Brain Body Reset

If you have POTS or another form of dysautonomia, you’ve probably been told to increase salt, push fluids, wear compression, and maybe try a medication or two. That advice isn’t wrong, but it’s compensation, not correction. And for most people, it’s a forever strategy.

In this episode, Dr. Spencer Zimmerman, a dual-licensed nurse practitioner and doctor of chiropractic, walks through the research on a system that is almost never evaluated in POTS, Long COVID, ME/CFS, or hypermobile EDS: the vestibular system.

Most people think of the vestibular system as balance and vertigo. But the gravity-sensing otolith organs feed directly into the brainstem’s cardiovascular centers. When you stand up, this vestibulosympathetic reflex fires before your blood pressure has a chance to drop, constricting blood vessels and activating the leg muscles that pump blood back to the heart. It responds roughly twice as fast as the baroreceptor reflex that most POTS models focus on. When that early-warning system isn’t working, blood pools, less returns to the heart and brain, and the heart races to compensate. That racing heart is the downstream effect, not the root problem.

Dr. Zimmerman connects this to a 2026 paper framing POTS, ME/CFS, and Long COVID as neuroimmune disorders, research showing brainstem inflammation in Long COVID near vagal and vestibular centers, a study showing otolith stimulation changes blood flow to the brain independent of blood pressure or breathing, and astronaut research where reduced gravity weakens the otoliths and produces POTS-like orthostatic intolerance on return to Earth.

He then gets practical: what testing should be done (and why video-recorded eye movement testing should be the minimum standard), why generic habituation-based vestibular rehab often makes this population worse, and what a complete plan looks like. That includes visual and vestibular work, cervical spine and proprioception, heart-rate-guided progression, and addressing “sabotagers” like mast cell activation, anemia, thyroid, hormones, and gut issues.

Key takeaways

• What triggers POTS (infection, surgery, injury) is different from what keeps it going
• The vestibular system directly regulates blood vessel tone, heart rate, the skeletal muscle pump, and blood flow to the brain
• Tachycardia in POTS is a compensation for upstream dysfunction, which is why rate-lowering medications rarely make people feel truly well
• Research shows reduced brain blood flow appears about two minutes before nausea sets in, which is why measuring physiology beats waiting for symptoms in sensitive patients
• “Normal” and “no pathology” are not the same thing; you can have intact balance and still have impaired vestibular function
• Standard vestibular rehab is built for conditions like BPPV and relies on pushing through symptoms, which backfires in dysautonomia
• The best outcomes come from treating vision, vestibular, cervical, proprioceptive, and whole-body factors together, not in isolation

Chapters

• 0:00 Why salt, fluids, and compression aren’t the full answer
• 1:23 Triggers vs. what keeps POTS going
• 3:46 The 2026 paper: POTS, ME/CFS, and Long COVID as neuroimmune disorders
• 4:47 How POTS is actually diagnosed
• 7:44 The vestibular system is more than your inner ear
• 9:22 The vestibulosympathetic reflex vs. the baroreceptor reflex
• 13:59 What likely breaks down in POTS
• 16:21 How the inner ear regulates blood flow to the brain
• 19:44 Blood flow drops before symptoms appear (and why we use fNIRS)
• 21:42 What astronauts teach us about POTS
• 24:12 What should be evaluated
• 26:07 The skeletal muscle pump and the vestibular connection
• 30:13 Brainstem inflammation and the self-perpetuating loop
• 33:12 Levels of vestibular testing: VNG, positional, caloric, rotary chair
• 37:27 Why generic vestibular rehab often makes people worse
• 39:58 What a thorough treatment plan looks like
• 44:08 The neck, upper cervical care, hypermobility, and CCI
• 47:03 The visual system and “central” dysfunction
• 48:23 What needs to change in the field
• 51:31 Research citations and where to learn more

Learn more: Peak Brain and Body, near Tampa, FL, serves patients traveling from across the country and around the world. Visit peakbrainandbody.com.

Brain fog. Exhaustion. Dizziness. Food reactions. Symptoms that flare without an obvious reason. If you’re living with long COVID or mast cell activation syndrome (MCAS), you may have collected diagnoses and tried multiple treatments without understanding why you still feel so sick.

In this episode of Brain Body Reset, Dr. Spencer Zimmerman sits down with long COVID researcher and immunology educator Dr. Novack PhD to explore what may be keeping that cycle going, and the research investigating ways to interrupt it.

Dr. Novack shares findings from his clinical trial examining a no-added-sugar diet and fasting in people with long COVID. We discuss autophagy, your cells’ internal cleanup and recycling process, and why researchers are interested in its potential role in persistent symptoms.

