Your autonomic nervous system operates beneath conscious thought—calibrating every heartbeat, adjusting every blood vessel, coordinating the thousand invisible recalibrations that keep you alive. When this exquisite machinery falters, your body becomes a stranger to itself. Standing transforms into a physiological crisis. A shower becomes an endurance event.
You might live with a heart rate that soars from 70 to 150 just by standing. Perhaps you've mastered the subtle art of pre-syncope—that grey-vision, cold-sweat dance at the edge of consciousness that others can't see but you navigate daily. Maybe your nervous system still responds to safety as threat—the lasting physiological echo of trauma medicine has only recently learned to measure.
We understand what others dismiss: orthostatic intolerance isn't deconditioning when you were an athlete six months ago. Your need to lie flat mid-conversation isn't drama—it's your brain protecting itself from hypoperfusion. The crushing fatigue after standing in a queue isn't laziness but your body fighting gravity with broken weapons.
These aren't anxiety symptoms—they're the measurable, predictable consequences of autonomic dysfunction that we know how to identify, validate, and treat.
This pathway recognises that dysautonomia rarely travels alone—and that its origins are as varied as its presentations.
Your POTS might coexist with the connective tissue disorder that predisposed you to it. Your trauma history might have created the autonomic instability that makes every day a physiological marathon. Your mast cell activation amplifies your orthostatic symptoms.
We don't force you to choose which specialist to see or which origin story matters most—we understand that your autonomic dysfunction is the common thread weaving through multiple diagnoses, demanding integrated treatment that addresses both cause and consequence.
Comprehensive questionnaires capture detailed symptom inventory, COMPASS-31 autonomic assessment, trauma/stress history, and trigger identification to map your autonomic reality rather than dismiss it as anxiety.
A thorough 60-90 minute assessment includes active stand testing, symptom correlation mapping, functional capacity evaluation, onset pattern analysis, and comprehensive story collection that connects your daily experiences to measurable physiological patterns.
Comprehensive evaluation identifies specific dysautonomia subtypes through POTS subtype investigation, underlying cause analysis, and targeted laboratory assessment including hormonal evaluation, metabolic profiling, MCAS investigation, and connective tissue screening.
If indicated, 24-48 hour Holter monitoring, ambulatory blood pressure assessment, and at-home HRV tracking provide precise documentation of heart rate variability, arrhythmia detection, and circadian rhythm patterns.
Formal diagnostic documentation, subtype-specific care plans, educational resources, and provider coordination letters ensure your entire healthcare team understands your specific constellation of autonomic dysfunction.
Your response to medications reflects your unique autonomic patterns—what stabilises one person's heart rate may destabilise another's blood pressure. Our integrative approach combines evidence-based pharmaceuticals with precise monitoring of your individual responses, adjusting dosing and timing to work with your body's specific dysregulation rather than against it. This isn't trial-and-error prescribing; it's systematic medication optimisation guided by your measurable autonomic patterns and real-world functional outcomes.
Dysautonomia rarely exists in isolation—it emerges from the complex interplay of genetics, infections, trauma, hormonal disruption, and immune dysfunction. Our integrative practitioners identify and address these underlying drivers while supporting your autonomic nervous system's capacity for regulation. Through targeted supplementation, nutrient repletion, and evidence-based natural therapies, we work to restore the foundational health that conventional medicine often overlooks while your symptoms persist.
Many POTS patients experience hypovolemia (low blood volume). While oral fluid intake is crucial, some patients benefit significantly from periodic IV fluid therapy, especially during challenging periods or weather changes. IV fluids often provide immediate relief from orthostatic symptoms, enhances energy levels and cognitive function. Your response to IV fluids also offers valuable diagnostic insights about your specific dysautonomia subtype, helping us refine your comprehensive treatment plan while supporting long-term autonomic regulation and improved quality of life.
