Great questions! Many of us have low stomach acid due to poor vagus nerve function. Parasym Plus is designed to correct that. If you have other symptoms of low acetylcholine and/or vagus nerve problems, it may be just what you need. Being a mild diuretic, many of us with POTS had your fears — HOWEVER, if you have any pressure on your brain stem from high intracranial pressure, that can cause issues with low BP, heart rate, etc. Reducing the pressure can often correct it. It’s contrary to what our first instincts are — I think that is one reason doctors don’t go to it first. I *hope* you are like many of us and can avoid decompression. I had “Chiari Zero” — sort of a no-brainer for me, but it can still be effective for “true” Chiari. In the Driscoll Theory book, I have some references to published research explaining this and presenting case studies. Fingers crossed for you!