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By Peter A. McCullough, MD, MPHA recent review on postural orthostatic tachycardia syndrome (POTS) appeared in JAMA and stupendously failed to appreciate the ubiquitous SARS-CoV-2 Spike protein has made this medical term a household name. The piece had no practical suggestions and did not address the root cause.Chung TH, Raj SR. Postural Orthostatic Tachycardia Syndrome (POTS): A Review.JAMA.Published online August 24, 2026. doi:10.1001/jama.2026.14809Pandemic POTS: Viral & Vaccine Spike Protein, the Autonomic Nervous System, and a Rational Treatment FrameworkPandemic-era postural orthostatic tachycardia syndrome is not a mystery illness. It is a predictable, mechanistically coherent consequence of a specific antigen—the SARS-CoV-2 spike glycoprotein—interacting with three organ systems that share a common vulnerability: theheart, thevasculature, and thecentral and autonomic nervous systems. What follows is a synthesis of the pathophysiology and a practical, phenotype-driven treatment approach that prioritizes symptomatic control, preservation of functional capacity in young people, and root-cause mitigation of the antigenic trigger.Subscribe nowRead more