A Blog Series on Misdiagnosis, Medical Bias, and Nutrition Support in Women’s Health
Welcome to “It’s Just Your Anxiety”—And Other Lies We Tell Women,” a blog series created to shine a light on the medical missteps far too many women have endured for far too long.
This series is for every woman who’s been told her symptoms were “just stress,” “just hormones,” “just in her head,” or to “just lose weight.” It’s for the women sent home with anxiety meds when the real issue was an autoimmune disease, a cardiovascular condition, or a hormonal disorder. And it’s for those still seeking answers—who deserve care that listens, validates, and supports them.
Why This Matters
Despite making up half the population, women weren’t required to be included in clinical trials until 1994. Yes, 1994. Until then, medical research defaulted to male subjects, assuming findings applied across the board.
This exclusion set the stage for widespread misdiagnosis in women, especially in conditions like heart disease, thyroid dysfunction, autoimmune disease, and chronic fatigue. Our symptoms often present differently. Our biology is distinct. And our needs deserve to be studied and addressed on their own terms.
Women are not just “smaller men.” We are biologically unique, and our medical care should reflect that.
What This Series Offers
This series aims to:
- Expose common misdiagnoses in women’s health and the real conditions behind them
- Unpack how gender bias influences diagnosis and treatment
- Explain the science behind these conditions—from pathology to symptom patterns
- Highlight the role of personalized nutrition support in healing and management
- Empower women to advocate for themselves with confidence and clarity
We’ve made progress in women’s health—but we still have a long way to go. This series is one way to help close that gap.
Let’s rewrite the narrative together.
Part One: When “It’s Just Anxiety” Isn’t the Answer – Understanding POTS
You’re lightheaded, clammy, and maybe even seeing stars when you stand up. Your heart races like you’re mid-spin class, but you’re just browsing Trader Joe’s. Hot showers make you dizzy. Long lines make you want to lie down. You tell your doctor, and they smirk and say: “Sounds like anxiety.”
But what if it’s more?
Welcome to Part One, where we dive into Postural Orthostatic Tachycardia Syndrome (POTS)—a complex and often-misdiagnosed form of dysautonomia that disproportionately affects women and is far too often mistaken for panic or anxiety disorders.
What Is POTS?
POTS is a dysfunction of the autonomic nervous system—the part of your body that regulates things like heart rate, blood pressure, digestion, and temperature control. In POTS, the heart rate jumps dramatically (by at least 30 beats per minute) within 10 minutes of standing, often without a corresponding drop in blood pressure.
Despite these physiological signs, many patients are dismissed with vague suggestions to “reduce stress” or are prescribed anti-anxiety medications.
Symptoms of POTS include:
- Elevated heart rate upon standing
- Dizziness or lightheadedness
- Brain fog
- Fatigue
- Palpitations
- Nausea
- Fainting (in some cases)
- Muscle weakness
- Chest discomfort
- Blurred vision
These symptoms frequently overlap with anxiety or panic attacks, which makes POTS a common misdiagnosis—especially in women.
The Science Behind the Syndrome
POTS is physiological, not psychological.
At its core, POTS involves an abnormal cardiovascular response to standing. Blood pools in the lower extremities, and the body compensates by increasing heart rate to maintain blood flow to the brain.
Potential contributing factors include:
- Viral infections (20–50% of cases)
- Physical trauma or surgery
- Hormonal changes (e.g., puberty, menstruation)
- Low blood volume
- Hyperadrenergic states (overactive fight-or-flight response)
- Autoimmune activity
- Genetic predispositions
- Severe deconditioning
POTS Rarely Travels Alone
Many individuals with POTS also contend with other chronic conditions, including:
- Celiac Disease: POTS patients may show increased rates of autoimmune disease. Celiac requires lifelong gluten avoidance.
- Mast Cell Activation Syndrome (MCAS): Symptoms range from rashes to GI issues and often overlap with POTS.
- Ehlers-Danlos Syndrome (hEDS): Connective tissue issues can worsen blood pooling and autonomic instability.
- GI Distress: Common issues include bloating, nausea, IBS, and SIBO.
- Low Vitamin C status: Some research suggests lower vitamin C levels may exacerbate symptoms and coexisting conditions.
When multiple conditions coexist, managing symptoms becomes even more nuanced—and nutrition can play a powerful role in stabilizing health.
