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What is POTS?


What is POTS?

POTS or Postural Orthostatic Tachycardia Syndrome is defined as an individuals heart rate increasing greater than or equal to 30 beats per minute within the initial 10 minutes upon standing from the lying position. (3) When this happens you undergo a point in time where an insufficient amount of blood flow is able to make its way up to the brain and with blood comes nutrients needed to function. Just as a plant needs water and oxygen to survive humans need blood which carries the oygen to all of our cells. I think of it like this, imagine you have a cup underneath a faucet. As that cup begins to fill with water, just as the heart fills with blood, it will eventually become full and will then need to be dumped in order to fill it up once again. The longer the cup sits underneath the faucet the more water will fill that cup. Similarly, if there is more time in between each heart contractions this allows more time for the heart to fill with blood before it pumps it out to the rest of the body. As we progress to a standing position from lying our heart should pump a little faster in order to make up for the blood that will naturally come down away from the head due to gravity. The problems begin to occur when the heart begins to beat too fast which leads to less time for the heart to actually fill before each contraction therefore less blood making its way back up the brain.

What are the symptoms of POTS?

This can lead to symptoms such as: (1)

  • Lightheadedness

  • Exercise intolerance

  • Chronic fatigue

  • Dizziness

  • Sleep disturbance

  • Headache

  • Tremors

  • Tachycardia

  • Anxiety

  • Depression

  • Gastrointestinal disturbances

  • Syncope

  • Vision changes etc.

Many patients will often classify this as normal behavior saying, "well I only get lightheaded when I stand up too quickly." While this may be common for you it is definitely not normal.\

What causes POTS?

There are numerous factors that can lead to one experiencing POTS, most commonly seen after head injury, leading to autonomic dysfunction, as well as various autoimmune conditions, viruses/infections, cardiac issues, physical deconditioning, or inhertied disorders such as ehlers-danlos syndrome. (2) The vast possibile mecahnisms for the condition is what makes it important for you as the patient to find a provider that is well versed in not only diagnosing but also treating indivduals with POTS.

How do you test for POTS?

Tilt table testing has become the standard test to diagnose individuals who are experiencing POTS like symptoms. During the tilt table test the patient will lie on a table that will passively progress them from a horizontal lying position to a vertical standing position. Throughout the test the physician will be monitoring the heart rate and blood pressure noting deviations from normal.

Can POTS be treated?

When it comes to POTS, each patient must be evaluated in order to develop an effective treatment plan. We know each patient is one-of-a-kind and we believe your treatment should be too! At Peak Brain Performance Centers we treat POTS through a myriad of various treatment applications by stimulating various regions of the brain that control the autonomics whether that be via electric stimulation, eye movements therapy, vestibular rehab, and especially tilt table therapy to stabilize the heart rate and retrain its response. I hope you were able to learn something today about POTS and if you have POTS that there are options out there. To learn more about Peak Brain Performance Centers and how we may be able to help you click the contact us button at the top of the page and schedule a complimentary phone consult with the doctor.


1. Fedorowski A. Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management. J Intern Med. 2019 Apr;285(4):352-366

2. Safavi-Naeini P, Razavi M. Postural Orthostatic Tachycardia Syndrome. Tex Heart Inst J. 2020;47(1):57-59. Published 2020 Feb 1. doi:10.14503/THIJ-19-7060

3. Zhao S, Tran VH. Postural Orthostatic Tachycardia Syndrome. 2020 Aug 15. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 31082118.

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