What Is Postural Orthostatic Tachycardia Syndrome (POTS)?

What Is Postural Orthostatic Tachycardia Syndrome (POTS)?

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    What Is Postural Orthostatic Tachycardia Syndrome (POTS)?

    8-minute read

    Introduction

    Have you ever stood up and suddenly felt dizzy, lightheaded, shaky, or like your heart was racing? For most people, this happens only occasionally. But for individuals living with Postural Orthostatic Tachycardia Syndrome (POTS), these symptoms can occur every day and significantly affect daily life.

    POTS is one of the most common forms of dysautonomia, a group of disorders that affect the autonomic nervous system. Although awareness has grown in recent years—particularly after the COVID-19 pandemic—many people still spend years searching for a diagnosis.

    The good news is that POTS is a recognized medical condition. While there is currently no cure, many people experience meaningful improvement through education, personalized treatment, and lifestyle strategies.

    What Is POTS?

    Postural Orthostatic Tachycardia Syndrome (POTS) is a disorder of the autonomic nervous system that affects how the body responds to standing.

    Normally, when you stand, gravity causes blood to pool in your legs and abdomen. Your autonomic nervous system quickly responds by tightening blood vessels and making small adjustments to your heart rate so that enough blood continues to reach your brain.

    In people with POTS, this automatic response doesn't work as efficiently.

    As a result, the heart beats much faster in an attempt to maintain blood flow to the brain. This rapid increase in heart rate can lead to symptoms such as dizziness, fatigue, brain fog, palpitations, and exercise intolerance.

    In adults, POTS is generally defined as an increase in heart rate of at least 30 beats per minute within 10 minutes of standing (or at least 40 beats per minute in adolescents), without a significant drop in blood pressure, along with chronic symptoms of orthostatic intolerance lasting at least six months.

    How Common Is POTS?

    Researchers estimate that between 1 and 3 million Americans live with POTS, although many experts believe the condition remains underdiagnosed.

    POTS most commonly affects:

    • Women

    • Teenagers and young adults

    • People between 15 and 50 years old

    However, anyone can develop POTS, including men and children.

    Awareness has increased substantially in recent years as POTS has been recognized as a possible complication following viral illnesses, including COVID-19.

    Common Symptoms

    Symptoms vary from person to person and often fluctuate from day to day.

    Common symptoms include:

    • Rapid heart rate when standing

    • Dizziness or lightheadedness

    • Feeling faint or fainting

    • Brain fog

    • Persistent fatigue

    • Exercise intolerance

    • Heart palpitations

    • Shortness of breath

    • Chest discomfort

    • Headaches or migraines

    • Trembling or shakiness

    • Nausea

    • Bloating or digestive problems

    • Temperature intolerance

    • Cold hands and feet

    • Difficulty concentrating

    • Poor sleep

    Many people also notice that symptoms become worse in hot weather, after large meals, during illness, or when they are dehydrated.

    What Causes POTS?

    There isn't one single cause of POTS.

    Researchers believe several different mechanisms may contribute, including:

    • Dysfunction of the autonomic nervous system

    • Reduced blood volume

    • Abnormal blood vessel function

    • Small fiber neuropathy

    • Autoimmune processes

    • Viral illnesses

    • Genetic factors

    • Connective tissue disorders such as hypermobile Ehlers-Danlos syndrome (hEDS)

    For many people, symptoms begin after a viral infection, surgery, pregnancy, concussion, or another significant physical stressor.

    Researchers continue to study why POTS develops and why it affects people differently.

    How Is POTS Diagnosed?

    Diagnosing POTS usually involves a combination of medical history, physical examination, and tests that evaluate heart rate and blood pressure.

    Your healthcare provider may recommend:

    • Orthostatic vital signs (heart rate and blood pressure while lying down and standing)

    • A tilt table test

    • Electrocardiogram (ECG)

    • Blood tests to rule out other conditions

    • Additional testing based on your symptoms

    Because many POTS symptoms overlap with other medical conditions, diagnosis may take time.

    How Is POTS Managed?

    Although there is currently no cure for POTS, many people experience significant improvement with a personalized treatment plan.

    Management may include:

    • Drinking adequate fluids throughout the day

    • Increasing sodium intake when recommended by a healthcare provider

    • Wearing compression garments

    • Eating smaller, more frequent meals

    • Gradually increasing physical activity using recumbent or seated exercise when appropriate

    • Prioritizing quality sleep

    • Avoiding prolonged standing when possible

    • Learning pacing and energy management strategies

    • Medications when appropriate

    Every treatment plan is different, and what works well for one person may not work for another.

    Living With It

    Living with POTS often means becoming more intentional about how you use your energy.

    Simple activities—standing in line, taking a hot shower, grocery shopping, or climbing stairs—may require much more planning than they once did. Some days you may feel capable of tackling your to-do list, while other days your body asks for more rest.

    That unpredictability can be frustrating, but it doesn't mean you're failing.

    Many people living with POTS discover that small daily habits make a meaningful difference. Staying hydrated, recognizing early symptoms, wearing compression garments, pacing activities, and getting adequate sleep can all help support better symptom control.

    Perhaps most importantly, remember that progress isn't measured by comparing yourself to who you were before POTS. It's measured by learning what helps your body thrive today.

    Common Misconceptions

    "POTS is just anxiety."

    Although POTS can cause a racing heart and feelings of nervousness, it is a disorder of the autonomic nervous system—not simply anxiety. Anxiety and POTS can occur together, but they are separate conditions.

    "You're just dehydrated."

    Dehydration can worsen symptoms, but it does not cause POTS.

    "Exercise will cure it."

