POTS, MCAS, and the Overlooked Venous System with Dr. Alexis Cutchins
Fri Feb 06 2026
Your dizziness when you stand up is real. Your pelvic pain is real. Your fatigue is real. And there's actually a connection between all of it that most doctors were never taught to look for.
If you've ever been told your dizziness, palpitations, or pelvic pain is "just anxiety," this episode is for you. Dr.Dr. Alexis Cutchins is a cardiologist treating POTS and MCAS—she's willing to say 'I don't know, let's figure it out' instead of dismissing patients.
We discuss what POTS actually is, how to diagnose it why 80% of her POTS patients have venous insufficiency, and how treating the veins can sometimes cure the POTS.
We also talk about the connection between POTS, mast cell activation syndrome, hypermobility, and pelvic venous disease conditions that often travel together and are frequently dismissed.
Dr. Alexis Cutchins explains why the venous system is a "lost organ system" that no one really learns about in med school,how left iliac vein compression (May-Thurner syndrome) can cause everything from pelvic pain to back pain and headaches
Plus, we discuss women's cardiovascular health, microvascular disease, coronary vasospasm, and why women's heart attack symptoms can look completely different including neck tightness from allergies that's actually cardiac ischemia.
Highlights:You don't need a tilt table test to diagnose POTS simple office based or at home tests can help identify it.First-line POTS treatment: volume expansion (drink water, eat salt), compression stockings, treating comorbid MCAS.About 80% of POTS patients have venous insufficiency treating it can dramatically improve or even cure symptoms.Pelvic venous disease is diagnosed with MRV (not CT) and treated with stenting by interventional radiologists.Women's heart attacks can present as abdominal pain, neck tightness, or jaw pain—not just chest pain.These conditions run in families mothers and daughters often share the same constellation of symptoms.
If you've been dismissed for POTS, MCAS, pelvic pain, or any constellation of symptoms that don't fit into a neat diagnostic box, this episode validates what you've been experiencing. These conditions are real. They're treatable. And more doctors are finally starting to listen.
Make sure to subscribe to the podcast so you don't miss upcoming episodes on related topics, and share this with anyone who needs to hear that their symptoms matter.
Get in Touch with Dr. Cutchins:
Website
Instagram
Youtube
Get in Touch with Me:
Website
Instagram
Youtube
Substack
More
Your dizziness when you stand up is real. Your pelvic pain is real. Your fatigue is real. And there's actually a connection between all of it that most doctors were never taught to look for. If you've ever been told your dizziness, palpitations, or pelvic pain is "just anxiety," this episode is for you. Dr.Dr. Alexis Cutchins is a cardiologist treating POTS and MCAS—she's willing to say 'I don't know, let's figure it out' instead of dismissing patients. We discuss what POTS actually is, how to diagnose it why 80% of her POTS patients have venous insufficiency, and how treating the veins can sometimes cure the POTS. We also talk about the connection between POTS, mast cell activation syndrome, hypermobility, and pelvic venous disease conditions that often travel together and are frequently dismissed. Dr. Alexis Cutchins explains why the venous system is a "lost organ system" that no one really learns about in med school,how left iliac vein compression (May-Thurner syndrome) can cause everything from pelvic pain to back pain and headaches Plus, we discuss women's cardiovascular health, microvascular disease, coronary vasospasm, and why women's heart attack symptoms can look completely different including neck tightness from allergies that's actually cardiac ischemia. Highlights:You don't need a tilt table test to diagnose POTS simple office based or at home tests can help identify it.First-line POTS treatment: volume expansion (drink water, eat salt), compression stockings, treating comorbid MCAS.About 80% of POTS patients have venous insufficiency treating it can dramatically improve or even cure symptoms.Pelvic venous disease is diagnosed with MRV (not CT) and treated with stenting by interventional radiologists.Women's heart attacks can present as abdominal pain, neck tightness, or jaw pain—not just chest pain.These conditions run in families mothers and daughters often share the same constellation of symptoms. If you've been dismissed for POTS, MCAS, pelvic pain, or any constellation of symptoms that don't fit into a neat diagnostic box, this episode validates what you've been experiencing. These conditions are real. They're treatable. And more doctors are finally starting to listen. Make sure to subscribe to the podcast so you don't miss upcoming episodes on related topics, and share this with anyone who needs to hear that their symptoms matter. Get in Touch with Dr. Cutchins: Website Instagram Youtube Get in Touch with Me: Website Instagram Youtube Substack