Health
What is POTS, the disease affecting Olympic swimmer Katie Ledecky?
After nearly a decade of keeping it under wraps, Olympic medalist Katie Ledecky has shared her POTS diagnosis with the world.
The athlete, who has won 14 Olympic medals for swimming, the most of any female Olympian, said she has POTS (postural orthostatic tachycardia syndrome).
In “Just Add Water: My Swimming Life,” Ledecky’s new memoir, which was published by Simon & Schuster in June, she wrote that the disease can cause “dizziness, fainting and exhaustion.”
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Here’s more.
What is POTS?
POTS is a disturbance in the autonomic nervous system, which controls some of the normal regulatory functions of the body, according to Dr. Blair Grubb, a cardiologist and expert on POTS at The University of Toledo College of Medicine and Life Sciences.
Katie Ledecky competes in the swimming 400m Freestyle Women Heats during the Paris 2024 Olympic Games at La Defense Arena on July 27, 2024. After nearly a decade of keeping it under wraps, Ledecky has shared her POTS diagnosis with the world. (Getty Images)
“When the person stands, gravity will try to displace downward roughly 20% to 30% of the body’s blood volume,” he told Fox News Digital.
In response to this displacement, the brain tells the heart to beat faster and more forcibly, and tells the blood vessels in the lower half of the body to tighten, or constrict, to three times the level they were previously, the doctor said.
“This allows for accumulation of much more blood than normal in the lower half of the body,” Grubb said.
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As more blood is displaced downward, the brain gets less and less oxygen.
Ledecky discussed this effect in her book. She wrote, “I pool blood in the vessels below my heart when I stand. My body then releases extra norepinephrine or epinephrine, which adds additional stressors on my heart, making it beat faster.”
What causes the condition?
Individuals with a genetic trait called Ehlers-Danlos syndrome (also known as joint hypermobility syndrome) appear to be more susceptible to developing this condition, according to Grubb.
“However, POTS is frequently triggered by a viral infection, such as Epstein-Barr virus or COVID-19,” he told Fox News Digital.
Katie Ledecky reacts after competing in the swimming 400m Freestyle Women Heats during the Paris 2024 Olympic Games at La Defense Arena on July 27, 2024. (Getty Images)
One of these infections can trigger an autoimmune response, in which the body’s immune system attacks itself and produces antibodies that interfere with the ability of blood vessels to tighten, the doctor said.
POTS can also occur on its own, without any obvious triggers.
Symptoms of POTS
A POTS patient’s symptoms will depend on how much blood is displaced downward, experts say.
“It can vary from mild cases where your heart races and you get a little dizzy upon standing, all the way to presenting as a disabling condition, disallowing patients from being upright,” Valerie Iovine, PT, a physical therapist at Strive Physical Therapy in Philadelphia, told Fox News Digital.
“It can also change over the course of life, but can also change day to day or week to week.”
“When the person stands, gravity will try to displace downward roughly 20% to 30% of the body’s blood volume.”
The disorder’s name — postural orthostatic tachycardia syndrome — literally translates to “when you become more upright, your heart races,” noted Iovine, who treats many patients with POTS and also has the disorder herself.
“The heart will flutter in an attempt to properly oxygenate the brain,” she said.
Symptoms can include “disabling fatigue, exercise intolerance, heat intolerance, palpitations, lightheadedness, dizziness, fainting and brain fog,” a doctor said. (iStock)
“But in addition to the dizziness, headaches, passing out or near passing out, many with this disorder don’t realize that it can account for other issues, like temperature dysregulation, blood pressure dysregulation and GI dysfunction.”
In more extreme cases, patients may have difficulty thinking, concentrating or remembering — sometimes called brain fog, according to Grubb.
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People may also experience blurred vision, black spots in their visual field, tunnel vision and headache.
“Even greater displacement of blood can cause the individual to lose consciousness,” Grubb said.
Treatments and therapies
The primary treatment for POTS is increasing water and salt intake, Grubb said.
“It is also important to recondition the patient through exercise, building the strength in their lower extremities,” he said.
Some medications, such as midodrine and droxidopa — known as vasoconstrictors — can work to tighten blood vessels and increase blood return to the heart, according to Grubb.
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Still other drugs, such as fludrocortisone or desmopressin, work by increasing the volume of fluids available for the heart to pump.
“Medications such as pyridostigmine facilitate nerve transmission and help the nervous system work more effectively to maintain normal vascular function,” Grubb added.
