Katie Ledecky opens up about POTS diagnosis and how she manages it when competing (2024)

Katie Ledecky, the most dominant female swimmer of her generation, has been making waves at the Paris Olympics.

But behind her Olympic gold medals and world records lies a lesser-known story of perseverance and resilience. In her recently released memoir, “Just Add Water: My Swimming Life,” Ledecky reveals her battle with postural orthostatic tachycardia syndrome (POTS), a condition that affects the nervous system.

What is POTS?

Postural orthostatic tachycardia syndrome (POTS) is a disorder of the autonomic nervous system, which controls body functions we often don’t think about, such as heart rate and blood pressure.

Katie Ledecky opens up about POTS diagnosis and how she manages it when competing (1)

As Ledecky describes in her memoir, “I pool blood in the vessels below my heart when I stand. My body then releases extra norepinephrine or epinephrine, which adds additional stressors on my heart, making it beat faster. Which, in turn, brings on dizziness, fainting, and exhaustion.”

The condition is generally diagnosed when a patient’s heart rate increases by at least 30 beats per minute (or 40 bpm in adolescents) within 10 minutes of standing, without a significant drop in blood pressure. This syndrome predominantly affects young women, such as Ledecky, particularly those between the ages of 15 and 50.

When was Katie Ledecky diagnosed with POTS?

Ledecky first experienced symptoms of POTS during the 2015 World Aquatics Championships in Kazan, Russia, she wrote in her memoir.

One evening after dinner, she felt unusually hot and lightheaded. In the days and weeks that followed, she endured episodes of extreme fatigue and dizziness, sometimes feeling faint even during simple activities like walking. These troubling symptoms eventually led to a surprising diagnosis: POTS.

In her book, Ledecky explains how her body struggles to regulate blood flow when she stands, forcing her heart to work harder and causing dizziness, fainting, and exhaustion.

How is POTS treated?

The causes of POTS are multifaceted including a possible link to COVID-19 infections, but in general are not entirely understood.

The best way to manage POTS also varies, but it often includes lifestyle modifications, such as increased salt and fluid intake. This is part of Ledecky's approach; her mother often has to remind her to get more salt or stay hydrated.Ledecky also avoids alcohol and wears compression garments, which can help manage symptoms.

Fortuitously for Ledecky, swimming is among the recommended exercises for patients with POTS. There is no specific cure for POTS, but many have found improvement of symptoms with some of the recommended treatments.

How POTS affects Ledecky’s swimming

Ledecky has not specifically described any changes to her swim training or routines as a result of the diagnosis, but she has stated in a previous interview with Self that the diagnosis was a new thing she had to acknowledge and be aware of, something that was always in the back of her mind.

"I’ve had it under control completely. I really just had to add salt to my diet and wear compression gear. Whenever I get sick and when I go to hot environments, I need to be especially careful to stay on top of my salt and hydration," she said.

"I thought it was important to tell my whole story, and that was a part of my story, especially leading up to the 2016 Olympics. It was a new thing that I had to acknowledge and be aware of, something that was always in the back of my mind. I wanted to share how that’s impacted me at different points and how I’ve been able to push through that and take control of that part and live a healthy lifestyle."

A recent study found that features of POTS, such as the change in heart rate or blood pressure when going from laying down to sitting up, can affect the performance of elite swimmers.

Why Ledecky’s diagnosis matters

Ledecky credits her former coach Bruce Gemmell, who recommended she see a specialist at Johns Hopkins, where she promptly received a diagnosis and treatment plan. But for most people with POTS, being diagnosed can take anywhere from two to seven years, including numerous emergency room visits and misdiagnoses along the way.

Ledecky’s public disclosure of the diagnosis has led to a groundswell of additional testimonials on social media and more awareness of a tricky to identify but possibly debilitating condition.

It is important to note that Ledecky’s experience with POTS is just that — unique and individual. Many people with POTS experience a great spectrum of symptoms, with some barely noticing any effects to others who experience complete disability.

One thing is certain: Ledecky’s talent for breaking Olympic records while raising awareness about a significant chronic condition deserves its own gold medal.

Kavita Patel, MD

Dr. Kavita Patel is NBC News medical contributor and professor of medicine at Standford.

Katie Ledecky opens up about POTS diagnosis and how she manages it when competing (2024)

FAQs

Katie Ledecky opens up about POTS diagnosis and how she manages it when competing? ›

"I've had it under control completely. I really just had to add salt to my diet and wear compression gear. Whenever I get sick and when I go to hot environments, I need to be especially careful to stay on top of my salt and hydration," she said.

