There’s a kind of dysregulation that doesn’t feel like illness in the traditional sense.
It feels like your body has lost its ability to find neutral.
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Your heart races when you stand.
Your blood seems to pool instead of circulate.
You feel overstimulated by things that never used to bother you—heat, light, certain foods, stress.
You’re tired, but wired.
Sensitive, but also depleted.
This is the terrain many people find themselves in with POTS, dysautonomia, and mast cell reactivity. And we're seeing it more and more post COVID. This terrain pattern is one of (if not) THE most common complaint I hear at my vendor booth at markets. How can we support this terrain with herbs when even doctors and specialists seem not to know much about how to help improve it? And it constellates into several other syndromes and disorders. Well...
I’ve lived inside this pattern myself.
After COVID, my system shifted in a way I couldn’t ignore. My tolerance dropped. My nervous system became reactive. My body felt like it was constantly trying to restabilize... and not quite getting there.
What I learned through that experience, both personally and clinically, is this:
This is not a condition you override.
This is a system you rebuild and regulate.
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Understanding the Physiology
To work with this pattern effectively, we need to understand not just what is happening—but why the body is making these adaptations.
1. Autonomic Nervous System & Vagal Tone
The autonomic nervous system operates through a dynamic balance between sympathetic (“mobilizing”) and parasympathetic (“restorative”) activity.
In dysautonomia, this balance is often skewed toward sympathetic dominance:
• elevated catecholamine output
• reduced vagal tone
• exaggerated response to minor stressors
From a signaling perspective, this can involve altered sensitivity at adrenergic receptors (mediators for fight/flight responses), reduced baroreceptor responsiveness, and impaired feedback loops that normally stabilize heart rate and blood pressure.
The result is not just “stress”; it’s loss of regulatory flexibility.
2. Vascular Tone & Endothelial Signaling
In POTS, impaired vasoconstriction (especially in the lower extremities) leads to blood pooling.
This isn’t just mechanical. It involves:
• reduced responsiveness of vascular smooth muscle
• altered nitric oxide signaling
• possible endothelial dysfunction
The heart compensates by increasing rate to maintain perfusion.
So the tachycardia is not the problem. It’s the adaptation.
3. Blood Volume & Mineral Status
Low plasma volume is a common feature in this terrain.
This can be influenced by:
• inadequate sodium retention
• low aldosterone signaling, in some cases
• insufficient mineral intake
Minerals are not just structural. They influence:
• nerve conduction
• muscle contraction (including vascular smooth muscle)
• fluid balance at the cellular level
4. Mast Cells & Neuroimmune "Cross-Talk"
Mast cells don’t operate in isolation.
They are in constant communication with the nervous system.
Histamine and other mediators can:
• increase vascular permeability
• stimulate nerve endings
• amplify sympathetic activation
This is why mast cell activation can feel like anxiety (or vice versa).
This is a bidirectional loop.
The Foundation
Before herbs, the terrain matters.
Salt, fluids, nutrient density, sunlight, electron gathering (yes, really) and gentle movement all contribute to restoring:
• plasma volume
• circadian rhythm
• autonomic balance
Without this, herbs have less to work with.
Materia Medica: Matching Herb to Pattern
This is where we move from general support to targeted intervention based on tissue state and physiology. I am certainly not the pinnacle of authority on this, but here are some herbs that I have found to help support and re-regulate this terrain pattern and, more importantly, WHY they work.
Primary actions:
• nutritive (rich in minerals)
• mild antihistamine
• supports kidney-adrenal interface indirectly
Why it works here:
Nettle provides ionic minerals that support nerve conduction and vascular tone. Its flavonoids and other constituents appear to modulate inflammatory pathways, including histamine responses.
Tissue state:
• depleted
• dry
• reactive
Use:
• daily tonic (tea or tincture)
• long-term rebuilding
2. Lemon Balm (Melissa officinalis)
Primary actions:
• calming nervine
• antiviral (secondary relevance in post-viral states)
• modulates GABA activity
Why it works:
Lemon balm has been shown to influence GABA transaminase activity, which can increase available GABA in the system, supporting inhibitory signaling in an overactive nervous system.
