What Is Postural Orthostatic Tachycardia Syndrome (POTS)?

Postural orthostatic tachycardia syndrome (POTS) is a term used to describe a group of neurological conditions that share similar symptoms. Individuals with POTS often feel extreme fatigue or dizziness when moving from a seated or lying position to standing. These symptoms can be disruptive and confusing, especially when they occur frequently.

Many people exploring their symptoms begin by searching for a POTS test online to better understand whether their experiences match this condition. While an online screening tool cannot replace a professional medical evaluation, it can provide helpful insight into patterns like orthostatic intolerance (OI) and guide discussions with a healthcare provider.

Most people diagnosed with POTS report heart palpitations or a markedly increased heart rate upon standing. When these symptoms occur after standing upright, the condition is referred to as orthostatic intolerance (OI).

Some sources estimate that as many as 1 million people in the United States are living with POTS. For some, symptoms resolve entirely within 2 to 5 years, while others experience flare-ups that come and go throughout their lives.

Symptom severity varies widely. Older 2008 research suggests that 25 percent of people with POTS have symptoms severe enough to interfere with household responsibilities or the ability to maintain employment.

Continue reading to learn about the signs and symptoms of POTS, potential causes, available testing methods — including options similar to a POTS test online — and strategies for managing daily life with this condition.

What are the symptoms?

People without POTS can typically transition between lying down, sitting, and standing without noticeable difficulty. The autonomic nervous system (ANS) automatically regulates how gravity influences the body’s circulation and balance. When a person stands, heart rate may increase for 15 to 20 seconds, but it usually stabilizes within a few minutes.

In someone with POTS, these regulatory signals do not function as they should. As a result, the heart rate may rise by up to 30 beats per minute (bpm) higher than normal when standing. This sudden increase can lead to lightheadedness, shakiness, or the urge to sit or lie down quickly.

Blood may also accumulate in the lower legs and feet, sometimes causing visible swelling or a purplish discoloration until the person changes position.

Additional symptoms of POTS include:

• headache
• blurred vision
• heart palpitations
• disturbed concentration
• gastrointestinal issues (nausea, cramps, bloating, etc.)
• weakness
• anxiety
• difficulty sleeping
• cold or pain in the arms or legs

Because these symptoms overlap with other conditions, some individuals first encounter the concept through a POTS test online or self-guided orthostatic heart rate checks before seeking formal medical care.

Types of POTS

There are several recognized subtypes of POTS. Although each subtype involves tachycardia (a heart rate faster than 100 bpm), the underlying mechanisms and associated symptoms may differ.

Neuropathic POTS

This form is linked to damage affecting small nerve fibers responsible for regulating blood vessel constriction in the legs and abdomen. Impaired constriction can contribute to blood pooling and limb discoloration upon standing.

Hyperadrenergic POTS

Hyperadrenergic POTS is associated with elevated levels of norepinephrine, a stress hormone. Individuals with this subtype may experience pronounced anxiety, tremors, and persistent heart palpitations in addition to tachycardia.

Hypovolemic POTS

People with hypovolemic POTS typically have reduced blood volume. Lower circulating blood levels can intensify dizziness and fatigue when upright.

Autoimmune POTS

Rather than a distinct subtype, autoimmune POTS is considered a possible contributing mechanism. It has been connected in some research to autoimmune conditions such as Hashimoto’s thyroiditis. Because certain biomarkers overlap, researchers suspect an immune system component in some cases.

Deconditioning POTS

Another theory suggests that POTS symptoms may be associated with deconditioning. Researchers believe that extended inactivity, such as prolonged bed rest, may lead to physiological changes that resemble or contribute to POTS. However, it remains unclear whether deconditioning causes POTS or results from it.

What causes POTS, and who’s at risk?

The exact cause of POTS is not always identifiable. The condition does not stem from a single origin in every case. There is some evidence suggesting that genetic factors may play a role in its development.

Although POTS can occur at any age, approximately 80 percent of diagnosed cases are in women between the ages of 15 and 50.

In certain situations, symptoms appear after significant life events, such as:

• puberty
• pregnancy
• major surgery
• traumatic blood loss
• viral illness

These events may temporarily or permanently alter the function of the ANS, leading to persistent orthostatic symptoms.