We also connect the dots between mast cells, inflammation, mitochondrial dysfunction, and the nervous system to help you better understand symptoms that are too often treated in isolation.

You’ll hear about:

• Why mast cells do much more than release histamine, and why that matters when antihistamines only help so much.
• How mast cell activity and autonomic dysfunction may influence each other in MCAS and POTS.
• The possible role of persistent virus in long COVID, and the limitations of current testing.
• How damaged mitochondria may contribute to fatigue and post-exertional malaise.
• Mast cell stabilizers, including cromolyn and ketotifen, and emerging treatment research.
• Why nutrition, sleep, and individual treatment responses deserve a place in the conversation.

If you’ve been told to manage each symptom separately, this conversation offers a more connected way to understand what may be happening and questions to bring to your healthcare team.

This episode discusses emerging research and proposed mechanisms, not established cures. Fasting is not appropriate for everyone, and changes to fasting or medication should be discussed with your treating clinician.

Have you been diagnosed with hEDS and have a variety of neurological symptoms and findings?

Maybe you struggle with: chronic fatigue, brain fog, headaches/migraines, dizziness, light/noise sensitivity and more.

Your imaging suggest chiari malformation or cranio-cervical instability.

A recent research article is proposing for a new subtype to hEDS, known as Neuro-EDS. This is meant to better capture what is happening.

To learn more about our approach to EDS: https://peakbrainandbody.com/conditions/eds/

Most conversations about Ehlers-Danlos syndrome focus on joint hypermobility, ligament laxity, pain, and the musculoskeletal system. But is that enough to explain the brain fog, fatigue, dizziness, headaches, sensory overload, anxiety, and autonomic symptoms many people with EDS experience?

In this episode, Dr. Spencer Zimmerman NP, DC, DACNB reviews a 2025 research paper exploring the neurological and neuropsychological side of Ehlers-Danlos syndrome.

You’ll learn about:

• The 13 recognized EDS subtypes and why hypermobile EDS receives the most attention
• Brain structural differences associated with EDS
• Chiari malformation and craniocervical instability
• Small fiber neuropathy and autonomic dysfunction
• The overlap between EDS, POTS, and reduced cerebral blood flow
• How impaired proprioception may affect balance, coordination, joint stability, and injury risk
• The roles of interoception, sensory processing, and neurological efficiency
• Why anxiety, panic disorders, depression, ADHD, and autism are discussed in EDS research
• How the amygdala, prefrontal cortex, insula, anterior cingulate cortex, cerebellum, and brainstem may contribute to symptoms
• Why normal structural imaging does not necessarily rule out impaired neurological function

The presence of a structural finding such as Chiari malformation or craniocervical instability does not automatically mean it explains every symptom. At the same time, treating EDS as purely a joint and connective-tissue condition may leave major pieces of the problem unaddressed.

This episode explains why people with EDS may need an integrated approach that considers the musculoskeletal system, nervous system, autonomic regulation, mental health, blood flow, immune function, and the way the brain processes information from the body.

Educational only and not personal medical advice.

https://peakbrainandbody.com/conditions/eds/

POTS is not one condition with one cause and treating the elevated heart rate alone often fails to address why someone remains sick.

In this episode, Dr. Spencer Zimmerman breaks down a major POTS review published in August 2026 and translates the findings into language patients and families can understand. He explains the different processes that may contribute to POTS, including small fiber and autonomic neuropathy, low blood volume, excessive sympathetic activation, and impaired blood flow and oxygen delivery to the brain.

You’ll also learn why normal oxygen saturation and blood pressure readings do not necessarily mean the brain is receiving adequate blood flow, which conditions most commonly overlap with POTS, and why migraines and irritable bowel syndrome may deserve more attention than they currently receive.

The episode also examines standard POTS treatments—including exercise, fluids, salt, compression garments, dietary changes, and medications—along with medications that may worsen symptoms. Finally, Dr. Zimmerman discusses what the current research may be missing, including vestibular and eye-movement dysfunction, cervical integration, overlooked lab findings, hormonal changes, and why neurological rehabilitation may need to come before traditional cardiovascular conditioning for some patients.

To learn more: https://peakbrainandbody.com/conditions/pots-dysautonomia/

If you become dizzy, nauseous, weak, foggy, or feel like you might pass out when you stand, it is easy for everything to get labeled as POTS. But POTS is only one form of orthostatic intolerance.

In this episode, Dr. Spencer Zimmerman breaks down the differences between POTS, orthostatic hypotension, and neurocardiogenic syncope. These conditions can cause very similar symptoms, but the changes in heart rate, blood pressure, and neurological regulation do not follow the same pattern.