It also has mild effects on thyroid modulation and autonomic tone.
Tissue state:
• tense
• overheated
• overstimulated
3. Skullcap (Scutellaria lateriflora)
Primary actions:
• trophorestorative to the nervous system
• reduces neural excitability
• supports recovery from chronic overstimulation
Why it works:
Skullcap is particularly useful when the nervous system has been in a prolonged state of activation. It appears to modulate neuronal firing thresholds, helping reduce hypersensitivity.
This is not sedation. It’s normalization of excitability.
Tissue state:
• frayed
• hypersensitive
• “spent but still firing”
4. Passionflower (Passiflora incarnata)
Primary actions:
• anxiolytic
• supports sleep onset
• modulates GABA receptors
Why it works:
Passionflower has affinity for GABAergic pathways and can help reduce excessive neuronal signaling, especially at night.
Useful when mental looping or restlessness prevents settling.
Tissue state:
• restless
• looping
• unable to “turn off”
5. Hawthorn (Crataegus spp.)
Primary actions:
• cardiotonic
• improves coronary and peripheral circulation
• antioxidant support for vascular tissue
Why it works:
Hawthorn supports endothelial function and may improve nitric oxide balance, contributing to better vascular tone and circulation.
Over time, this can reduce the compensatory strain on the heart.
Tissue state:
• weak circulation
• poor tone
• mild stagnation
Primary actions:
• nervous system trophorestorative
• supports HPA axis resilience
• gently stabilizing to mood and stress response
Why it works:
Milky oats are one of the most important herbs for rebuilding a nervous system that has been depleted over time. In dysautonomia patterns, there is often a combination of hypersensitivity and exhaustion, where the system is reactive, but also under-resourced. Milky oats help address that underlying depletion.
Rather than directly sedating or altering neurotransmitters acutely, they work over time to:
• improve baseline resilience
• reduce reactivity to stressors
• support more stable autonomic function
They are especially useful in post-viral states, postpartum transitions, and chronic stress patterns where the system has been “running hot” for too long.
Tissue state:
• depleted
• fragile
• overstimulated but exhausted
Use:
• best taken consistently over time
• fresh milky oat tincture is ideal for full effect
7. Elderflower (Sambucus nigra/canadensis)
Primary actions:
• diaphoretic
• supports mucosal surfaces
• modulates immune response
Why it works:
Elderflower helps regulate the interface between environment and body, especially in the respiratory system. This becomes relevant when mast cell activity is triggered by environmental exposure.
Pregnancy & Nursing Considerations
During pregnancy and breastfeeding, the emphasis shifts even more toward gentle, nutritive, and non-disruptive support.
Often appropriate (when indicated):
• Nettle — mineral replenishment, foundational support
• Oatstraw/Oat Tops — long-term nervous system nourishment
• Lemon balm — mild calming support
These herbs work because they:
• do not force physiological shifts
• support underlying systems gradually
• are generally well tolerated
Always:
• start low
• observe carefully
• prioritize simplicity
A Personal Note
During pregnancy, my symptoms largely disappeared.
Blood volume increases.
Hormonal shifts support vascular tone.
The system is buffered in a way that often reduces reactivity.
Postpartum (especially with the return of menses) those buffers change, and the system can become more reactive again.
This isn’t regression.
It’s physiology.
What to Expect
This work is not about eliminating symptoms instantly.
It’s about:
• improving baseline stability
• reducing amplitude of reactions
• increasing resilience over time
Herbs, when matched correctly, help the system remember how to regulate.
POTS, dysautonomia, and mast cell reactivity are complex, but not incomprehensible.
When you understand the patterns, you can work with them. Not by forcing the body into submission. But by giving it what it needs to find its way back to balance.
Slowly.
Consistently.
And with respect for the system as a whole.
Healing isn’t about chasing symptoms. It’s about building relationship. Start with one plant. Start with one ritual. 👉 Explore the Full Apothecary