The disease can often cause a flu-like feeling after exercise, something called post-exertional malaise/post-exertional symptom exacerbation (PEM/PESE). (iStock)
Many often use the term “exercise intolerance” when describing symptoms of POTS, but Iovine said that “poorly prescribed and dosed exercise” is the problem.
“Exercise is the best management for POTS,” she said.
“I would argue that for these patients, movement is medicine.”
In her book, Ledecky noted that swimming can be an effective treatment for POTS, writing that “reclined aerobic exercise, such as swimming, and strengthening your core, can provide relief.”
“For these patients, movement is medicine.”
Seeking care from a cardiologist and a physical therapist is essential, according to Iovine.
The cardiologist can help to get vital signs like heart rate and blood pressure under control, she said, while a knowledgeable physical therapist can help to manage symptoms and increase upright tolerance.
“Things like proper hydration, extra electrolytes, and being able to keep cool can also help manage symptoms,” an expert advised. (iStock)
“Things like proper hydration, extra electrolytes, and being able to keep cool can also help manage symptoms,” Iovine advised.
“The heat will make the blood vessels expand, making it harder to get the blood up the head against gravity,” she said.
How POTS impacts athletes
“POTS can be a challenge for anyone — from people with complicated pre-existing conditions, all the way to the top athletes, like Katie Ledecky,” Iovine told Fox News Digital.
The disease can often cause a flu-like feeling after exercise, something called post-exertional malaise/post-exertional symptom exacerbation (PEM/PESE).
“This is when the autonomic nervous system can have a reflexive reaction to stress or exercise, either making existing symptoms worse or creating a new host of issues in people with POTS,” Iovine said.
“This can pose an issue in the sense of rigorous exercise for an Olympic athlete — or in other cases, exertion may be as simple as getting out of bed and walking to the kitchen.”
While there is no cure for POTS, many patients are able to manage their symptoms and return to their daily activities with the help of a care team. (iStock)
POTS causes a “dynamic disability,” Iovine noted.
“One day, it may allow you to swim like an Olympic athlete, and other days, [it will] have you stuck in bed or even in a wheelchair.”
POTS is particularly challenging in athletic activities that involve frequent “start and stop” activities, such as basketball, volleyball, soccer and field hockey, added Grubb.
‘A real illness’
Both experts emphasized that POTS is a “real illness.”
“People who were previously quite healthy develop severe limitations and disabilities,” Grubb said.
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“They can experience disabling fatigue, exercise intolerance, heat intolerance, palpitations, lightheadedness, dizziness, fainting and brain fog.”
Iovine said that due to the “invisibility” of the disease combined with the high heart rate and variability of presentations, it is often dismissed as a function of mental health.
“One day, it may allow you to swim like an Olympic athlete, and other days, have you stuck in bed or even in a wheelchair.”
“Patients are often turned away from proper care, made to believe it is all in their heads,” she said.
“POTS is a very real condition, and the good news is that there are very real management strategies as well,” Iovine went on.
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While there is no cure for POTS, many patients are able to manage their symptoms and return to their daily activities.
Added Iovine, “Build up your care team and your confidence to advocate for your health and keep to your regimented routines for management.”
Welcome to the Brain Health Challenge! I’m Dana Smith, a reporter at The New York Times, and I’ll be your guide.
To live a healthy life, it’s crucial to have a healthy brain. In the short term, it keeps you sharp and firing on all cylinders. In the long term, it can reduce your risk of cognitive decline, dementia and stroke.
Practicing basic healthy behaviors, like eating nutritious food and getting regular exercise, is the best way to enhance your brain power and protect the longevity of your neurons. These types of lifestyle habits can benefit the brain at any age. And while they won’t guarantee that you’ll never develop dementia or another brain disease, several clinical trials have shown that they can improve cognition or slow decline.
Every day this week, you’ll do an activity that’s good for your brain, and we’ll dig into the science behind why it works. Some of these activities can provide a small immediate cognitive benefit, but the bigger reward comes from engaging in them consistently over time. So along with the neuroscience lessons, we’ll include a few tips to help you turn these actions into lasting habits.
To keep you accountable, we’re encouraging you to complete this challenge with a friend. If you don’t have a challenge buddy, no problem: We’re also turning the comments section into one big support group.
There are so many fascinating ways your daily behaviors affect your brain. Take sleep, for example.
