From 160 BPM episodes to a major breakthrough: How I discovered a B1 deficiency was mimicking/worsening my POTS symptoms
Hi everyone,I’m sharing my story here in hopes of finding some answers, but also to share a sliver of light at the end of the tunnel for anyone who might be going through something similar.
The Trigger (December 2025)
My journey started 5 months ago, specifically in December 2025. Right after eating meat, my heart rate randomly shot up to 160 BPM out of nowhere. I panicked so badly I had to call 911 because I genuinely thought I was having a heart attack. It turned out it wasn't.I went on with my life while trying to get checked by a cardiologist. Over the next few months, I had about 5 more episodes. They were spaced out at first (every month) and then grew closer (every 3 weeks), always right after eating. All my lab results and cardio workups came back excellent—nothing weird at all.
The Turning Point
Everything changed after the 5th episode. This time, my body couldn't return to its baseline. After that day, I couldn't even take a single step without my heart rate hitting 130 BPM, accompanied by chest pain and a burning sensation. I couldn't walk without feeling short of breath, and I felt a heavy pressure in my epigastric area. I had no idea what was happening to me.Background info: I was already on 50mg of Losartan for high blood pressure and 50mg of Atenolol for arrhythmias (diagnosed 2 years ago).
The ER visits and self-advocacy
I ended up in the ER about 5 times. My labs were always "normal" except for low potassium due to dehydration. I assumed the diuretic I had been taking for two years was drying me out. Together with my cardiologist, we decided to stop it. At the time, I was only getting about 500mg of sodium a day via a water bottle, and I wasn't feeling any better.My doctor then added Ivabradine to my regimen, which helped stabilize my heart rate significantly when standing up and walking. However, the shortness of breath, profound weakness, and epigastric pressure remained. I constantly felt "drunk" and sluggish.Realizing I couldn't just sit and wait around for medical appointments, I took matters into my own hands. I started aggressive sodium loading using Vitassium salt pills and electrolytes, reaching 5,000mg of sodium per day, alongside medical compression stockings. I noticed a substantial improvement, but it still wasn't a 100% fix. I knew I needed something to help my blood pump back up, but my BP was consistently sitting around 99-100 / 60-70. I realized my BP med (Losartan) might actually be counterproductive now, since it blocks Angiotensin II (which is crucial for blood vessel vasoconstriction). I cut the dose in half, and within two weeks, I was finally able to drive again. Still, the extreme fatigue and constant yawning wouldn't go away.
The Big Discovery: Vitamin DeficienciesI
Asked my PCP to run a full B-vitamin blood panel. BOOM. Surprise.I tested severely deficient in Vitamin B1 (Thiamine) and Folic Acid, while my B6 was abnormally elevated (not sure why yet).I started taking 200mg of Thiamine HCL, and thank God, the difference the very next day was absolute night and day. I felt completely better. I hadn't realized just how awful I had been feeling this entire time until it stopped. It felt like I was finally becoming myself again. I've been on B1 for 7 days now: the crushing sleepiness is gone, and my energy levels are actively improving, taking 100 mg TTFD and 600 mg thiamine hcl, waiting for paradox symptoms and then increase up the dose.
Where I stand now
Obviously, I am still on this POTS journey. It feels heavily like Hyperadrenergic POTS because I constantly feel like I am in a "fight or flight" mode.I wanted to share this because Beriberi (severe B1 deficiency) can mimic or severely worsen POTS symptoms. Please, if you can, get your B-vitamin levels checked. In my case, I have now added Magnesium and Methyl-B12 to my routine. I also stopped drinking my electrolytes. (since it contains B6, which likely caused my elevated levels) and switched exclusively to another.This breakthrough has finally given me enough breathing room to keep searching for a specialist who can help me figure out the root cause. For context: I never actually experienced true dizziness—only severe tachycardia and exercise intolerance. I can move around now (not all the day, I am like baby steps), but I'm still left wondering: Is my POTS causing a secondary B1 deficiency, or was my dysautonomia triggered by the B1 deficiency in the first place?
Thanks for reading, and I'd love to hear your thoughts or if anyone else has experienced a link between Thiamine and their dysautonomia!