You’ll learn:

• What should normally happen to your circulation when you stand
• How POTS, orthostatic hypotension, and neurocardiogenic syncope are diagnosed
• Why the timing of heart-rate and blood-pressure changes matters
• Which of these conditions can occur together—and which cannot
• Why cardiac testing is still important, even when it comes back normal
• How dehydration, anemia, medications, neurological conditions, and other factors can contribute
• Why salt, fluids, compression, exercise, and medications help some people but not everyone
• Why receiving the correct diagnosis is only the beginning of understanding what you need to improve

If you have been diagnosed with dysautonomia but still do not understand why you are struggling or why the standard recommendations have only helped partially; this episode will help you see what may still be missing.

This episode is for educational purposes only and is not medical advice. Speak with your healthcare provider before changing medications or treatment.

To learn more: https://peakbrainandbody.com/conditions/pots-dysautonomia/

It is slightly too long for a podcast episode description. The content is good, but I’d tighten it so someone can understand the episode quickly without feeling like they have already consumed it.

If your heart races every time you stand—but your cardiac testing keeps coming back normal—the heart may not be the real problem.

POTS is diagnosed by changes in heart rate, but research suggests that the heart-rate increase may be a response to something happening earlier: an excessive drop in cerebral blood flow when you become upright.

In this episode, Dr. Spencer Zimmerman explains why this matters, how the brain and autonomic nervous system normally regulate blood flow, and how impaired regulation may contribute to dizziness, brain fog, fatigue, shortness of breath, digestive problems, temperature intolerance, and other symptoms.

You’ll also learn why salt, electrolytes, compression, and medications may help without fully explaining—or addressing—why you remain stuck.

If you have POTS or dysautonomia and feel like no one has connected all your symptoms, this episode will help the bigger picture make more sense.

If you've been told there's nothing more to do for your long COVID, or that the research just isn't there yet, this episode pushes back on both claims. 

Dr. Zimmerman NP, DC, DACNB breaks down one of the most comprehensive 2025 research papers on the neurological effects of long COVID, walking through what's actually driving symptoms like brain fog, fatigue, dizziness, mood changes, and post-exertional malaise. 

He covers the imaging and lab findings showing real, measurable brain changes, the overlapping mechanisms long COVID shares with POTS, MCAS, EDS, ME/CFS, and post-concussion syndrome, and why treating these as separate, isolated diagnoses keeps people stuck. 

You'll learn why a single test or single treatment was never going to be the answer, what a layered, multimodal approach actually looks like, and why most people aren't failing because they're "defective" — they're failing because the approach they were given wasn't built for the complexity of what's really going on. This is research translated into something you can actually use, and a roadmap for the conversation to have with any provider willing to dig in with you.

Dizziness is one of the most common symptoms people struggle with… and one of the most misunderstood.

If you’ve been told everything looks “normal,” yet you still feel off, this episode explains why.

Instead of chasing a single cause, we break down a more accurate framework — looking at how dizziness can come from metabolic issues, inflammation, the immune system, vascular changes, the neck, and ultimately how the brain processes it all. 

You’ll learn:

•  Why “normal labs” don’t always mean normal function 
•  Why treatments work for some people but not others 
•  The overlooked role of the brain, vision, and vestibular system 
•  And why there’s no one-size-fits-all fix 

If you’re tired of guessing and want to understand what’s actually driving your symptoms, this episode will give you a completely different lens to look through.

https://peakbrainandbody.com

Are your migraines or headaches still running your life—despite normal scans, multiple medications, and endless “try this” advice?

In this research-backed Q&A, Dr. Spencer Zimmerman breaks down why migraines and chronic headaches are far more complex than most people are told. Instead of focusing on labels, he walks through the four core arenas that must be evaluated to truly reduce frequency and intensity:

• Immune system & inflammation (CGRP, histamine, gut health, autoimmune links)
• Vascular factors & autonomic regulation
• Mitochondrial energy and metabolic efficiency
• Brain connectivity (cerebellum, vestibular system, trigeminal pathways)

You’ll learn:

• Why normal MRIs don’t mean “nothing is wrong”
• How medications like CGRP inhibitors work—and why they don’t solve the root cause
• The hidden role of magnesium, riboflavin, omega-3s, and ketones
• Why gut health and brain health are inseparable
• How caffeine and common OTC medications can perpetuate rebound headaches
• Why no one is looking at brain connectivity—and why that matters

If you’ve been told to “just manage it,” this episode will challenge that narrative and give you a systems-based framework for understanding what’s actually driving your migraines.

Because the goal isn’t to block pain.
 The goal is to prevent it.

If you’re ready to understand your headaches differently—and explore what’s actually possible—this episode is for you.

https://peakbrainandbody.com/