Reversing POTS with Holistic Living – Part 3 (Exercise Intolerance)

Run for Your Life

It was the weekend of my 15th birthday when I won my first cross country race. As luck would have it, it was the JV conference championship race, and for the first time ever, the girls and boys teams shared the course and raced together (usually the male teams would race first and the female teams would follow after).

I consider myself lucky that day because I was running with undiagnosed Postural Orthostatic Tachycardia Syndrome (POTS) at the time, which meant I was running with extreme brain fog…and thus…intense directional challenges.

All in all, if I wasn’t passing out in the woods, I was usually getting lost in them…both scenarios existing as major detriments to my race time.

On this October weekend I was doubly lucky because, not only was I having a rare “good day” (in regards to my health), but also, I didn’t have to worry about getting lost. Despite being the first place female runner, I was still running behind a nice little trail of male runners showing me the way.

When I crossed the finish line and the male racers ahead of me rushed over, congratulating me with cheers, high fives, and even a few hugs…I was confused. I had no idea I was the first girl to finish. When I realized it, I was so excited I nearly peed my shorts (for real though, if you’re a runner, you understand that urination on race days is v difficult to control).

In addition to the medal the race coordinators placed around my neck that chilly morning, my coach also let me know I qualified for States with the varsity team…which meant I’d be traveling to the state capital (Columbus, OH) to run in the big leagues.

It was seriously a dream come true. And better yet, if I continued to train and got my health under control, coach said I’d run with the varsity team the following year…and could potentially run in college too.

So yes, it was an incredible birthday.

Unfortunately, I could not get my health under control. In fact, things became so bad, the following summer I checked into the Cleveland Clinic to have a heart ablation performed.
My family also moved from Cleveland to Columbus around this time, resulting in me transferring to a high school which struggled to recruit enough female students to form a full racing team.

I joined their cross country group anyway, eager to adjust back into running post-surgery. However, despite “fixing my heart”, my health issues persisted. I continued blacking out on runs; fainting episodes remained frequent as well.

After completing this new run season full of frustrating obstacles, I finally found a doctor who diagnosed me with POTS via a tilt table test. Unfortunately, he also recommended I quit sports.

For more details on my diagnoses and symptoms, check out Part 1 of this series.

Long story short, at age 16, I believed my athletics career was over. I was devastated. I was also intensely envious of my peers who were running, jumping, and competing without issue…and equally angry with my doctors who couldn’t seem to help me.

Furthermore, having grown up on a cul-de-sac street where a different game was being played each night–from roller hockey to kickball and everything in between–sports existed as both a source of joy and a large part of my identity as a kid. Thus, having my participation abilities stripped from me left me feeling so lost…a helpless feeling which only ignited my illnesses further.

It wasn’t long before I missing too much school (legally) and, despite maintaining a 4.0, feeling afraid I wouldn’t be able to complete my higher education goals. Luckily, I discovered the power of nutrition in the knick of time, and ten years after my symptoms first began, life became mine again.

For more details on my experience reversing POTS with nutrition, check out Part 2 of this series.

Once my health started to return to me, you better believe the first thing I did was dive back into athletics. I missed it more than I missed my mom and dad at summer camp as a kid (which was A LOT).

Of course, moving from a place of bed riddance to where I am today–currently typing at my climbing gym (The Seattle Bouldering Project) where I’m about to practice rock climbing, complete a HIIT (high intensity interval training) workout, and eventually *cool down* with a nice little hot yoga class–wasn’t easy… And herein lies my reason for writing today.

The two main reasons I’m writing this post about exercise:


Exercise is truly an INCREDIBLE tool for reversing chronic illnesses like POTS, as it increases the number of mitochondria in our bodies and keeps these mighty-chondria (for real, they are so mighty) healthy and provided with the oxygen needed to complete cellular respiration–the process by which glucose (via the foods we eat) is converted into USABLE energy (ATP). This is the energy we use to thrive and heal. So we want A LOT of it, and regular exercise provides us with more.

