Postural Orthostatic Tachycardia Syndrome (PoTS) is a condition that affects the autonomic nervous system — the part of the body that controls heart rate, blood pressure, and circulation.

When a person with PoTS stands up, the body struggles to maintain even blood flow to the brain. This can lead to a racing heartbeat, dizziness, and feelings of fatigue or light-headedness.

PoTS can develop after illness, viral infection, pregnancy, or surgery — and sometimes with no clear cause. It’s also seen more commonly in people with connective tissue conditions such as Ehlers-Danlos Syndrome (EDS).

Although symptoms can vary from mild to life-altering, there is growing understanding and support for people living with PoTS. 

Each word of “postural orthostatic tachycardia syndrome” has a meaning:

• Postural: Related to the position of your body.
• Orthostatic: Related to standing upright.
• Tachycardia: A heart rate over 100 beats per minute.
• Syndrome: A group of symptoms that happen together.

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.

 Many people experience a mixture of the following:

• Rapid heartbeat when standing
   
• Dizziness or light-headedness
   
• Fatigue and brain fog
   
• Palpitations
   
• Headaches or migraines
   
• Shortness of breath
   
• Nausea or digestive discomfort
   
• Sweating or temperature changes
   
• Poor sleep
   
• Anxiety or feeling “wired but tired”
   

Symptoms can fluctuate throughout the day and are often worse after standing for long periods, after meals, or in hot environments.
 

 PoTS affects everyone differently, and management often involves a combination of lifestyle changes and medical or complementary care.

Practical tips often include:

• Staying hydrated and increasing salt intake (where advised by your doctor)
   
• Rising slowly and avoiding long periods of standing
   
• Gentle movement or recumbent exercise
   
• Wearing compression garments
   
• Pacing energy and listening to your body

• Acupuncture
   

A multidisciplinary approach — involving cardiologists, physiotherapists, nutritionists, and complementary therapists — often works best.