Postural Orthostatic Tachycardia Syndrome (POTS Syndrome) has gained increasing recognition in recent years as more patients seek answers for persistent dizziness, rapid heartbeat, fatigue, and difficulty standing for long periods. Although POTS is not the same as POTS Heart Disease, its symptoms frequently overlap with cardiac concerns, which is why many patients consult a cardiologist—especially a functional medicine cardiologist who can evaluate the condition from a whole-body perspective.

If you or someone you love experiences symptoms that worsen when standing and improve when lying down, understanding POTS is the first step toward getting proper care. This comprehensive guide explains what POTS Syndrome is, how it is diagnosed, which treatment options are available, and how functional medicine can play a role in long-term management.

What Is POTS Syndrome?

POTS Syndrome—short for Postural Orthostatic Tachycardia Syndrome—is a form of dysautonomia, meaning it affects the autonomic nervous system. This system controls automatic body functions such as heart rate, digestion, breathing, and blood pressure.

When a healthy person stands up, blood vessels tighten slightly to keep enough blood flowing to the brain. In individuals with POTS, this response does not work properly. As a result, the heart begins beating much faster to compensate.

POTS is generally defined by:

A heart rate increase of 30 beats per minute or more within 10 minutes of standing (or 40 bpm in adolescents)
Symptoms of orthostatic intolerance such as dizziness, lightheadedness, or fatigue
Symptoms lasting at least 6 months

Although POTS is sometimes confused with heart disorders, it is not typically classified as POTS Heart Disease. Instead, it’s a circulatory and nervous system condition that can significantly impact quality of life.

Common Symptoms of POTS Syndrome

Symptoms vary widely from person to person, but the most commonly reported include:

1. Rapid Heartbeat

A fast heartbeat upon standing is the hallmark of POTS. Some patients feel palpitations, while others simply notice fatigue or weakness.

2. Dizziness or Lightheadedness

Reduced blood flow to the brain when upright can cause near-fainting or the sensation of “blacking out.”

3. Fatigue

Chronic fatigue is one of the most disabling symptoms. Many patients describe it as overwhelming or disproportionate to activity level.

4. Exercise Intolerance

Light physical exertion may lead to an exaggerated heart rate response and exhaustion.

5. Digestive Issues

The autonomic nervous system also controls digestion, leading to nausea, bloating, or stomach pain.

6. Brain Fog

Difficulty concentrating, memory problems, and mental fatigue are extremely common.

7. Temperature Sensitivity

Many individuals with POTS experience intolerance to heat or extreme cold.

8. Chest Pain or Shortness of Breath

Although POTS is not heart disease, chest discomfort can occur due to circulation changes or rapid heart rate.

If you recognize these symptoms, seeking evaluation from a healthcare professional—particularly a cardiologist familiar with POTS—can help guide the next steps.

Who Is Most Affected by POTS?

POTS Syndrome can affect anyone, but it is most commonly seen in:

Females between ages 15 and 50
Individuals recovering from viral infections
Those with autoimmune disorders
People with connective tissue conditions like Ehlers–Danlos Syndrome
Patients with a history of prolonged bed rest, physical deconditioning, or chronic stress

Recent studies suggest that some cases may be linked to immune system dysfunction or inflammatory responses, which is one reason functional medicine has become an important part of POTS management for many patients.

How POTS Syndrome Is Diagnosed

Proper diagnosis is essential because POTS symptoms often resemble other health issues. Misdiagnosis is common, which is why many patients spend years searching for answers.

A functional medicine cardiologist typically evaluates the whole body rather than only the cardiovascular system, offering a more complete perspective.

1. Detailed Medical History

Your clinician will review symptoms, triggers, duration, and family history.

2. Physical Examination

Blood pressure and heart rate are measured while lying down, sitting, and standing.

3. Tilt Table Test

This is the most accurate diagnostic tool for POTS. It measures how your body responds to changes in position.

4. Blood Tests

To rule out underlying causes such as anemia, thyroid disorders, vitamin deficiencies, or autoimmune markers.

