At the clinic led by Dr. Sarah Diekman, we hear this question almost daily:
“Could my symptoms after COVID-19 be dysautonomia?” For many, the answer is yes.
Dr. Sarah Diekman, founder of the practice and a physician who also lives with dysautonomia herself, is uniquely positioned to understand this condition — both scientifically and personally. This blog explores the link between Long COVID and dysautonomia, what current research shows, and how you can get help if you’re struggling.
What Is Dysautonomia, and Why Does It Matter Post-COVID?
Dysautonomia refers to a malfunction of the autonomic nervous system (ANS) — the part of the body that controls involuntary processes like heart rate, blood pressure, temperature regulation, digestion, and more. When this system malfunctions, everyday activities like standing up, eating, or even thinking clearly can become overwhelming.
One of the most common forms is Postural Orthostatic Tachycardia Syndrome (POTS) — a condition Dr. Sarah Diekman has lived with and now treats in her clinical practice. POTS is defined as a sustained increase in heart rate of at least 30 bpm in adults (40 bpm in adolescents) within 10 minutes of standing, without a significant drop in blood pressure.
The Link Between COVID-19 and Autonomic Dysfunction
COVID-19 affects multiple systems in the body, and researchers now recognize that the virus can damage or destabilize the autonomic nervous system — even in mild cases.
So, how does this happen?
Immune System Overactivation
COVID can trigger an autoimmune-like response that misfires, attacking the body’s own tissues — including parts of the nervous system.
Inflammatory Damage
The inflammatory storm during infection can disrupt nerve signaling, especially small fibers that regulate autonomic function.
Viral Persistence or Residual Damage
Some studies suggest that lingering viral particles or post-viral debris (residual viral proteins or inflammation left after infection) can continue to affect nerve regulation.
Blood Volume and Circulatory Issues
Dysautonomia often includes hypovolemia (low blood volume) and venous pooling, both of which have been seen in post-COVID cases.
Symptoms of Long COVID Dysautonomia
If you’ve had COVID and are experiencing the following symptoms — especially if they worsen when standing — dysautonomia may be the missing diagnosis:
- Rapid heartbeat or palpitations when standing
- Dizziness, especially upon standing (orthostatic intolerance)
- Brain fog or trouble concentrating
- Fatigue that doesn’t improve with rest
- Nausea, bloating, or other GI issues
- Heat or cold intolerance
- Shakiness, especially in the limbs
- Shortness of breath, often described as a sensation of not getting enough air
- Chest discomfort not related to heart disease
Many of our patients report being dismissed by providers who chalk these symptoms up to anxiety. At Dr. Sarah Diekman’s clinic, we know better — because we’ve been there.
Dr. Sarah Diekman’s Unique Approach: From Patient to Physician
Dr. Sarah Diekman was diagnosed with POTS while still in medical school. She understands firsthand the frustration of having real symptoms without real answers.
After recovering enough to finish her medical training — including a residency at Johns Hopkins in Occupational and Environmental Medicine — she founded her clinic with a mission:
“To give patients the care, knowledge, and hope I wish I had when I was in their shoes.”
Today, Dr. Sarah Diekman works with patients from across the country, including many Long COVID sufferers who are just beginning to understand the role of autonomic dysfunction in their lingering symptoms.
How Is Post-COVID Dysautonomia Diagnosed?
There’s no single “dysautonomia test.” Diagnosis is made through clinical evaluation, symptom history, and specialized testing, including:
- Active Stand Test
Monitoring blood pressure and heart rate while lying down, then standing for 10 minutes. - Tilt Table Test
Performed in a clinical setting to assess cardiovascular response to position changes. - 24-Hour Holter Monitor
Tracks heart rate variability and abnormalities throughout a day. - Autonomic Function Testing
A series of evaluations that assess how the nervous system reacts to different stressors.
Dr. Sarah Diekman also reviews daily function, symptom triggers, medication history, and coexisting conditions like Mast Cell Activation Syndrome (MCAS), Ehlers-Danlos Syndrome (EDS), and small fiber neuropathy — which often appear alongside post-viral dysautonomia.
What Treatment Options Exist?
Although there’s no cure for dysautonomia, treatment can greatly improve quality of life. At Dr. Sarah Diekman’s clinic, care plans are personalized to meet patients where they are — physically, emotionally, and functionally.
H3: Core treatment strategies include:
Lifestyle Modifications:
- Increased fluid and salt intake
- Compression garments
- Elevating the head of the bed
- Recumbent or graded exercise
Medications:
- Beta blockers
- Fludrocortisone
- Midodrine
- Ivabradine (in select cases)
Nutritional Guidance:
- Anti-inflammatory diets
- Small, frequent meals
- Addressing GI issues like gastroparesis
Environmental Adjustments:
- Cooling vests
- Adaptive scheduling for work or school
- Ergonomic supports
Emotional & Mental Support:
- Therapy
- Mindfulness practices
- Access to support groups
What Research Is Telling Us So Far
Emerging studies from institutions like NIH and Mayo Clinic are beginning to validate what many patients have known for years — Long COVID can trigger autonomic dysfunction, especially in young women.
H3: Key findings include:
- Over 60% of Long COVID patients report orthostatic intolerance or related symptoms
- Patients with pre-existing dysautonomia may experience worsening post-COVID
- Early intervention and validation improve long-term outcomes and reduce disability
But this is still a developing field. That’s why Dr. Sarah Diekman stays current with peer-reviewed research and evolving treatment protocols — committed to applying the latest science to compassionate, real-world care.
When to Seek Help
If your life has been derailed by post-COVID symptoms that doctors can’t explain — especially if you feel worse when upright, after eating, or in hot environments — it’s time to consider dysautonomia.
You don’t have to suffer in silence, and you don’t have to accept “It’s just anxiety” as your final answer.
At the clinic led by Dr. Sarah Diekman, we hear you. We believe you. And we’re ready to help.
Ready to Take the Next Step?
If you think you may be dealing with post-COVID dysautonomia, reach out today. We offer telemedicine appointments, comprehensive evaluations, and care plans tailored to your life and symptoms.
Call: 833-768-7633
Location: Diekman Dysautonomia, LLC. 5000 Thayer Center, Oakland, MD
Email: DysautonomiaInquiry@yahoo.com
Schedule a new patient appointment today — and start your path toward reclaiming your life.
