Postural tachycardia syndrome (PoTS)

Postural tachycardia syndrome (PoTS) is when your heart rate increases very quickly after getting up from sitting or lying down, often making you feel dizzy or lightheaded.

There's currently no cure, but it can be managed with changes to your lifestyle, or sometimes treatment with medicines.

Check if it's postural tachycardia syndrome (PoTS)

Postural tachycardia syndrome (PoTS) affects everyone differently. Some people have mild symptoms, while for others it can have a big impact on their everyday lives.

Some symptoms happen when you stand up and can get better when you sit or lie down, such as:

• dizziness or lightheadedness
• noticeable heartbeats (heart palpitations)
• chest pain
• shortness of breath
• shaking and sweating
• fainting or nearly fainting

You may also get other symptoms, such as:

• problems with your stomach or digestion, such as feeling sick, being sick, diarrhoea, constipation, bloating and tummy pain
• headaches and problems with your sight, such as blurred vision or tunnel vision
• your hands and feet looking purple – this may be more difficult to see if you have brown or black skin
• weakness and extreme tiredness (fatigue), not being able to do much exercise, and sleeping badly
• problems with thinking, memory and concentration (brain fog)

You may find your symptoms are worse in the morning, and they may change from day to day.

Causes of postural tachycardia syndrome (PoTS)

It's not clear what causes postural tachycardia syndrome (PoTS). It can develop suddenly or gradually over time.

You may be more likely to get PoTS if you have long covid, myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS), or joint hypermobility syndrome.

Some things can also make your symptoms worse, such as:

• being in a hot place
• standing or sitting upright for long periods of time
• eating, especially refined carbohydrates like white bread
• not drinking enough fluids
• drinking alcohol
• resting too much
• exercise
• being on your period
• stress

How postural tachycardia syndrome (PoTS) is diagnosed

If you have symptoms of postural tachycardia syndrome (PoTS), a GP may check your blood pressure and heart rate before and after you stand up.

You may also have some blood tests and an electrocardiogram (ECG).

You may be referred to a specialist if:

• making changes to your lifestyle does not help
• you're very unwell
• it's not clear what's causing your symptoms

The specialist may perform more tests, such as:

• blood tests
• pee (urine) tests
• heart and blood pressure tests, such as an echocardiogram, ECG, and 24-hour blood pressure and heart rate monitoring
• a tilt table test, where you lie on a flat bed that's tilted upwards so your heart rate can be monitored

It can take time for people to be diagnosed with PoTS, as the symptoms are similar to other conditions.

Find out more about how PoTS is diagnosed on the PoTS UK website

Treatments for postural tachycardia syndrome (PoTS)

If you're diagnosed with postural tachycardia syndrome (PoTS), finding the right treatment for you can take time.

A GP or specialist may suggest lifestyle changes first, such as drinking more fluids, eating small meals low in refined carbohydrates, and wearing compression clothing.

You may be prescribed medicines to help control your symptoms, such as steroids, medicines used to treat heart conditions and manage your blood pressure, and selective serotonin reuptake inhibitors (SSRIs).

You may also need to try several different medicines or combinations of medicines.

Things you can do if you have postural tachycardia syndrome (PoTS)

If you have postural tachycardia syndrome (PoTS), there are things you can try to help ease your symptoms.

If you suddenly feel faint or dizzy, you can try lying down and raising your legs until you feel better.

If you cannot lie down, you can try:

• crossing your legs with 1 in front of the other while standing
• rocking up and down on your toes
• clenching your buttocks and tummy muscles
• clenching your fists

Making changes to your lifestyle may also help with PoTS.