The Ultimate Beginner’s Guide to POTS: Symptoms, Causes, and the First Steps to Managing Your Diagnosis
If you’re reading this, chances are you or someone you love has been newly diagnosed with POTS (Postural Orthostatic Tachycardia Syndrome)—or you suspect you may have it. You’re not alone. Millions of people worldwide live with this form of dysautonomia, yet it remains one of the most misunderstood and underdiagnosed conditions in medicine.
The good news?
With the right knowledge, lifestyle changes, and support, you can manage your symptoms and reclaim your life. This guide breaks down everything you need to know in clear, simple terms.
What Is POTS?
POTS stands for Postural Orthostatic Tachycardia Syndrome, a type of dysautonomia in which your autonomic nervous system struggles to regulate heart rate and blood flow when you stand up.
In simple terms:
Your body has trouble adjusting to gravity.
When most people stand up, their blood vessels tighten to keep blood flowing to the brain. But with POTS, that adjustment doesn’t happen correctly. As a result, your heart races to compensate.
Common Symptoms of POTS
Everyone experiences POTS differently, but the most common symptoms include:
• Rapid heart rate when standing (tachycardia)
• Dizziness or feeling faint
• Lightheadedness
• Exhaustion or chronic fatigue
• Brain fog
• Nausea or GI issues
• Headaches
• Shortness of breath
• Shakiness or jittery feelings
• Temperature dysregulation
• Weakness, especially in legs
• Palpitations
• Exercise intolerance
Many people describe POTS as feeling like their body is constantly running a marathon—even when they’re just standing still.
Who Gets POTS?
While POTS can affect people of all ages, it is most commonly diagnosed in:
• Women and AFAB individuals between ages 12–50
• People who’ve had viral or bacterial infections
• People with Ehlers-Danlos syndrome
• Those with autoimmune conditions
• People who’ve experienced trauma, surgery, or major stress
• Adolescents going through hormonal changes
Many people develop POTS after a triggering event, such as an illness, pregnancy, surgery, or a period of extreme stress.
What Causes POTS?
There’s no single cause of POTS, but several contributing factors include:
1. Viral or bacterial infections
Many people report symptoms beginning after a flu-like illness.
2. Nervous system dysfunction
POTS is fundamentally a dysautonomia disorder, meaning the autonomic nervous system is dysregulated.
3. Low blood volume or pooling
Blood may pool in the lower body instead of circulating efficiently.
4. Hyperadrenergic responses
Some people have an overactive fight-or-flight response.
5. Autoimmune involvement
The immune system may mistakenly affect nerve function.
6. Hormonal imbalances
Especially during teen years, pregnancy, or postpartum.
Understanding the cause isn’t always necessary for treatment—but understanding your symptoms is.
How Is POTS Diagnosed?
Most people receive a POTS diagnosis through a:
✔ Tilt Table Test
Measures how your heart rate and blood pressure respond when moving from lying to upright.
✔ Active Stand Test
Your heart rate is tracked while you stand for several minutes.
Diagnostic Criteria for POTS:
• Heart rate increases 30+ bpm within 10 minutes of standing
• Without a significant drop in blood pressure
• Symptoms persist for 3+ months
• No other condition explains the symptoms
If this sounds like your experience, you’re not imagining it—POTS is real, diagnosable, and treatable.
The First Steps After a POTS Diagnosis
Once you’ve been diagnosed, it’s normal to feel overwhelmed. These first steps help create a foundation for improvement.
1. Increase Hydration + Electrolytes
Aim for 2–3 liters of water daily.
Salt and electrolyte supplementation (if recommended by your doctor) help increase blood volume and reduce dizziness.
2. Make Key Dietary Changes
Nutrition plays a major role in reducing POTS symptoms.
Focus on:
• High protein meals
• Consistent blood sugar balance
• Anti-inflammatory foods
• Increased sodium (if approved)
• Daily electrolytes
• Smaller, more frequent meals
Avoid or reduce:
• Alcohol (major POTS trigger)
• Excess caffeine
• High sugar foods
• Processed or inflammatory foods
3. Begin Gentle Movement & Pacing
Exercise intolerance is real—but complete rest worsens symptoms over time.
Start with:
• Recumbent exercise
• Gentle strength training
• Slow, consistent pacing
• Short movement sessions with rest
Avoid pushing yourself to the point of crashing—pacing is essential.
4. Manage Nervous System Stress
Stress is one of the biggest POTS flare-up triggers.
Helpful tools include:
• Breathwork
• Meditation
• Grounding practices
• Staying on a consistent sleep schedule
• Reducing multitasking and sensory overload
Nervous system regulation is a critical part of long-term improvement.
5. Build a Support System
This might include:
• A POTS-literate doctor
• A physical therapist
• A nutritionist
• A POTS coach who understands the emotional and physical aspects of healing
Having someone guide you through pacing, diet changes, symptom management, and daily routines can dramatically improve your progress.
Can You Improve With POTS?
Yes.
Many people see significant improvement in their symptoms through lifestyle adjustments, nervous system regulation, strength-building, and targeted nutrition. Some even go into remission.
Improvement is absolutely possible—you just need the right roadmap.
You’re Not Alone on This Journey
Being newly diagnosed with POTS can feel scary, but you don’t have to navigate it alone. Understanding how your body works is the first step toward healing, and small daily changes lead to big results over time.
If you need support implementing your treatment plan, establishing routines, or learning how to reduce flare-ups, a POTS coach can guide you every step of the way. Contact today to schedule a consultation.