However, in regards to chronic illnesses like POTS, exercise needs to be approached slowly and carefully… The adrenal glands of those living with chronic illness are already inundated with stress, and overdoing a workout only adds more…which is a “bad news bears” situation you don’t want to get yourself into…trust me.
After all, living with stressed out adrenals (aka, “fatigued” adrenals) is a recipe for lowered immunity and widespread hormonal imbalances–two of the main contributors to the development of chronic conditions and degenerative diseases.


I want to offer a glimpse into the journey I took to get to where I am today–running 30-40 miles a week and completing high intensity workouts with “ease” (relatively speaking…they definitely kick my butt)–because I think it’s important to realize this is in fact a journey. It takes time, yet, is totally and completely doable…and 100% worthwhile.

My journey moving from exercise intolerance into a highly active life:

Recumbent Biking

After beginning my nutrition protocol, which got me out of bed without black outs or fainting spells, I started with 5-10 minutes of recumbent biking in my family’s basement each day. Straight up, had I not figured out my nutrition needs beforehand, I could not have started biking. Nutrition got me out of bed and on the bike. So if you haven’t gone deep with nutrition yet, changing your diet to meet your unique needs, talk to a therapeutic nutritionist like myself TODAY. Within just a few weeks I promise you’ll be AMAZED by how different your body feels and works.
Annnnyway…gradually (over the course of 6 months) I upped my time from 5-10 min to 60-90 of biking each day, binging on my favorite Netflix series as I went. I felt SO STRONG! …and seriously felt connected to Cici and Schmidt from New Girl.

Weight Lifting

Once I felt confident enough to workout at the gym (aka, as though I wouldn’t pass out in a room full of strangers), I began lifting weights to build muscle. Muscle tissue is the most mitochondria-rich tissue in the body, meaning the more I have, the more energy my body produces, and thus, the more energy I’d have to continue healing and living.
I started with seated leg presses and other static weight machines, choosing to skip the free weights at first, because I knew the added requirement of #balance would be too much for my body. Eventually, however, I began squatting, bench-pressing, and performing weighted step ups, lunges, and bicep curls. It was so empowering to see my muscles growing again after losing most of my muscle mass during the height of my illnesses.

Jacob’s Ladder

As my muscles continued to build, I began completing more intense cardio workouts.
When I first started lifting weights, every day was leg day because my goal was to build up my legs muscles in order to prevent blood from pooling in my extremities (hands and feet) rather than being pumped to the heart (a hallmark symptom of POTS). By strengthening my leg muscles, I assisted the flow of blood back up to my heart, which in turn resulted in less fainting episodes while working out in an upright position. This is when I incorporated more intense, upright forms of cardio, like Jacob’s Ladder.
If you’re not familiar, Jacob’s Ladder is a machine which mimics climbing a 45 degree ladder, eternally. Literally, it’s just a loop, so you never run out of rungs and it moves at the pace you climb, giving you full control of the intensity. Your hands are also involved, which I loved as it allowed me to stay balanced as I worked out, helping build my endurance, strength, and confidence.


In addition to Jacob’s Laddering and lifting weights 3x a week, I tried incorporating Barre3 workouts to strengthen my core. Unfortunately, this proved way too intense a workout for me at first.
After my first class my adrenals were shot and I slept for 3 hours. So I continued hitting the gym for a few more months before trying Barre again–and when I did go back, I went through the workout at my own pace, rather than trying to keep up with everyone else in the room.
Eventually this became one of my favorite workouts because the instructors were all about “listening to your body” and “honoring your truth” — they never yelled at the class telling us to go harder. The environment felt really healing. That’s really the only way I can describe it.


FINALLY, a year in and I was running on the treadmill. I started on the treadmill because I did not want to risk passing out alone on the streets. That being said, treadmill running–in my opinion–is the most uninspired form of exercise, so as soon as I felt confident in my running abilities, I hit the streets…


The first time I ran outside with my newfound health I stopped a mile in and started bawling. It was such an emotional moment for me. Nearly 10 years had gone by since the cross country race I described at the beginning of this post, and for so many of those years I thought I’d never race again.
Additionally, my first run outside was 8 miles. EIGHT MILES. I couldn’t believe it. I was so much stronger than I thought. I quickly made plans to train for my first marathon–a dream I’ve had since I started running at age 12–and last year I began my training officially.
Unfortunately, IT band issues have caused my training to be a bit complicated, but I’m working through it (soon with the help of Personal Trainer Rachel Turner). Overall, I cannot wait to get back on the road without pain–every run I get to take causes me to cry now. Just another weird quirk of mine.


