Bethenny Frankel is EchoSensekeeping it real when it comes to her health struggles. 

The Real Housewives of New York City alum got candid about her battle with postural orthostatic tachycardia syndrome (POTS).

"There were some comments about my face looking different in recent videos, so here is why," Bethenny, 52, wrote on Instagram Feb. 23. "I'm bloated, swollen and I've gained 4 lbs., in 3 days because my body is desperately hanging on to any water it can." 

POTS is a condition that causes your heart to beat faster than normal when you transition from sitting or lying down to standing up, according to the Cleveland Clinic.

But as Bethenny noted, several factors contribute to her own personal health struggles. "I suffer from chronic severe dehydration," she explained. "I have always experienced extremely low blood pressure and dehydration, but it's gotten exponentially worse."

And when you combine altitude and a dry climate similar to the one she is currently experiencing in Aspen, Colo., Bethenny says additional challenges surface.

"I make a tremendous effort to stay hydrated, get IV's and I haven't had liquor for 6 months," Bethenny added. "I'm basically on the case."

Despite the health setbacks in the mountains, Bethenny is "so grateful to be able to experience such a beautiful place and indulge in my favorite pastime and sport." 

"The health struggle is real," she added. "But the joy of the ride almost makes it worth it."

The Just B With Bethenny Frankel podcast host also has a reminder to those who are quick to mention it all and comment on her looks.

"PS. When you comment on someone's physical appearance, you may not know exactly what they're enduring personally, physically and emotionally," she said. "Prioritizing health and activity is so important as we strive to be our healthiest for our children and families."

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