5. Cardiac Testing

Although POTS is not a form of POTS Heart Disease, tests like ECGs and echocardiograms are often performed to rule out structural or electrical heart issues.

What Causes POTS Syndrome?

There is no single cause, but research has identified several contributing factors:

1. Autonomic Nervous System Imbalance

The body’s automatic regulation of heart rate and blood vessel tone does not function properly.

2. Low Blood Volume

Some people with POTS have reduced circulating blood volume, leading to symptoms when upright.

3. Excessive Norepinephrine Release

This stress hormone can trigger an exaggerated heartbeat response.

4. Autoimmune Factors

Some patients develop POTS following infections or immune system disruptions.

5. Deconditioning

Prolonged inactivity or illness may weaken circulation and autonomic control.

Functional medicine focuses on uncovering these root causes instead of simply managing symptoms.

POTS Syndrome Treatment Options

While there is no single cure for POTS, many people experience significant improvement with appropriate treatment. A functional medicine cardiologist may combine conventional therapies with lifestyle and nutritional strategies to support whole-body healing.

1. Lifestyle Adjustments

Increase Hydration

Many patients benefit from increased fluid intake to support blood volume.

Add Electrolytes

Electrolyte-rich fluids may help stabilize blood pressure and prevent dizziness.

Compression Garments

Waist-high compression stockings can improve circulation and reduce symptoms.

Elevate the Head of the Bed

Helps regulate blood flow and reduce morning dizziness.

2. Graded Exercise Therapy

Not intense exercise—rather gentle, recumbent activity (such as rowing or cycling) that gradually increases over time. This can help improve autonomic function and circulation.

3. Nutritional Support

A functional medicine approach may recommend food plans or nutritional supplementation to address deficiencies influencing autonomic health, such as:

B vitamins
Magnesium
Essential minerals
Anti-inflammatory diets
Gut-supportive foods if digestive issues are present

These should always be guided by a qualified practitioner.

4. Medications

In some cases, clinicians may prescribe medication to help manage symptoms. These may include:

Heart rate–control medications
Blood pressure–supporting medications
Volume expanders

Because every patient is unique, treatment must be individualized and guided by a trained healthcare professional.

5. Addressing Root Causes

A functional medicine cardiologist may look beyond symptom control and investigate:

Hormonal imbalances
Immune function
Sleep patterns
Stress responses
Nutrient deficiencies
Gut health

This comprehensive approach may help reduce flare-ups and support long-term stability.

Living With POTS Syndrome

Adjusting to life with POTS can be challenging, but many individuals see dramatic improvements with the right care plan. Successful management often includes:

Listening to your body and pacing activities
Avoiding long periods of standing
Staying hydrated throughout the day
Building up physical tolerance gently
Working with clinicians who understand POTS and its complexities

Because symptoms can fluctuate, follow-up care and regular adjustments to a treatment plan are essential.

Why Choose a Functional Medicine Cardiologist for POTS?

A functional medicine cardiologist offers several advantages:

✔ Whole-Body Evaluation

Instead of examining only the heart, they assess hormonal, neurological, metabolic, and lifestyle factors.

✔ Root-Cause Approach

They identify underlying triggers rather than relying only on medication.

✔ Personalized Treatment Plans

Tailored care can make a significant difference in POTS symptom control.

✔ Support for Chronic and Complex Symptoms

Many patients with POTS have overlapping issues like fatigue, autoimmune conditions, or digestive problems—areas where functional medicine excels.

If you’re seeking a practitioner who can look deeper into your symptoms and partner with you in long-term recovery, this holistic approach may be ideal.

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Take the Next Step—Get Help for POTS Syndrome Today

If you’re experiencing symptoms such as dizziness, rapid heartbeat, chronic fatigue, or trouble standing, you don’t have to navigate this alone. Early evaluation and a personalized treatment plan can make a life-changing difference.

Schedule a consultation with a functional medicine cardiologist today and get the support you need for accurate diagnosis and effective treatment.

Your path to feeling better can start now.

POTS Syndrome Diagnosis & Treatment: What You Need to Know