autoimmunity, POTS nutrition

POTS patients and plastic: Don’t take another sip from that Evian bottle ‘til you read this

One of the many bummers associated with having POTS is being at higher risk for autoimmunity (1). Dr. Svetlana Blitshteyn showed higher rates of autoimmune disease and autoimmune markers in POTS patients, and mounting evidence suggests that POTS may itself be the result of an autoimmune process in many of us (2, 3, 4).

There are over 100 different autoimmune diseases (here’s a list), and they all involve the immune system attacking and destroying one’s own tissue.  For example, in Hashimoto’s, the thyroid gets attacked; in rheumatoid arthritis the joint tissue gets attacked; in MS the protective sheath around neurons gets attacked.  There are numerous different autoimmune diseases because there are so many different types of tissue that your immune system can destroy.

Unfortunately, having one autoimmune disease doesn’t protect you from getting others. I’ve got 3 so far, which is why I’m fairly obsessed with preventing any more. Hence, my disdain for the the chemical in many plastics, BPA, which stands for Bisphenol A.

BPA is common in many soft plastics, like water bottles, food packaging, food storage containers, and the lining of cans.  When our food is stored or heated in these plastics, the BPA can leach into the food, where we eat it.  Why do we care?

Top experts in the field of autoimmunity call BPA “a notorious player in the mosaic of autoimmunity” (5).  Dr. Datis Kharrazian, a leader in autoimmune research, has described 12 (twelve!) different ways that BPA may lead to autoimmunity (6; see Figure 1 if you’d like to count the ways).

Now, we already knew that BPA is an “endocrine disrupter”, meaning it disturbs our hormones and contributes to sexual dysfunction, infertility, miscarriage, obesity, cancer, gynecomasty (male breast development), type 2 diabetes, and other hormone-related problems.  Newer research suggests it also causes neurological problems, especially with exposure at a young age (7).  In response, the industry largely removed BPA from food packaging and replaced it with different bisphenols, such as BPB, BPF or BPS.  These new plastics proudly display the “BPA-free” label.  

Great, so “BPA-free” items are safe, right?  Can we get on with our lives now, without worrying our food packaging is toxic?  I wish!

Here’s the part of the story where, if you’re like me, your blood begins to boil:  When industry replaced BPA with substitute chemicals, they did not test them for safety first.  Our government does not require any safety tests before companies can put new materials on the market.  Research suggests the new chemicals are just as bad, if not worse, than BPA (8).

So try to get a glass or stainless steel water bottle to replace single-use plastic bottles.  Consider replacing plastic Tupperware with glass containers.  Never microwave foods in plastic.  When possible, avoid canned beans and use dried beans instead.  Bring your own ceramic mug to Starbucks instead of accepting hot liquids in plastic-lined paper cups.  You get the idea:  BPA…Be Plastic Avoidant!


  1. Blitshteyn S. Autoimmune markers and autoimmune disorders in patients with postural tachycardia syndrome (POTS). Lupus. 2015;24(13):1364-1369. doi:10.1177/0961203315587566
  2. Gunning WT 3rd, Kvale H, Kramer PM, Karabin BL, Grubb BP. Postural Orthostatic Tachycardia Syndrome Is Associated With Elevated G-Protein Coupled Receptor Autoantibodies. J Am Heart Assoc. 2019;8(18):e013602. doi:10.1161/JAHA.119.013602
  3. Fedorowski A, Li H, Yu X, et al. Antiadrenergic autoimmunity in postural tachycardia syndrome. Europace. 2017;19(7):1211-1219. doi:10.1093/europace/euw154.
  4. Watari M, Nakane S, Mukaino A, et al. Autoimmune postural orthostatic tachycardia syndrome. Ann Clin Transl Neurol. 2018;5(4):486-492. Published 2018 Feb 28. doi:10.1002/acn3.524
  5. Aljadeff G, Longhi E, Shoenfeld Y. Bisphenol A: A notorious player in the mosaic of autoimmunity. Autoimmunity. 2018;51(8):370-377. doi:10.1080/08916934.2018.1551374
  6. Kharrazian D. The Potential Roles of Bisphenol A (BPA) Pathogenesis in Autoimmunity. Autoimmune Dis. 2014;2014:743616. doi:10.1155/2014/743616
  7. Inadera H. Neurological Effects of Bisphenol A and its Analogues. Int J Med Sci. 2015;12(12):926-936. Published 2015 Oct 30. doi:10.7150/ijms.13267
  8. Moon MK. Concern about the Safety of Bisphenol A Substitutes. Diabetes Metab J. 2019;43(1):46-48. doi:10.4093/dmj.2019.0027

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