WHAT IS
P TS?

Postural Orthostatic Tachycardia Syndrome: POTS, is a complex and often misunderstood condition that affects the autonomic nervous system—the system responsible for regulating essential functions like heart rate, breathing, and digestion. When this system doesn’t work as it should, it can lead to a wide range of symptoms that may appear unrelated, making diagnosis challenging.

Sometimes POTS is referred to as dysautonomia, which is an umbrella term for multiple conditions that affect the autonomic nervous system: ANS.

The ANS is like your body’s autopilot. It runs all the things you don’t have to think about—like breathing, digesting food, keeping your heart beating, regulating your temperature and sweating, balancing hormone levels, and even managing your bladder. It takes care of the body’s automatic functions so you can focus on everything else.

The ANS has two key branches that work together to keep everything running smoothly:

The sympathetic nervous system—your body’s “fight or flight” mode, which kicks in when you’re stressed, scared, or need to react quickly.
The parasympathetic nervous system—often called “rest and digest,” which helps your body calm down, recover, digest and save energy.

When these two systems are balanced, your body stays in harmony. But when that balance is off—like in POTS—it can cause a wide range of symptoms that affect everyday life.

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Who Gets POTS?

POTS can affect anyone, but it most often appears in teenagers and young adults—typically between the ages of 15 and 50. It can also occur in children and older adults, though that’s less common.

Like many inflammatory and autoimmune conditions, POTS affects significantly more women than men. In fact, research suggests that females are around five times more likely to be diagnosed with POTS. Scientists are still working to understand exactly why this difference exists, but hormones, immune function, and genetic factors may all play a role.

At Home Tests

Active Stand Test

Sometimes known as the ‘NASA Lean Test’ or the “poor man’s tilt”, this simple test helps people to check for POTS. Measure your heart rate and blood pressure while lying down, then again after standing.

If your heart rate increases by 30 beats or more within 10 minutes—and you feel dizzy, light headed, or unwell—it may suggest POTS.

Symptom Survey Test

The Malmo POTS Survey is a simple questionnaire developed by researchers in Sweden to help screen for POTS. It gives doctors a better understanding of your symptom patterns and can support the diagnostic process.

You can fill it out at home and bring the results to your GP or specialist to guide further discussion.

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What Causes POTS?

POTS is a condition with complex origins, and its exact causes are not always clear. Sometimes symptoms start suddenly after certain events or conditions:

Infections and Viral Illnesses:

POTS may develop following an infection or viral illness, such as COVID 19 or glandular fever. It’s thought that the body’s immune response to the infection may trigger changes in the autonomic nervous system, leading to the onset of POTS symptoms.

Surgery and Trauma:

POTS can also be triggered by surgery or traumatic events, including concussions. These events can disrupt the communication between the brain and the autonomic nervous system.

Hormonal Changes:

Hormonal fluctuations during significant life events such as pregnancy, menopause, or puberty can sometimes trigger POTS symptoms. Changes in hormone levels can affect blood volume, circulation, and the functioning of the autonomic nervous and immune system, potentially leading to the onset of POTS.

Connective Tissue Disorders:

Individuals with hypermobile Ehlers Danlos syndrome: hEDS, a connective tissue disorder, are at an increased risk of developing POTS. Furthermore, they are more likely to have it for life.

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Further Tests

Tilt Table Test
In this specialised assessment, you lie on a motorised table that tilts you upright while your heart rate and blood pressure are continuously monitored.

To diagnose POTS, doctors look for a few key signs during testing:

Your heart rate increases by 30 beats per minute bpm or more, or goes over 120 bpm within 10 minutes of standing.
Your blood pressure doesn’t drop significantly when you stand.
You have symptoms like dizziness, fainting, or light headedness that improve when you lie down.
These symptoms have been happening for at least three months.
There’s no other condition that explains what you’re feeling.

Holter Monitor

A small, portable device worn for 1 – 2 days that continuously records your heart’s electrical activity. It helps detect irregular heart rhythms that may not show up during a short clinic visit.

Echochardiagram

An ultrasound of the heart that shows its structure and how well it’s working. It can identify issues like valve problems or heart muscle abnormalities.

what causes POTS

Symptoms

Heat Intolerance

Dehydration

Dizziness and Fainting

VIsion Problems

Rapid Heart Rate and Chest Pain

GI Problems

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Fluids and Salt

How to Treat it

General Lifestyle Changes

Managing POTS starts with lifestyle changes, which are often the most important part of care. These strategies can help stabilize symptoms and improve daily functioning:

Avoiding common triggers such as heat, prolonged standing, intense exercise, alcohol, caffeine, and other stimulants
Maintaining consistent sleep and eating patterns to support your body’s natural rhythms

POTS is a handicap qualifying condition and a placard can be issued by your doctor to make these changes easier to implement.

Compression Wear

These are specially designed garments—such as tights, stockings, or shorts—that apply gentle pressure to the legs and lower abdomen to support blood flow.

Medical grade compression garments are classified by their pressure level, usually starting from 15–20 mmHg for mild compression. For POTS, a pressure rating of 20 mmHg or higher is generally recommended, ideally with coverage from ankle to waist. However, any amount of compression is generally better than nothing

While traditional medical grade options are available through pharmacies or medical suppliers, there are now a number of brands producing functional, comfortable compression wear designed for daily use—often used by athletes or people with chronic conditions.

Medications

If lifestyle changes alone do not improve your symptoms, then your doctor may consider some medications.

The following medications are sometimes used by doctors to support people in managing POTS:

Midodrine: This medication helps constrict blood vessels in the legs and abdomen, helping to improve blood flow to the heart and brain.
Ivabradine: is another medication that can lower heart rate and improve symptoms of POTS.
Fludrocortisone: helps increase blood volume by promoting salt and fluid retention in the body.
Propranolol: is a beta blocker that can help control heart rate and reduce symptoms like palpitations and tachycardia.
Atenolol: another beta blocker that helps lower heart rate, lasts longer than propranolol and is taken in lower dosages only once a day.

Medications commonly prescribed for POTS are often intended as short term symptom management, not a permanent solution.

Many doctors will prescribe these with the goal of gradually reducing or discontinuing use over time, since long-term medication can sometimes create side effects or complications that outweigh the benefit.

Treatment plans should always be personalized, monitored, and adjusted by a qualified healthcare provider. This page is for informational purposes only and is not medical advice.

Prognosis

More research is needed to fully understand POTS and how it affects people over time. Current understanding suggests that it is often a chronic and fluctuating condition.

Tachycardia is dangerous, without proper care, prolonged tachycardia can lead to serious long term effects, including heart failure, stroke, blood clots, and even sudden cardiac arrest. This is because the heart muscle can become overworked and weakened and lead to cardiomyopathy.

However, with the right support and management, many people experience improvement in their symptoms and quality of life.

Everyone’s journey is different, but there is hope, and you are not alone.

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WHAT IS P TS?

Get the Right Information:

Who Gets POTS?

Symptoms

Heat Intolerance

Dehydration

Dizziness and Fainting

VIsion Problems

Rapid Heart Rate and Chest Pain

GI Problems

How to Treat it

General Lifestyle Changes

WHAT IS
P TS?