Postural orthostatic tachycardia syndrome (POTS) is a term used to describe a group of neurological conditions that have similar symptoms. People with POTS feel fatigued or dizzy when they stand up from a sitting position.
Most people diagnosed with POTS experience heart palpitations or a significantly increased heart rate when they stand up. When you have these symptoms after standing upright, it’s known as orthostatic intolerance (OI).
Some sources estimate that as many as
People with POTS also experience different degrees of symptom severity. Older 2008 research estimates that
Keep reading to learn more about the symptoms, why POTS happens, and how to cope.
People who don’t have POTS can switch between reclining, sitting, and standing without much thought. The autonomic nervous system (ANS) takes over and manages how gravity affects the body according to its position, including the mechanism that manages balance and blood flow. Your pulse rate may increase for
If you have POTS, though, your body doesn’t send the right signals to your brain and heart when you change position. This results in an increased heart rate of up to
Blood may also pool in your lower legs and feet, giving them a swollen or purple appearance, until you sit down again.
Other symptoms of POTS include:
- blurred vision
- heart palpitations
- disturbed concentration
- gastrointestinal issues (nausea, cramps, bloating, etc.)
- difficulty sleeping
- cold or pain in the arms or legs
There are a few different
This subtype is associated with damage to small nerves that regulate the constriction of blood vessels in the legs and abdomen. This may increase the symptom of limb discoloration when standing up.
This type of POTS is associated with elevated levels of norepinephrine, which is a stress hormone. The symptoms of hyperadrenergic POTS can include increased anxiety, tremors, and heart palpitations.
People with the hypovolemic subtype of POTS typically have decreased blood levels.
Less of an actual subtype and more of a hypothesis, autoimmune POTS is thought to occasionally be connected to other autoimmune conditions, especially Hashimoto’s thyroiditis. Since many of the biomarkers of autoimmune disease match those seen in people with POTS, researchers believe there might be a connection.
Another subtype that’s more of a hypothesis,
The cause of POTS isn’t always clear. That’s because the condition doesn’t trace back to one root cause for every person that has it. There is some evidence that certain genes may contribute to POTS development.
Although POTS can affect anyone of any age, about
Sometimes, POTS symptoms may be triggered by life events, such as:
These events may change the way that the ANS behaves for a period of time.
If you think you are experiencing symptoms of POTS, talk with a doctor. They will most likely ask detailed questions about:
- what your daily activities are
- how long the symptoms have been occurring
- how much the symptoms affect you
You should also talk with your doctor about any medications you take. Certain medications, such as some drugs for blood pressure, depression, and anxiety, can interfere with your ANS and blood pressure control.
If your doctor suspects POTS, they’ll observe you sitting, lying down, and standing. They will record your pulse and blood pressure after every position change and note what symptoms you experience.
Your doctor may also recommend a tilt table test. As the name suggests, this test involves being fastened to a table while it is moved to different angles and positions. Your doctor will also monitor your vital signs during this test.
Seeing a specialist
If further evaluation is needed, your doctor may refer you to a neurologist, cardiologist, or specialist that focuses on the connection between the brain and the heart. POTS is sometimes misdiagnosed as an anxiety or panic disorder, so it’s important that your doctor understand your symptoms.
If you’re diagnosed with POTS, your doctor will work with you to develop an individualized treatment plan.
There isn’t a one-size-fits-all treatment or medication for postural orthostatic tachycardia syndrome. It may take some trial and error to determine which combination of medication and lifestyle changes helps you the best.
There are a variety of medications that seem to work in the short term for POTS, although it still remains
- fludrocortisone (Florinef), a corticosteroid
- midodrine (ProAmatine), which provides blood pressure support
- selective serotonin reuptake inhibitors (SSRIs)
Sometimes, your doctor may also suggest salt tablets as part of a prescription treatment regimen. Intravenous (IV) saline solutions are another short-term treatment.
Changing your diet is often part of treatment for POTS. By increasing your water intake and adding more sodium to what you eat, you can increase your blood volume. This can lessen the severity of your symptoms.
However, most people aren’t advised to eat a high sodium diet, so talk with your doctor about how much sodium you need.
Certain recommended lifestyle tips include:
- Add an extra dash of table salt to your food.
- Snack on pretzels, olives, and salted nuts.
- Eat smaller meals throughout the day, and take snack breaks to help maintain hydration and energy.
- Get enough regular, quality sleep.
- Participate in a regular, structured exercise routine if possible.
- Make it a point to stay hydrated.
If you’re living with POTS, one of the best things you can do is identify the trigger points for your symptoms. Keep a journal of your symptoms. It may help you better identify things that could be related to your symptoms.
For example, you may tend to have symptoms before your period. Maybe dehydration aggravates your symptoms. Perhaps warmer temperatures make you more likely to feel dizzy or anxious when you stand up.
If you can, limit periods of extended standing when you know that your POTS may be triggered, and consider carrying a bottle of water with you at all times.
You may also want to speak with a counselor or other mental health professional about how your symptoms impact your life. If you’ve been diagnosed with POTS, it’s important to know that your symptoms are real — you aren’t imagining them — and that you’re not alone.
In up to
While it’s possible for symptoms to completely disappear, it’s also possible that symptoms can come and go for years. Working with your doctor on a personalized treatment plan that includes lifestyle changes can increase the chances that your symptoms will ease.
If you believe you may be dealing with POTS symptoms, talk with a doctor as soon as you can. POTS can occasionally be misdiagnosed (for example, as anxiety), so make sure you keep a detailed record of your symptoms, and always get a second opinion if you think it could help.