    Appropriate exercise is an important part of treatment for many people with POTS, but it should be introduced gradually and individualized. Simply pushing through symptoms is rarely helpful.

    "POTS isn't a real medical condition."

    POTS is recognized by major medical organizations worldwide and has been the subject of extensive scientific research.

    Frequently Asked Questions

    Is POTS life-threatening?

    POTS is generally not considered life-threatening, but it can significantly affect quality of life and daily functioning. Anyone experiencing new or concerning symptoms should seek medical evaluation.

    Can POTS go away?

    Some people experience substantial improvement over time, while others continue to manage symptoms long-term. The course of POTS varies from person to person.

    Can I exercise if I have POTS?

    Many people benefit from individualized exercise programs that begin with recumbent or seated activities and progress gradually under medical guidance.

    Can POTS affect digestion?

    Yes. Because the autonomic nervous system helps regulate digestion, many people with POTS experience nausea, bloating, constipation, diarrhea, or other gastrointestinal symptoms.

    Is POTS related to Long COVID?

    Some individuals develop POTS following COVID-19 infection. Researchers continue to study the relationship between Long COVID and autonomic dysfunction.

    Conditions That Commonly Occur Alongside POTS

    Although not everyone with POTS has additional medical conditions, research has found that some disorders occur more frequently together.

    These may include:

    • Hypermobile Ehlers-Danlos syndrome (hEDS)

    • Mast Cell Activation Syndrome (MCAS)

    • Small fiber neuropathy

    • Migraine disorders

    • Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

    • Long COVID

    • Autoimmune diseases

    If you have concerns about additional symptoms, discuss them with your healthcare provider rather than assuming they are related to POTS.

    Where to Go Next

    If you're learning about POTS, you may also find these topics helpful:

    • What Is Dysautonomia?

    • PEM vs. Fatigue

    • Understanding Energy Envelope Theory

    • The Spoon Theory Explained

    • Why Symptoms Come and Go

    • Understanding Symptom Flares

    • Living with an Invisible Disability

    • Hydration for Chronic Illness (coming soon)

    • Exercise with POTS (coming soon)

    • Electrolytes Explained (coming soon)

    Key Takeaways

    • POTS is a form of dysautonomia that affects the body's response to standing.

    • Common symptoms include rapid heart rate, dizziness, fatigue, brain fog, and exercise intolerance.

    • POTS can develop after infections, surgery, pregnancy, or other physical stressors, and it is associated with several other chronic conditions.

    • Although there is no cure, many people improve with individualized treatment, hydration, exercise, pacing, and medical care.

    • Understanding your body and developing sustainable daily habits can help you manage symptoms and improve your quality of life.

    Learn More

    National Institute of Neurological Disorders and Stroke (NINDS)
    Autonomic Disorders
    https://www.ninds.nih.gov/health-information/disorders

    Dysautonomia International
    Postural Orthostatic Tachycardia Syndrome (POTS)
    https://www.dysautonomiainternational.org/page.php?ID=30

    Medical Disclaimer

    This article is intended for educational purposes only and should not be considered medical advice. It is not a substitute for professional medical evaluation, diagnosis, or treatment. If you experience persistent dizziness, fainting, rapid heart rate, or symptoms that interfere with your daily life, consult your physician or another qualified healthcare professional for evaluation and personalized care.

    What It Actually Does

    Ashwagandha is classified as an adaptogen - a substance that helps the body adapt to physical and psychological stress. But that description undersells the specificity of the evidence.

    In peer-reviewed clinical trials, ashwagandha root extract has been shown to:

    01

    Reduce serum cortisol levels significantly in adults under chronic stress

    02

    Support testosterone levels and muscle recovery in resistance-trained adults

    03

    Improve subjective measures of stress, anxiety, and wellbeing

    04

    Improve subjective measures of stress, anxiety, and wellbeing

    05

    Improve sleep quality and reduce time to sleep onset

    Why The Form Matters

    Here is where most supplement labels become misleading.
    The clinical trials that produced the evidence above didn't use generic ashwagandha root powder. They used standardised, patented extracts - specifically KSM-66® and Sensoril®, both of which are produced from roots using proprietary extraction methods that concentrate the active withanolides to a consistent, clinically meaningful level.
    Generic ashwagandha powder can contain anywhere from 1% to 8% withanolides. KSM-66® is standardised to a minimum of 5% withanolides with a full-spectrum root extract, which means it retains the natural balance of the plant's compounds rather than isolating one component.
    When you buy a supplement that says "ashwagandha" without specifying the extract form, you have no way of knowing whether it contains enough active compounds to do anything at all.
    At Arise, we use KSM-66® in every formula that contains ashwagandha. It's more expensive. It's worth it.

    Third-party Testing

    Supplements are not regulated the same way pharmaceuticals are. In most markets, a supplement company can put almost anything in a capsule and make almost any claim about it, as long as they don't claim to treat a specific disease.
    This is why third-party testing matters. It means an independent laboratory - one with no financial relationship to the supplement company - has tested the product to verify that:

    1. The ingredients listed are actually present
    2. They're present at the stated concentrations
    3. The product doesn't contain contaminants, heavy metals, or undisclosed substances

    Look for: NSF Certified for Sport, Informed Sport, or USP Verified certification on any supplement you take. These are the most rigorous third-party standards available.
    Every Arise formula is third-party tested before it reaches you. The results are available on request.

    The Honest Bottom Line

    Ashwagandha works. The evidence is genuinely strong. But the quality of the extract determines the quality of the outcome — and most of what's available on the market doesn't use the forms that the clinical research actually studied.
    Read the label. Ask for the extract form. Expect a specific answer.