Postural orthostatic tachycardia syndrome (POTS) is a condition that causes your heart to beat faster than normal when you transition from sitting or lying down to standing up. It’s a type of orthostatic intolerance.
Each word of “postural orthostatic tachycardia syndrome” has a meaning:
Normally, your body’s autonomic nervous system balances your heart rate and blood pressure to keep your blood flowing at a healthy pace, no matter what position your body is in. If you have POTS, your body can’t coordinate the balancing act of blood vessel constriction (squeezing) and heart rate response. This means that your body can’t keep your blood pressure steady and stable. This causes a variety of symptoms.
Each case of POTS is different. People with POTS may see symptoms come and go over a period of years. In most cases, with adjustments in diet, medications and physical activity, a person with POTS will experience an improvement in their quality of life.
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The majority of people with POTS are women and people assigned female at birth aged 15 to 50 years. But men and people assigned male at birth can also have POTS.
You’re at a higher risk of developing POTS after experiencing the following stressors:
People who have certain autoimmune conditions, such as Sjogren’s syndrome, lupus and celiac disease, are also more likely to develop POTS.
POTS is common. It affects about 1 to 3 million people in the United States.
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Normally, when you stand up, gravity causes about 10% to 15% of your blood to settle in your abdomen, legs and arms. This means that less blood reaches your brain, which can cause brief lightheadedness. If you don’t have POTS, this lightheaded feeling doesn’t happen often because your leg muscles help pump blood back up to your heart.
In addition, your autonomic nervous system turns on a series of rapid responses. To compensate for the lower amount of blood returning to your heart after standing up, your body releases the hormones epinephrine (adrenaline) and norepinephrine.
These hormones typically cause your heart to beat a little faster and with more force. Norepinephrine also causes your blood vessels to tighten or constrict. This all results in more blood returning to your heart and brain.
People with POTS tend to pool a larger amount of blood in vessels below their heart when they stand. Their body responds by releasing more norepinephrine or epinephrine to try to cause more squeezing of their blood vessels. For several reasons, their blood vessels don’t respond normally to these hormones. Because their heart remains able to respond to the norepinephrine and epinephrine, their heart rate often increases.
This imbalance causes many possible symptoms, such as dizziness, fainting and exhaustion.
While POTS isn’t life-threatening, it can greatly interfere with daily living and tasks. The good news is that a variety of treatments and strategies can help improve symptoms.
Postural tachycardia syndrome (PoTS) is when your heart rate increases very quickly after getting up from sitting or lying down. It can get better with changes to your lifestyle, but some people may need treatment with medicines.
It's also known as postural orthostatic tachycardia syndrome.
Certain symptoms of postural tachycardia syndrome (PoTS) happen when you stand up and get better when you lie down, such as:
You may also get other symptoms, such as:
Information:
These symptoms can be caused by other conditions, such as low blood pressure. Having them does not mean you definitely have PoTS.
It's not clear what causes postural tachycardia syndrome (PoTS). It can develop suddenly or gradually over time.
Some people have mild symptoms, while for others it can have a big impact on their everyday lives.
You may find your symptoms are worse in the morning, and they may change from day to day.
Some things can make your symptoms worse, such as:
Non-urgent advice:
See a GP if: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.
If they think you may have PoTS, they'll refer you to a specialist.
The specialist may perform more tests, such as:
It can take time for people to be diagnosed with PoTS, as the symptoms are similar to other conditions.
If you're diagnosed with postural tachycardia syndrome (PoTS), finding the right treatment for you can take time.
A specialist may suggest making changes to your lifestyle, such as eating and drinking at regular times and trying to manage stress, first.
You may also need to try several different medicines or combinations of medicines.
You may be prescribed medicines to help control your symptoms, such as beta blockers, steroids and selective serotonin reuptake inhibitors (SSRIs).
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:
Making changes to your lifestyle may also help with PoTS.
try to avoid the things that trigger your symptoms
drink plenty of fluids until your pee is pale
try gentle exercise, such as walking, jogging, pilates and swimming
raise the head of your bed so you're not lying completely flat
wear support tights to improve blood flow
do not stand up for too long
do not get up too quickly after lying down – sit for a while before standing up
do not drink too much caffeine or alcohol
Page last reviewed: 26 January 2023
Next review due: 26 January 2026
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