Dizziness, POTS and Histamine

Understanding the nervous system connection

Dizziness is one of the most common symptoms I see in clinic, and also one of the most confusing for clients to navigate. It can come and go, feel unpredictable, and often appear alongside fatigue, palpitations, brain fog, nausea or anxiety. Many people with dizziness and histamine related symptoms struggle to understand why everything feels so connected, yet so hard to explain.

Some clients are told their tests are normal or that stress explains their symptoms. Others receive diagnoses such as POTS, mast cell activation, vasovagal syncope or histamine intolerance, but still feel unsure how these pieces fit together.

Over time, a clear pattern has emerged. Clients with dizziness improve most when we stop treating symptoms in isolation and instead support the brain, nervous system, blood vessels, gut and immune system together.

In this blog, I explain how dizziness and histamine connect through conditions such as POTS and mast cell activity, and why nervous system regulation plays such an important and often overlooked role.

What is POTS

Postural Orthostatic Tachycardia Syndrome, commonly known as POTS, affects how the autonomic nervous system regulates heart rate and circulation. When someone with POTS moves from lying or sitting to standing, their heart rate rises significantly, often without the expected increase in blood pressure.

People with POTS commonly experience dizziness or lightheadedness, a racing heart, fatigue, weakness, brain fog, nausea, temperature sensitivity and, in some cases, fainting. Many also notice anxiety-like sensations, even when anxiety itself does not drive the symptoms.

Rather than being a heart condition alone, POTS reflects disrupted communication between the brain, nervous system, blood vessels and heart, particularly during changes in posture.

Blood flow, blood pressure and the autonomic nervous system

Understanding why dizziness occurs in POTS starts with how the nervous system controls blood flow.

In a well regulated system, standing up triggers a rapid response. Blood vessels constrict, the heart adjusts its rate, and the body redirects blood to the brain.

In POTS and related conditions, this response often misfires. Blood pools in the lower body, the heart speeds up to compensate, and the brain briefly receives less blood. This reduction in cerebral circulation commonly causes dizziness and visual disturbances.

The autonomic nervous system controls these adjustments. Chronic stress, inflammation, illness or prolonged physiological strain can disrupt this system and make these responses less reliable.

Mast cells, histamine and blood vessel regulation

Mast cells play another key role in dizziness.

These immune cells drive inflammation and help coordinate communication between body systems. They sit throughout the body, including near blood vessels, nerves and within the brain.

When mast cells become overactive or unstable, they release mediators such as histamine. Histamine directly affects how blood vessels widen and narrow, which then influences blood pressure, heart rate and circulation.

This is often where dizziness and histamine connect. When the body struggles to regulate histamine, vascular responses can become exaggerated, leading to dizziness, flushing, palpitations and fatigue.

This shared mechanism helps explain why POTS, mast cell activation and histamine intolerance so often occur together.

The brain, vestibular system and dizziness

Dizziness does not always start in the inner ear. The vestibular system, which regulates balance and spatial awareness, connects closely with the brain, eyes and nervous system.

This system sits near the amygdala, a brain region that manages threat detection and stress responses. When the nervous system stays in a heightened state, the brain can misread or amplify signals coming from the eyes and ears.

As a result, everyday movement or changes in position can feel disorienting. The brain struggles to accurately integrate visual, sensory and balance information, which can create sensations of spinning, rocking or feeling unsteady.

This connection explains why dizziness often intensifies during periods of stress, illness or hormonal change, even when inner ear tests show no abnormalities.

Stress, nervous system dysregulation and symptom amplification

Chronic stress affects far more than mood. It alters nervous system signalling, blood vessel tone, gut function and immune activity.

When the nervous system remains in a heightened state of alert, signals from the gut, immune system and vestibular system are processed through a sensitised brain. Symptoms such as dizziness, palpitations and brain fog can become more frequent and intense.

This does not mean symptoms are imagined. It means the system interpreting them is overloaded.

For many clients, addressing dizziness and histamine together through nervous system support becomes a key turning point.

Vasovagal syncope and positional dizziness

Vasovagal syncope is another common contributor to dizziness.

It occurs when the nervous system triggers a sudden drop in heart rate and blood pressure, often in response to standing, emotional stress or prolonged upright posture. This temporarily reduces blood flow to the brain, leading to dizziness or fainting.

Like POTS, vasovagal syncope reflects a nervous system regulation issue rather than a structural heart problem. Many people experience features of both conditions, particularly when the nervous system is already under strain.

Why food alone is rarely enough

Dietary strategies such as low histamine eating can be extremely helpful, particularly for reducing mast cell activation and inflammatory load.

However, food is only one part of a much larger system. If nervous system regulation is not addressed, symptoms related to dizziness and histamine may persist despite careful dietary management.

This is often when people feel stuck or confused, doing everything right but still feeling unwell.

A systems based approach recognises that gut health, mast cell stability, blood vessel regulation and nervous system support must work together.

A whole systems approach to dizziness and histamine

In practice, meaningful improvement often occurs when support includes:

• nervous system regulation and stress reduction
• targeted gut and histamine support
• mast cell stabilisation strategies
• blood pressure and circulation support
• gentle vestibular and sensory integration
• appropriate nutritional and lifestyle foundations

This integrated approach helps restore clearer communication between the brain and body, allowing automatic systems to function more reliably again.

Dizziness, POTS and histamine issues are rarely isolated problems. They reflect complex interactions between the nervous system, immune system, blood vessels and brain.

When we understand the connection between dizziness and histamine, we can move beyond symptom management and towards more effective, sustainable support that addresses the system as a whole.

You can recover from dizziness and POTS. Angela got amazing results in the Happy Without Histamine Method program, and went from bed and wheelchair bound to doing yard work, cooking and homeschooling her kids again! Watch more below.

Struggling to get answers about your histamine intolerance symptoms?

Watch my free Masterclass – The 5 Steps to Healing from Histamine Intolerance.

You will learn my 5-Step plan, the exact same method I used to recover from histamine intolerance. These 5 steps everyone with histamine intolerance must know to resolve all those confusing symptoms and get back to eating foods you love without fear!