Chronic autonomic dysfunction creates specific metabolic demands that oral supplementation often cannot meet—absorption issues, increased cellular requirements, and depleted reserves all conspire against recovery. Our targeted injections and infusions deliver therapeutic levels of B vitamins, vitamin C, and other essential nutrients directly to support mitochondrial function, reduce inflammation, and strengthen your autonomic nervous system's capacity for regulation. Each protocol is designed around your specific presentation, whether addressing MCAS flares, immune dysfunction, or the crushing fatigue that conventional doses cannot touch.
Your movement patterns both reflect and influence autonomic function—poor proprioception, compensatory strategies, and guarding behaviours create a cycle that perpetuates dysregulation. Our specialised physiotherapists understand how connective tissue laxity, orthostatic intolerance, and post-exertional malaise intersect with movement dysfunction. Through targeted manual therapy, breathing retraining, and graded movement progression, we help restore the physical foundation that supports autonomic stability while respecting your body's current limitations.
Nutrition in dysautonomia extends far beyond increasing salt intake—your digestive system, blood sugar regulation, and inflammatory responses all influence autonomic stability. Our specialised dietitians understand how gastroparesis, blood pooling, and MCAS affect nutrient absorption and tolerance. Through personalised protocols addressing meal timing, macronutrient ratios, and trigger identification, we help stabilise the metabolic foundation that supports autonomic function while working within your body's current digestive limitations.
Exercise intolerance in dysautonomia isn't deconditioning—it's a measurable autonomic response that requires specialised understanding and intervention. Our exercise physiologists focus specifically on autonomic nervous system regulation through carefully calibrated movement programs that respect your orthostatic limitations while progressively building capacity. Using heart rate variability monitoring and symptom tracking, we develop exercise prescriptions that strengthen rather than destabilise your autonomic function, recognising that traditional exercise advice often worsens dysautonomia.
Trauma-induced dysautonomia requires interventions that address the nervous system's protective responses at their foundation. The Safe and Sound Protocol uses specifically filtered music to gently stimulate the neural pathways associated with safety and social connection, helping reset the hypervigilant autonomic responses that trauma can create. This evidence-based intervention supports your nervous system's recognition of safety, allowing the parasympathetic recovery responses that trauma often interrupts.
Your vagus nerve serves as the primary pathway for parasympathetic regulation—when dysautonomia disrupts this communication, targeted stimulation can help restore balance. Our tVNS protocols use precise, gentle electrical stimulation to support vagal tone and autonomic regulation. This evidence-based intervention helps modulate the fight-or-flight responses that often become stuck in dysautonomia, supporting your nervous system's return to more flexible, adaptive functioning without pharmaceutical side effects.
Hormonal fluctuations profoundly impact autonomic stability—oestrogen affects blood vessel function, testosterone influences heart rate variability, and thyroid hormones regulate the metabolic processes that support autonomic function. Our hormone optimisation protocols address the specific endocrine imbalances that contribute to your autonomic dysfunction. Through bioidentical hormone replacement and careful monitoring, we help restore the hormonal foundation that supports stable autonomic function, particularly crucial for those whose dysautonomia worsens with hormonal changes.
Directly targeting the autonomic nervous system, acupuncture has emerged as a potentially powerful tool for individuals with these POTS, dysautonomia and ME/CFS, with clinical studies showing up to 70% reduction in key symptoms across multiple trials. Our experienced practitioners use evidence-based point combinations specifically selected for autonomic dysfunction, targeting the measurable imbalances that contribute to your symptoms. This ancient practice offers a gentle yet effective way to support nervous system regulation, often providing relief when other interventions have reached their limits.
Heart Rate Variability (HRV) biofeedback is a technology enhanced approach for improving autonomic nervous system function. During sessions, you watch your HRV patterns on a screen (real-time biofeedback) while practicing specific breathing techniques and receiving guidance on how to achieve a more balanced nervous system state, known as "coherence."
Research has shown that regular HRV biofeedback training can lead to lasting improvements in autonomic function, with benefits including reduced anxiety, better stress management, improved sleep quality, and enhanced recovery from physical exertion - making it particularly valuable for individuals with dysautonomia and POTS who often struggle with autonomic regulation.
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