Are You Always Dizzy When You Are Standing Up? When To Think About POTS

Feeling lightheaded when you stand up is something most people experience now and then. But if it happens often, comes with a racing heart, or leaves you feeling physically or mentally exhausted after simple tasks, there may be something else going on.

One condition that is frequently missed or misunderstood is postural orthostatic tachycardia syndrome, more commonly known as POTS.

What Is POTS?

POTS is a condition that affects how the body controls heart rate and blood flow when you move from lying to standing. In people with POTS, standing up causes larger amounts of blood to pool in the lower part of the body, reducing the amount going to the heart and brain.

To compensate, the heart rate increases abnormally, often by more than expected, without a significant drop in the blood pressure. This can lead to a range of symptoms that can be frustrating, disabling and often dismissed.

POTS is more common than many people realise and can affect all ages, more commonly in females and in adolescents or young adults.

Common Symptoms of POTS

POTS looks different from person to person, but common symptoms include:

These symptoms can manifest or worsen with standing, heat, dehydration, illness or prolonged activity. Symptoms tend to improve when lying down flat.

Why POTS Is Often Missed

Many people with POTS are told their symptoms are due to anxiety, stress, deconditioning or low fitness. While anxiety can coexist with POTS, it is not the cause.

Because routine tests can appear normal and symptoms can fluctuate, people often go months or years without a clear diagnosis. Being heard and properly assessed makes a big difference.

How POTS Is Investigated and Diagnosed

Diagnosis is based on a combination of symptoms, heart rate response to standing, and exclusion of other conditions. This includes:

• A detailed medical history
• Heart rate and blood pressure measurements lying and standing for 10 minutes
• Blood tests to look for any contributing factors and exclude other medical conditions
• ECG or other heart monitoring if required
• Referral to other non-GP specialists if required

Diagnosis does not rely on a single test. It requires careful, comprehensive assessment and follow up.

Managing POTS Is Possible

While there is no single cure for POTS, symptoms can often be significantly improved with the right support. Management may include:

• Increasing fluid intake
• Increasing salt intake
• Compression garments
• Graduated exercise programs
• Medication when needed
• Managing and minimising triggers such as heat and prolonged standing
• Referral to a POTS-informed dietician, exercise physiologist or psychologist
• Referral to non-GP specialist if required

Education and reassurance are also crucial. Understanding what is happening in your body can be empowering.

Patient Resources

If you suspect you may have POTS, gathering information is a great first step. We recommend the following resources:

Why Seeing a POTS Aware Clinic Matters

POTS management works best when clinicians understand the condition.

At Belair Family Health Centre, our GPs are POTS aware and experienced in assisting with investigation, diagnosis and ongoing management. Our clinic nurses are also POTS informed and play an important role in supporting patients through monitoring, education and care planning.

When to See Your GP About Possible POTS

You should consider a review if you:

• Feel dizzy or faint most times you stand
• Have a racing heart without a clear reason
• Feel exhausted after simple daily activities
• Have symptoms that improve when lying down
• Have been told tests are normal but still feel unwell

Early assessment can reduce frustration and help guide the right management plan.

The Take Home Message

POTS is real. It is common. And it is manageable.