Postural orthostatic tachycardia syndrome (POTS) is a chronic autonomic disorder marked by a rapid heart rate increase upon standing while maintaining stable blood pressure, and it often affects daily activities. POTS predominantly affects women, and symptoms typically arise during adolescence or adulthood; there are potential associations with other conditions, like Ehlers-Danlos syndrome and chronic fatigue syndrome.

The main signs and symptoms of postural orthostatic tachycardia syndrome include an increased heart rate and feelings of lightheadedness, dizziness, and nausea when standing up, whereas symptoms improve upon lying down. Additional symptoms may include brain fog, gastrointestinal issues, and fatigue.

Postural orthostatic tachycardia syndrome (POTS) is diagnosed by ruling out other conditions and assessing symptoms through a physical exam, medical history, and blood tests. A tilt-table test is commonly used; an increase in heart rate of more than 30 bpm in adults or more than 40 bpm in adolescents upon standing indicates POTS.

There are no standard treatments for postural orthostatic tachycardia syndrome, but management focuses on reducing heart rate, increasing blood volume, and stabilizing blood pressure. Common medications include mineralocorticoids, vasopressin receptor agonists, beta-blockers, and alpha-agonists, along with occasional intravenous saline, though the latter is not recommended for long-term use.

There is limited research on supplements for treating postural orthostatic tachycardia syndrome (POTS), although some studies indicate that people with POTS may be at risk for vitamin B12 and B1 deficiencies. Additionally, although it has not been specifically studied for POTS, correcting deficiencies in iron and vitamin D may help alleviate symptoms in people with chronic fatigue and autonomic dysfunction.

A high-sodium diet has been shown to lower standing heart rate and increase blood volume in people with postural orthostatic tachycardia syndrome (POTS), and recommendations advise 2 to 3 liters of fluids and 3 to 10 grams of sodium daily. Additionally, a gluten-free diet may alleviate some POTS symptoms, but further research is necessary to confirm this effect.

A carefully designed exercise program that includes resistance and endurance training can enhance quality of life and alleviate symptoms in people with postural orthostatic tachycardia syndrome. Additionally, physical maneuvers such as squeezing a rubber ball, crossing legs, tensing muscles, and cooling the skin can help improve tolerance to standing.

The cause of postural orthostatic tachycardia syndrome is unknown, but it is often associated with events like infections, concussions, or pregnancy. Genetics, family history, and conditions that affect muscle control or connective tissue may also play a role in its development.