POTS: Why Standing Up Is Harder Than It Sounds
Written by a spoonie, for spoonies 💜
Imagine this: every time you stand up, your heart has to work extra hard to push blood up to your brain, because your body's automatic systems aren't doing their job. For most people, this happens seamlessly. For those of us with POTS, it's a whole production.
What's actually happening
POTS stands for Postural Orthostatic Tachycardia Syndrome. When you stand up, blood pools in your lower body. In a healthy autonomic nervous system, your blood vessels constrict and your heart adjusts automatically. With POTS, this doesn't happen properly.
The result: your heart rate spikes (often 30+ beats per minute just from standing), blood doesn't reach your brain efficiently, and you feel dizzy, lightheaded, exhausted, or like you might faint.
The symptom list is wild
POTS can cause: - Rapid heartbeat (tachycardia) when standing - Lightheadedness and near-fainting - Brain fog so thick you can barely form a sentence - Extreme fatigue - Nausea - Temperature regulation issues - Exercise intolerance - And more, depending on the person
"But you look fine"
This is the chronic illness classic, right? POTS is invisible. You can be at a standing party, smiling and nodding, while internally your heart is racing and the room is spinning and you're calculating how long until you can sit down again.
You are not exaggerating. Your symptoms are real.
What actually helps (for many people)
Management varies, but common approaches include: - **Salt and fluid loading** — increasing sodium and water intake to add blood volume - **Compression garments** — helps blood from pooling in legs - **Elevating the head of your bed** — helps your body practice the position - **Exercise programs** — specifically horizontal/recumbent exercise to start - **Medications** — beta-blockers, fludrocortisone, midodrine, and others depending on your type
Find a knowledgeable provider
POTS is underdiagnosed and undertreated. Many providers still don't know much about it. Seek out a cardiologist or neurologist who specializes in dysautonomia. Dysautonomia International has a physician list.
You deserve a provider who takes this seriously. 💜
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