When my IT band began acting up, I got into spinning, because I could do it without pain and it helped me stay on top of my cardio progress. The intensity of spinning should not to be ignored, however. It is VERY different from recumbent biking. Definitely do not start here if you’re looking to start your own journey back into exercise.
Like Barre3, I enjoyed spinning because I could control the intensity of my personal workout by controlling the resistance of my bike. Additionally, I was able to hone in on a few instructors who talked more about honoring your body with exercise than pushing yourself past your comfort zone. To this day, I seek out these kinds of instructors because I believe exercise should exist as a positive, loving experience in which I honor my body and allow it to express itself through movement–not a stressful hour of pain.


When I realized my body could handle the intensity of spinning, I decided to try HIIT again (high intensity interval training). The first time I tried HIIT (over a year before), I passed out within the first 30 seconds–no joke. It was awful. I thought I’d never be able to do a HIIT workout, but now I enjoy them 4x/week.
This exists as my current exercise favorite because 1) I can do it ANYWHERE, 2) it only takes 20 min., and 3) it is so so so great for increasing mitochondria health and counts.


Is it weird that yoga is LAST on my list? Maybe. But for years (even after regaining my health) I couldn’t complete a yoga class without acquiring a migraine–specifically when my head was “under my heart”–as it often is in basic poses such as “downward facing dog”)
Then I saw a chiropractor and within a month I was doing jump squats without blacking out for the first time… 6 months later I moved to Michigan and joined a local yoga studio to make friends (not caring if I had to endure headaches after class…I just needed friends), and was ecstatic to realize my yoga-migraines were gone!!
Upon realizing this, I dove into yoga completely, signing up for the studio’s 30 day challenge. All in all, for 30 consecutive days I attended yoga class without fail. By the end, I felt more in touch with my body and in control of my emotions than ever before. It was so incredibly healing. Additionally, the flows I learned during the month of January are muscle memory now–I do them nearly every day in my room before bed.
Oh, and I also walked away with an awesome Manduka yoga mat which is now one of my most prized possessions, because of all it represents.

Intuitive Exercise

Today–POTS behind me and my health before me–I choose to exercise intuitively. This means some days I go for a long, peaceful hike, and others I run a fast 2 miles and follow with a HIIT workout… Some days I do yoga or dance in my room, and others I go to the gym to climb rocks or spin.
It means I don’t worry about what I can and can’t do, but instead, listen to my body and do what it craves, allowing movement to exist as a source of pleasure rather than a task I need to complete for X, Y, or Z reason.
In these ways, exercise has holistically served me as I’ve worked to regain my life after suffering for years with chronic illness and cancer, and I encourage everyone struggling with similar issues to find a way to begin incorporating movement into their lifestyles. If you need help doing so, I highly suggest contacting a professional who can help you get started. It’s worth the investment, I promise.

Welp, that’s everything!

I hope you found this information helpful and motivating. I promise, regaining my health wasn’t a miracle (although, finding holistic nutrition may have been). I worked for it. The things I did are simple in theory, and you can do them too. I know how it feels to have your health stripped away from you, but please, if nothing else, keep hope alive.

Each time I walk with a client from a place of exercise intolerance to a place of healthy movement, I remember 14 year old me crying in the woods alone, realizing she passed out and forfeited yet another race. The same girl who dreamed of climbing mountains and diving coral reefs, yet couldn’t get out of bed many days. I think of her and I thank her, because thanks to her determination to find answers and regain her lost health, so many others are now doing the same.

I never knew life could be this beautiful, and I wouldn’t trade it for all the varsity letters or a college running career. I wouldn’t trade it for anything.

XO, Sarah


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