Nutrition Strategies for POTS Management
While there is no cure for POTS, nutrition support is a practical and empowering way to ease symptoms and improve daily functioning. Every patient is different, and each care plan should reflect that.
As a dietitian, I always tailor care to your specific needs. Your salt tolerance, hydration requirements, GI symptoms, and food preferences all matter.
General Nutrition Guidelines for POTS:
💧 Hydration is foundational
Aim for 2–3 liters of fluids daily. Electrolytes help retain fluids and support blood pressure stability.
🧂 Be Salty
Many with POTS benefit from 3,000–10,000 mg of sodium per day. This is therapeutic sodium—not processed food sodium.
🍴 Smaller, more frequent meals
Large meals can trigger post-meal hypotension. Eating every 3–4 hours helps maintain energy and blood flow.
🥦 Prioritize nutrient density
B vitamins, magnesium, omega-3s, and vitamin C support autonomic function, reduce inflammation, and promote resilience.
🕒 Time your meals and fluids around activity
Whether it’s walking the dog or heading to PT, plan fuel and hydration before and after for symptom control.
Why Working With a Dietitian Matters
At Wellness and Sports Dietetics, I’ve supported many women navigating POTS and overlapping conditions. What I’ve seen time and time again: there is no one-size-fits-all.
Through a personalized nutrition assessment, we can:
- Fine-tune hydration and sodium strategies
- Address vitamin/mineral deficiencies (B12, iron, magnesium)
- Support MCAS-safe and GI-friendly eating
- Reduce symptom flares and improve energy levels
- Coordinate care with your broader medical team
- Create a sick day plan
Summary: It’s Not in Your Head. It Might Be POTS.
POTS is a real, physical condition that’s often misdiagnosed as anxiety in women.
You are not overreacting. You are not imagining it. And you deserve real answers and real support.
When nutrition is individualized and rooted in science, it becomes one of your most effective tools for managing POTS and related conditions.
🌟 You deserve to feel better.
🌟 You deserve to be believed.
🌟 Let’s build a care plan as unique as you are.
Call 757-559-1549 or visit www.wsdiets.com
Serving Virginia Beach and beyond — virtual sessions available
Let’s get your blood flowing, your energy back, and your symptoms managed—on your terms.
References:
Elahi, M., Eshera, N., Bambata, N., Barr, H., Lyn-Cook, B., Beitz, J., Rios, M., Taylor, D. R., Lightfoote, M., Hanafi, N., DeJager, L., Wiesenfeld, P., Scott, P. E., Fadiran, E. O., & Henderson, M. B. (2016). The Food and Drug Administration Office of Women’s Health: Impact of Science on Regulatory Policy: An Update. Journal of women’s health (2002), 25(3), 222–234. https://doi.org/10.1089/jwh.2015.5671
Vernino, S., Bourne, K. M., Stiles, L. E., Grubb, B. P., Fedorowski, A., Stewart, J. M., Arnold, A. C., Pace, L. A., Axelsson, J., Boris, J. R., Moak, J. P., Goodman, B. P., Chémali, K. R., Chung, T. H., Goldstein, D. S., Diedrich, A., Miglis, M. G., Cortez, M. M., Miller, A. J., Freeman, R., … Raj, S. R. (2021). Postural orthostatic tachycardia syndrome (POTS): State of the science and clinical care from a 2019 National Institutes of Health Expert Consensus Meeting – Part 1. Autonomic neuroscience : basic & clinical, 235, 102828. https://doi.org/10.1016/j.autneu.2021.102828
Raj, S. R., Bourne, K. M., Stiles, L. E., Miglis, M. G., Cortez, M. M., Miller, A. J., Freeman, R., Biaggioni, I., Rowe, P. C., Sheldon, R. S., Shibao, C. A., Diedrich, A., Systrom, D. M., Cook, G. A., Doherty, T. A., Abdallah, H. I., Grubb, B. P., Fedorowski, A., Stewart, J. M., Arnold, A. C., … Vernino, S. (2021). Postural orthostatic tachycardia syndrome (POTS): Priorities for POTS care and research from a 2019 National Institutes of Health Expert Consensus Meeting – Part 2. Autonomic neuroscience : basic & clinical, 235, 102836. https://doi.org/10.1016/j.autneu.2021.102836