Lots of studies have shown that getting a good night’s rest (seven to eight hours) is associated with better memory and other cognitive abilities. That’s because sleep, especially REM sleep, is when your brain transfers short-term memories — things you learned or experienced during the day — into long-term storage.
Sleep is also when your brain does its daily housekeeping. While you rest, the brain’s glymphatic system kicks into high gear, clearing out abnormal proteins and other molecular garbage, including the protein amyloid, which is a major contributor to Alzheimer’s disease. A buildup of amyloid is one reason experts think that people who routinely get less sleep have a higher risk of dementia.
What other behaviors play a big role in brain health? For today’s activity, we’re going to test your knowledge with a quiz. Share your score with your accountability partner and in the comments below — I’ll be in there too, cheering you on.
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An often-overlooked part of the body may reveal important clues about overall health.
Researchers from the University of Westminster in the U.K. discovered that the shape of the gluteus maximus muscle in the buttocks changes with age, gender, lifestyle and frailty, as well as certain conditions like osteoporosis and type 2 diabetes.
Using advanced MRI scans that create 3D images, researchers revealed “distinct” patterns in the gluteus maximus associated with type 2 diabetes.
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This suggested that the shape of the muscle, rather than the size, may “reflect underlying metabolic differences,” a press release stated.
The findings were presented in December at the annual meeting of the Radiological Society of North America (RSNA) in Chicago.
Butt shape may indicate underlying health conditions, according to new research. (iStock)
Unlike previous studies looking at muscle size or fat, the 3D imaging identified exactly where the muscle changes occur, according to the researchers.
As one of the largest muscles in the human body, the gluteus maximus “plays a key role” in metabolic health, according to lead study author E. Louise Thomas, Ph.D., professor of metabolic imaging at the University of Westminster’s School of Life Sciences.
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The researchers analyzed more than 61,000 MRI scans from a large UK health database to better understand the muscle’s structure.
The data also included the participants’ physical measurements, demographics, disease biomarkers, medical history and lifestyle habits. The researchers studied how these variables were linked to muscle shape over time.
An infographic from the Radiological Society of North America presentation displays research findings on the shape of the gluteus maximus. (RSNA)
“People with higher fitness, as measured by vigorous physical activity and hand grip strength, had a greater gluteus maximus shape, while aging, frailty and long sitting times were linked to muscle thinning,” study co-author Marjola Thanaj, Ph.D., a senior research fellow at the University of Westminster’s Research Centre for Optimal Health, said in the release.
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The researchers concluded that butt shape changes may indicate an “early functional decline” and “metabolic compromise” in type 2 diabetes patients.
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Men with type 2 diabetes showed muscle shrinkage, while women displayed enlarged muscle, likely due to “infiltration of fat” within it, according to the researchers.
These results suggest that men and women have “very different biological responses to the same disease,” Thanaj suggested.
Butt shape changes may indicate an “early functional decline” and “metabolic compromise” in type 2 diabetes patients. (iStock)
Men who were categorized as “frail” were recognized as having more “general shrinkage” across the gluteus maximus, but women experienced a “limited” frailty effect.
Building strong glutes for better health
Strengthening the glutes is an “investment in long-term health,” according to Tanya Becker, co-founder of Physique 57 in New York City.
“While full-body strength training is essential, focusing on your glutes — the largest muscle group in your body — deserves special attention,” she told Fox News Digital.
“While full-body strength training is essential, focusing on your glutes — the largest muscle group in your body — deserves special attention.” (iStock)
Becker refers to the glutes as the body’s “shock absorbers,” because they protect the lower back, knees and hips from taking on stress they weren’t designed to handle.
Larger muscle groups also burn more calories and help regulate blood sugar, the expert added, noting that muscles are often referred to as the “organ of longevity.”
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Strengthening the glutes also helps to protect the lower back, hips and knees, and also improves posture and balance, reducing the risk of falls and improving mobility.
“People with higher fitness, as measured by vigorous physical activity and hand grip strength, had a greater gluteus maximus shape.”
Becker recommends traditional weighted exercises like squats, lunges and bridges, although they are not suited for everyone, especially older adults with injuries and joint pain.
“Pilates and barre classes offer bodyweight exercises that are ideal for beginners or individuals with physical limitations,” she suggested. “They can be done anytime, anywhere, making them accessible for beginners before progressing to weighted versions.”
