It starts the moment you stand. Your heart races — or sometimes it doesn’t — but you still feel that surge of adrenaline. Your hands tremble, your chest tightens, and your body reacts as if you’ve just run a sprint. Then, when you sit back down, the feeling slowly fades.

For many patients with Lyme disease and hyperadrenergic POTS, this isn’t anxiety or stress. It’s the body’s autonomic nervous system locked in a “fight or flight” mode. This form of dysautonomia, often triggered by Lyme disease, causes adrenaline surges, dizziness, and a body that won’t settle down.

What Is POTS and How It Relates to Lyme Disease

POTS, or Postural Orthostatic Tachycardia Syndrome, affects the autonomic nervous system, which regulates heart rate, blood pressure, and circulation. When you stand, your body should automatically adjust blood flow to your brain.

In POTS, that adjustment falters. Some patients develop a sharp rise in heart rate — 30 beats per minute or more within minutes of standing — while others have little or no tachycardia, yet experience the same adrenaline surge, dizziness, and internal vibration.

Hyperadrenergic POTS is a specific type of POTS characterized by excessive sympathetic (“fight-or-flight”) nervous system activity when standing. It’s often associated with high levels of norepinephrine (a stress hormone) in the blood upon standing.

In Lyme and hyperadrenergic POTS, the defining feature isn’t always heart rate. It’s the excess release of norepinephrine. Your body behaves as though it’s under attack when you’re simply standing still.

How Lyme Triggers Hyperadrenergic POTS

Lyme disease can inflame or damage the small nerve fibers that regulate automatic body functions. When this system is disrupted, the sympathetic (“fight or flight”) pathway becomes locked in high gear.

Even after the infection clears, the nervous system may take time to recalibrate. This doesn’t always mean persistent infection — it can reflect post-infectious autonomic imbalance, which often improves as the system heals.

Not every POTS patient has a racing heart—some just have a racing nervous system.

Recognizing the Pattern

Patients with Lyme and hyperadrenergic POTS often describe a body that overreacts to everyday situations. Standing up to make coffee, walking across a room, or even mild warmth can trigger a rush of adrenaline. Their pulse may or may not jump dramatically, but their bodies respond as if they’ve just run a marathon.

They describe trembling hands, a sense of internal vibration, or waves of heat that come from nowhere. Some feel dizzy or faint; others feel flushed and wired. Many experience brain fog or headaches, as if the nervous system can’t decide whether to accelerate or slow down.

The pattern is familiar: small triggers, big reactions, and a body that won’t settle back down. Heat, dehydration, or stress can magnify symptoms.

For patients living with Lyme and hyperadrenergic POTS, understanding that these reactions are physiologic, not psychological, often changes everything. It replaces self-doubt with validation.

Finding Calm After Chaos

For many, the hardest part is being told “it’s all in your head.” But POTS is real and measurable. Recognizing the connection between Lyme disease and autonomic imbalance is the first step toward understanding why the body feels stuck in overdrive.

Recovery takes time. As inflammation subsides and the nervous system finds stability, adrenaline surges become less frequent, the heart steadies, and daily life begins to feel normal again.

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