Bethenny Frankel is opening up about her health issue, explaining to her Instagram followers about her battle with postural orthostatic tachycardia syndrome (POTS) after receiving comments about the change in her physical appearance.
In the video she posted on Thursday, the "Real Housewives of New York City" alum detailed her suffering from a severe dehydration issue and shared that her doctor has associated the symptoms with POTS.
According to the National Institute of Neurological Disorders and Stroke, POTS is one of a group of disorders that have orthostatic intolerance (OI) -- a condition in which an excessively reduced volume of blood returns to the heart after an individual stands up from a lying down position. The primary symptom caused by the OI is lightheadedness or fainting. The exact cause of the disorder is unknown, but dehydration can contribute to these symptoms.
"Only because I love you while I share this with you," Frankel, 52, said in the clip. "Many of you are asking why my face looks different in my makeup videos and it's because I am messed up. I am not doing that great."
She continued, "I'm so dehydrated and riddled with aches and pains. I have had liters of Pedialyte and water and kombucha and coconut water and it just goes right through me and I've gained like four pounds while being here because my body's trying to hold onto any water it can."
Frankel described in the video that the symptoms are "very intense and it's gotten really bad in the last few years," causing her to wake up "every two hours in such pain and dying of thirst."
MORE: Bethenny Frankel shares unfiltered selfie to show girls a 'realistic female image'"So that's why I look f--ked up because I'm a little f--ked up," she explained. "It's crazy. My doctor said it's definitely connected to this POTS syndrome that I have. So many of you have experienced that too, I think."
In the caption, Frankel said the disorder she experienced "seems to have been drastically exacerbated since COVID," noting that "it's certainly a condition to manage."
While some studies show an association between COVID-19 infection and POTS, more research is needed to understand the connection.
The reality star also further explained her condition, writing, "I suffer from chronic severe dehydration. I have always experienced extremely low blood pressure and dehydration, but it's gotten exponentially worse."
"I make a tremendous effort to stay hydrated, get IV's, and I haven't had liquor for 6 months. I'm basically on the case," she said.
Frankel concluded her post with a reminder to her followers about commenting on "someone's physical appearance," telling them: "You may not know exactly what they're enduring personally, physically and emotionally."
Anyone can develop POTS at any age, according to a report from NINDS. However, it mainly affects women between the ages of 15 to 50. Some women report an increase in episodes of POTS right before their menstrual period. POTS often begins after a pregnancy, major surgery, trauma, or a viral illness. The condition may make individuals unable to exercise because the activity brings on fainting spells or dizziness.
The cause of the disorder is unknown. Treatment is targeted at relieving low blood volume or regulating circulatory problems that may cause the disorder. A number of drugs seem to be effective in the short term. Whether they help in the long term, is uncertain, according to NINDS.
Simple interventions such as adding extra salt to the diet and attention to adequate fluid intake are often effective.
NINDS further advises that POTS may follow a relapsing-remitting course, in which symptoms come and go, for years. In most cases, an individual with POTS improves to some degree and becomes functional, although some residual symptoms are common.