you know, any little thing could, you know?
Dr. Leslie: Do you want that friend or do you want the friend that's like, Hey, you know what, you should go for it. Right? You can do it.
Mari: Right. And you deserve it too.
Dr. Leslie: Yeah. You right. You deserve that success. You deserve to be happy. Right? Well, Leslie, I don't really think you deserve that. Like, which friend are you gonna go ask out for coffee again?
Mari: Yep.
Dr. Leslie: So, you know, it's important what we're surrounding ourselves with.
Mari: [01:00:00] Mm-hmm.
Dr. Leslie: It's, it's really important.
Mari: Yep. Hundred percent agree.
Dr. Leslie: Well, Mary, I think I've had a, uh, gotten on and off my soapbox enough time on this one, huh?
Mari: Me too, bro. Me too. So see everybody next time, I guess.
Dr. Leslie: Thank you so much. I'll talk to you soon.
