Understanding PoTS: Clear Information and Practical Support

If you’ve been experiencing dizziness, palpitations, fatigue or “brain fog” when standing, you may have come across Postural Orthostatic Tachycardia Syndrome (PoTS).

PoTS is a condition affecting the autonomic nervous system. According to PoTS UK, it is defined by a sustained rise in heart rate of more than 30 beats per minute within 10 minutes of standing (40 bpm in young people aged 12–19), without a significant drop in blood pressure, alongside symptoms of orthostatic intolerance that improve on lying down.

Common Symptoms

As outlined by PoTS UK, symptoms can include:

• Lightheadedness or feeling faint

• Rapid or pounding heartbeat

• Fatigue

• Brain fog

• Headaches

• Nausea

• Heat intolerance

• Visual disturbances

Symptoms often fluctuate and may be worse in the morning or after triggers such as dehydration, heat, prolonged standing, or large meals.

Why Diagnosis Can Be Challenging

Diagnosing PoTS isn’t always straightforward.

Symptoms overlap with other conditions such as:

• Anxiety disorders

• Chronic fatigue syndrome

• Vasovagal syncope

• Inappropriate sinus tachycardia

• Hypermobility syndromes

Because of this overlap, careful assessment is essential. Diagnosis is usually made using an active stand test or sometimes a tilt-table test, alongside a detailed clinical history.

It’s important to exclude other cardiac, endocrine or neurological causes of symptoms before confirming PoTS.

How I Can Help

If you are concerned about PoTS, I can help by:

• Taking a detailed symptom history

• Performing structured lying and standing heart rate and blood pressure measurements

• Arranging appropriate heart rhythm monitoring if needed

• Assessing for other possible causes of your symptoms

• Providing clear guidance on evidence-based management strategies

Be Reassured

PoTS can be frustrating and sometimes overwhelming, particularly if you’ve struggled to get clear answers. The good news is that with the right assessment and a personalised plan, many patients see meaningful improvement.

If you would like support with diagnosis or management, I’d be very happy to help guide you through the process.

For a trusted UK-based patient resource and support, visit: www.potsuk.org