When did Katie Ledecky get diagnosed with POTS? ›

Ledecky was diagnosed with POTS in 2015 after feeling extreme fatigue and dizziness after her workouts. Katie Ledecky has been making waves during her record-breaking run at the Paris 2024 Olympics, but the accomplished swimmer's career hasn't been all calm waters.

How did Katie Ledecky change the world? ›

Her world records came in the 800- and 1500-meter freestyles. Ledecky became the first swimmer—male or female—to win the 200-, 400-, 800- and 1500-meter freestyles in a major competition. Ledecky was also named the female swimmer of the meet.

How is Katie Ledecky inspirational? ›

As personable and relatable as she is laser-focused on achieving her goals, she shares her perspective on developing a winner's mentality, goal setting, swimming past adversity, and the importance of discipline, practice, and support in reaching peak performance.

Which Olympic athlete has POTS? ›

Katie Ledecky is an athlete who competes at the highest level, and she does it despite living with postural orthostatic tachycardia syndrome (POTS) – a physically debilitating disorder.

What is POTS often misdiagnosed as? ›

While some of the physical symptoms of POTS overlap with the symptoms of anxiety, such as tachycardia and palpitations, POTS is not caused by anxiety. POTS patients are often misdiagnosed as having anxiety or panic disorder, but their symptoms are real and can severely limit a person's ability to function.

How to be an athlete with POTS? ›

Build up the number of minutes spent exercising very slowly.

Many with POTS have exercise intolerance and orthostatic intolerance (symptoms increase when standing). You might start with five minutes on a recumbent bike.

Are Michael Phelps and Katie Ledecky friends? ›

Are Michael Phelps and Katie Ledecky friends? They are! In fact, Phelps is quite proud of Ledecky.

Has Katie Ledecky ever lost a race? ›

Ledecky has not lost a 1,500-meter freestyle race in 14 years. Even her rivals admit they hit the water knowing they're racing for second. The last time that Katie Ledecky was beaten in a 1,500-meter freestyle event was a regional swim meet in Maryland 14 years ago.

Why is Katie Ledecky the goat? ›

Record times

Ledecky holds world records in two events, and has broken world records over a dozen times, according to NBC Olympics. And remember how her 1500m freestyle race broke her own Olympic record? That's happened a majority of the time Ledecky has broken a swimming record.

What is Katie Ledecky's personality? ›

For example, at the 2015 World Championships, she became the first person ever to sweep five events. Her accomplishments at this event became known as the “Ledecky Slam.” Katie is aggressive in the water, but in all other respects, people have found her to be humble, calm, and collected.

How much does Katie Ledecky weigh? ›

What does Katie Ledecky do in a day? ›

8 AM – Nap. 10 AM – Snack of yogurt, honey and granola with mixed berries, plus either an apple or pear. 11 AM – Dryland training. 12:30 PM – Lunch of pasta with chicken or Caesar salad with chicken and an avocado.

Does Katie Ledecky have a syndrome? ›

But beneath the surface, things haven't been completely smooth swimming for Ledecky for the past nine years. The nine-time Olympic gold medalist has had to deal with POTS. And in this case, POTS stands for postural orthostatic tachycardia syndrome. Each of the words in POTS is a clue to what the condition is.

Are POTS autoimmune? ›

The role of autoimmunity in POTS

The role of the immune system in POTS has attracted much interest in recent years. While a clear autoimmune etiology has not been identified, the shared clinical features between POTS and various autoimmune conditions suggest several immune-mediated mechanisms.

What celebrities have POTS? ›

  • What is POTS? Postural Orthostatic Tachycardia Syndrome (POTS) is a condition characterized by an excessive increase in heart rate upon standing. ...
  • Halsey. ...
  • Billie Eilish. ...
  • Bethenny Frankel. ...
  • Tori Foles. ...
  • Mara Wilson. ...
  • Brittany Bowes. ...
  • Gigi Robinson.

How did you get diagnosed with POTS? ›

People with POTS may have symptoms for months to years before finally being diagnosed with the condition. A healthcare provider will ask questions about your symptoms, medications and medical history. They'll also perform a physical exam. A tilt table test is the main way providers diagnose POTS.

What is the average age for POTS? ›

Anyone at any age can develop POTS, but it mainly affects women between the ages of 15 to 50 years of age. Some women report an increase in episodes of POTS right before their menstrual periods. POTS often begins after a pregnancy, major surgery, trauma, or a viral illness.

Who is most likely to get POTS? ›

Dysautonomia International estimates that POTS affects between one and three million people in the U.S. The majority of them are women, although men may also develop POTS. POTS is less common in young children, but it affects adolescents, and symptoms often develop during puberty.

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