Dr Nathan Keiser

Serving patients with debilitating neurological symptoms #POTS #concussion #dysautonomia

Many patients with #dysautonomia were already active. So why does “exercise” sometimes help later? Neurological rehab doesn’t use movement purely for fitness. It uses targeted stimuli to retrain #autonomic, vascular, respiratory, and vestibular control systems. #POTS

What Really Started the Problem? Why You Might Be Missing The Most Important Moment x.com/i/broadcasts/1…

She was told it was “just aging.” But certain head positions were reducing blood flow to her brain by ~40% and disrupting vestibular–autonomic control. Once we addressed that system, she could move normally again. Sometimes it’s not aging. It’s physiology.

Sometimes what looks like #POTS aren’t coming from the heart. The neck contains proprioceptors that tell the brain where the head is in space. Things like #whiplash or hypermobility- signals can become distorted. The MRI may look normal, but the problem appears when the system moves.

COVID may trigger POTS, but it’s often not why someone still has it. Two people get the same virus. One develops POTS, the other doesn’t. The real question is: what vulnerabilities were already there? #POTS #dysautonomia #LongCOVID

Sometimes the brain isn’t low on energy — it’s misallocating it. If the brain has to spend extra energy just processing basic signals, that energy can’t go toward cognition, focus, or mood. That’s one pathway behind brain fog, fatigue, and overwhelm. #BrainFog #MECFS #dysautonomia

For a long time, I’ve shared stories about patients we’ve helped navigate #dysautonomia and complex #neurological symptoms. I’ve talked about mechanisms, testing, and #recovery — always from the outside looking in. But there’s one story I haven’t really talked about. Mine.

Many patients spend years treating #MCAS, #EBV, or chronic #inflammation. The immune system doesn’t operate alone. It’s regulated by the brain and autonomic nervous system. If that's dysregulated, the immune system can become hypersensitive. Sometimes the question is: What is the brain doing? #POTS #dysautonomia #mastcell

If reading or having a conversation leaves you wiped out for hours, the issue may not be standing. It may be neurovascular decoupling. Fix the brain’s energy delivery, and the compensation often disappears. #POTS #dysautonomia #brainhealth

@AbbateAntonio I have a lot of content with detailed explanations about this on YT if you want to check it out.

@DocKeiser Are you saying that the tachycardia in POTS is purely compensatory? If yes how do you explain that many patients improve with heart rate lowering drugs like propranolol or ivabradine?

You got the tilt table test. You got the #POTS diagnosis. But the symptoms never improved. Why? Using transcranial Doppler during tilt testing helps identify the actual mechanism behind symptoms — not just the compensation. #POTS #Dysautonomia

#POTS describes what’s happening- not why it’s happening. An elevated heart rate when standing is often the body compensating for reduced blood flow to the brain. Better questions lead to better recovery pathways. #Dysautonomia

Complex neurological cases rarely have simple answers. That’s why every patient case in our clinic is discussed as a team. Multiple clinicians reviewing exams, diagnostics, and progress—daily. More perspectives = better problem-solving. #Neurology #Dysautonomia #POTS

“Graded exercise therapy” became controversial for a reason. Generic protocols that push global activity often crash ME/CFS patients. But the body also adapts to inactivity. Capacity still has to be rebuilt — just not with algorithmic workouts. #MECFS #dysautonomia #chronicillness

#Mold can absolutely trigger illness. But when every chronic condition gets blamed on mold alone, we may miss the bigger picture. In many #neurological conditions, the issue may be how the brain regulates immune responses and interprets environmental threats. #dysautonomia #chronicillness

Certain patterns can trigger dizziness. The key question is in the details- when does it happen? That distinction can reveal whether the issue involves visual pathways, vestibular reflexes, the inner ear, or the neck. #dizziness #vestibular #pppd #neurology #pots

A simple 5-minute eye test might reveal something surprising about your dizziness. If this is you, it could be pointing toward a central #vestibular issue affecting eye coordination. #centralvestibulardisorder #dizziness #vertigo

Your tests are normal...but you still feel #dizzy Understanding visual motion processing is a key step for many patients who haven’t found answers through traditional #vestibular testing. #vertigo #visualvertigo

Trapped in the Dark: Why Your Brain Constructs Suffering x.com/i/broadcasts/1…

A study of ~3,500 ME/CFS patients using ~150 treatment approaches found distinct symptom clusters. These groups responded very differently to treatment. It also helps explain why #MECFS and #POTS overlap Both commonly involve cerebral hypoperfusion. #dysautonomia