What PoTS can feel like
- Light-headedness or near-fainting when you stand, especially in the morning
- A racing or pounding heartbeat that settles when you lie down
- Fatigue and “brain fog” that make work or study harder
- Feeling worse in heat, after large meals or after illness
- Tremor, nausea or cold, purple-tinged legs when upright
How it is diagnosed
A careful history comes first: when it started, what makes it better or worse, and what tests you have already had. Then your heart rate and blood pressure are measured lying down and standing for 10 minutes, or on a tilt-table in a clinic. An ECG, blood tests and sometimes a heart scan rule out other causes.
“Normal results do not mean nothing is wrong. They often mean the right question has not been asked yet.”
What helps
Most people start with simple changes: two to three litres of fluid a day, extra salt if your blood pressure allows, waist-high compression, and a gradual, recumbent exercise programme such as rowing or a recumbent bike. When these are not enough, medication can steady the heart rate or support blood pressure — chosen for you, and reviewed.
Living with it
PoTS often improves over months, particularly after a viral illness. Keeping a short symptom diary, pacing your day and planning around heat and long periods of standing make a real difference while treatment takes effect.