Glute bridges (demonstrated above) are a recommended exercise for strengthening those muscles. (iStock)
Becker shared the following three glute exercises that improve hip mobility, stability and overall strength.
No. 1: Quadruped leg lifts (strengthens entire core and glutes)
Start on the hands and knees, engage your core, and lift one leg off the floor (bent or straight). Pulse up and down a few inches for 30 to 60 seconds, then repeat on the other leg.
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No. 2: Clamshells (strengthens gluteus medius)
Lie on your side with knees bent at 90 degrees in front of you. Lift your top knee away from your bottom knee, then lower slowly.
For an increased challenge, lift both feet off the ground while keeping the heels together. Repeat for 30 to 60 seconds per side.
Strong muscles are responsible for maintaining metabolic health, according to Becker. (iStock)
No. 3: Glute bridges (strengthens lower back and glutes)
Lie on your back with knees bent and feet parallel, a few inches from your hips. Engage your abs, and squeeze your glutes to lift your hips toward knee height, then lower.
If you feel pressure in your neck, you’ve lifted too high. Perform for 30 to 60 seconds. Complete three sets with 30-second rests between them.
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Those looking to start a new fitness routine should first consult with a doctor.
Fox News Digital reached out to the study authors for comment.
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What if your New Year’s resolution could fit inside a tote bag? Social media users are trying the “analog bag” trend, replacing phones with offline activities.
The trend is widely credited to TikTok creator Sierra Campbell, who posted about her own analog bag — containing a crossword book, portable watercolor set, Polaroid camera, planner and knitting supplies — and encouraged followers to make their own.
Her video prompted many others to share their own versions, with items like magazines, decks of cards, paints, needlepoint and puzzle books.
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“I made a bag of non-digital activities to occupy my hands instead of the phone,” said Campbell, adding that the practice has significantly cut her screen time and filled her life with “creative and communal pursuits that don’t include doom-scrolling.”
“I created the analog bag after learning the only way to change a habit is to replace it with another,” she told Fox News Digital.
Social media users are trying the “analog bag” trend, replacing phones with offline activities like cameras, notebooks and magazines. (Fox News Digital)
The science of healthier habits
Research on habit formation supports the idea of the analog bag, according to Dr. Daniel Amen, a California-based psychiatrist and founder of Amen Clinics.
“Your brain is a creature of habit,” Amen said during an interview with Fox News Digital. “Neurons that fire together wire together, meaning that every time you repeat a behavior, whether it’s good or bad, you strengthen the neural pathways that make it easier to do it again.”
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Studies show that habits are automatic responses to specific cues — such as boredom, stress or idle time — that typically deliver some kind of reward, according to the doctor. When no alternative behavior is available, people tend to fall back on the same routine, often without realizing it.
Research suggests that replacing an old habit with a new one tied to the same cue is more effective than trying to suppress the behavior altogether.
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“[When] cutting out coffee — you need to have another drink to grab for, not just quit cold turkey. It’s how the pathways in our brains work,” Campbell said.
By substituting a different routine that still provides stimulation and engagement, people can gradually weaken the original habit and build a new automatic response.
Substituting another activity instead of scrolling on your phone can help quell the impulse to reach for it. (iStock)
“Simply stopping a behavior is very challenging,” Amen said. “Replacing one habit with something that is better for your brain is much easier. That’s how lasting change happens, one step at a time.”
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If alternatives are within arm’s reach, people will be more likely to use them, the doctor said. “Your brain does much better with small, simple actions than big, vague intentions.”
Instead of saying, “I’ll stop scrolling today,” the doctor recommends choosing a small habit you can do in a few moments in specific situations, like knitting 10 rows of a scarf on your commute or reading a few pages of a book while waiting at the doctor’s office.
“If alternatives are within arm’s reach, you’re more likely to use them,” a brain doctor said. “Your brain does much better with small, simple actions than big, vague intentions.” (iStock)
Campbell shared her own examples of how to use an analog bag. At a coffee shop with friends, she said, she might pull out a crossword puzzle and ask others to help with answers when the conversation lulls.
Instead of taking dozens of photos on her phone, she uses an instant camera, which limits shots and encourages more intentional moments.
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In casual outdoor settings, such as a park or winery, she brings a small watercolor set for a quick creative outlet.
“It’s brought so much joy,” Campbell said of the analog bag trend, “seeing how it resonates with so many.”
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