How it’s diagnosed

If you suspect POTS, consult a healthcare professional. While taking a POTS test online may help you recognize symptom patterns, an in-person assessment is necessary for diagnosis.

Your doctor will likely ask detailed questions about:

• your typical daily activities
• how long symptoms have been present
• the degree to which symptoms affect your quality of life

It is also important to review any medications you are taking. Certain drugs — including some used for blood pressure, depression, and anxiety — may influence ANS function and blood pressure regulation.

Testing

If POTS is suspected, your doctor may measure your pulse and blood pressure while you are lying down, sitting, and standing. Changes in heart rate and symptoms will be carefully documented.

Some clinicians may recommend a tilt table test, during which you are secured to a motorized table that shifts angles to simulate standing. Vital signs are continuously monitored to evaluate cardiovascular response.

In some cases, structured at-home assessments such as a POTS test at home or a POTS 10 minute standing test may be discussed with your provider as preliminary screening tools. These methods can offer additional data but should not replace formal evaluation.

Seeing a specialist

If further investigation is necessary, you may be referred to a neurologist, cardiologist, or a specialist in autonomic disorders. Because symptoms can overlap with anxiety or panic disorders, misdiagnosis sometimes occurs. A clinician familiar with POTS can help differentiate between these conditions.

If diagnosed, your doctor will collaborate with you to create a personalized treatment strategy tailored to your specific subtype and symptom severity.

Treatment options

There is no universal treatment for postural orthostatic tachycardia syndrome. Management often involves a combination of medication and lifestyle modifications, and determining the most effective approach may require some adjustment over time.

Medications

Several medications may provide short-term symptom relief, although it remains uncertain whether they offer sustained long-term benefits. These include:

• fludrocortisone (Florinef), a corticosteroid
• midodrine (ProAmatine), which supports blood pressure
• beta-blockers
• selective serotonin reuptake inhibitors (SSRIs)

Salt tablets may also be recommended in certain cases. Additionally, intravenous (IV) saline infusions can provide temporary relief during severe symptom flare-ups.

Lifestyle changes

Dietary and behavioral adjustments are often central to symptom control. Increasing fluid intake and modestly raising sodium consumption may help expand blood volume, potentially reducing dizziness and tachycardia.

However, a high sodium diet is not appropriate for everyone, so individualized guidance from your healthcare provider is essential.

Commonly recommended lifestyle strategies include:

• Adding a small amount of table salt to meals if advised by your doctor.
• Choosing snacks like pretzels, olives, or salted nuts when appropriate.
• Eating smaller, more frequent meals to maintain stable energy levels.
• Prioritizing consistent, high-quality sleep.
• Engaging in a gradual, structured exercise program focused on building tolerance.
• Maintaining adequate hydration throughout the day.

Living with POTS

If you are living with POTS, tracking your symptoms can be extremely helpful. Keeping a journal may allow you to identify patterns and triggers.

For instance, symptoms may worsen before menstruation, during dehydration, or in hot weather. Long periods of standing can also intensify orthostatic intolerance.

When possible, limit prolonged standing during flare-prone times and carry water to stay hydrated. Compression garments and gradual positional changes may also reduce symptom intensity for some individuals.

Emotional support is equally important. Speaking with a counselor or mental health professional can help address the impact of chronic symptoms on daily life. If you have been diagnosed with POTS, remember that your symptoms are valid and recognized — and many others share similar experiences.

Outlook

In up to 80 percent of treated postural orthostatic tachycardia syndrome cases, symptoms improve enough to enhance daily functioning.

Some individuals experience complete resolution, while others have recurring symptoms over time. Partnering with your healthcare provider and adhering to a tailored treatment plan — including lifestyle strategies — can significantly improve long-term outcomes.

If you suspect you may have POTS, seek medical advice promptly. Although tools like a POTS test online can raise awareness, only a qualified professional can confirm a diagnosis. Because POTS may sometimes be mistaken for anxiety, keeping a thorough record of your symptoms and seeking a second opinion when necessary can help ensure accurate care.