Basingstoke Team Parish


Orthostatic intolerance:

is a term that is sometimes used to describe symptoms of PoTS. It means symptoms that occur on standing and are relieved by lying down. In addition to heart rate and blood pressure, other bodily functions that are regulated by the autonomic nervous system can be affected.

Symptoms can be debilitating, ranging from mild to severe and varying from day to day.

  • Dizziness or light-headedness or presyncope (almost fainting)

These symptoms usually occur when standing up,  but can occur with prolonged sitting.

  • Syncope (fainting or blackouts)

Approximately  30 % of people with PoTS experience fainting.

  • Palpitations

Palpitations are a sensation of your heart pounding in your chest.

  • Headaches

Approximately two thirds of those with PoTS have orthostatic headaches which means they occur as a result of being upright and may be caused by reduced blood supply to the brain.  Most people with PoTS also have migraine type headaches.

  • Tiredness or weakness

These are common symptoms of PoTS and can last for a considerable time after a bout of symptoms of PoTS.

  • Brain fog

People with PoTS often complain of ‘brain fog’ which is difficulty in thinking or concentrating.

  • Shakiness or Tremulousness

This is often worse with upright posture

  • Shortness of breath

Patients can feel breathless when standing up or with slight exertion.

  • Chest pain

Chest pain is fairly common in patients and can be worse when upright. The cause is not clear.

  • Excessive or patchy reduced sweating
  • Gut problems

Nausea is common. Other symptoms include diarrhoea, constipation, bloating, abdominal pain and vomiting.  Many people with PoTS are told that they have irritable bowel syndrome.

  • Poor sleep

Many patients with PoTS have insomnia. This can be trouble getting to sleep,  waking in the middle of the night and trouble getting back to sleep.

  • Visual problems

This can be described as excessive glare, blurred or tunnel vision.

  • Bladder problems

Triggers which may worsen symptoms

  • Excess heat
  • After eating – especially refined carbohydrate eg sugar, white flour
  • Speed of positional change – don’t stand up quickly
  • Dehydration
  • Time of day (may be worse in the morning, especially rising after wakening)
  • Menstrual period
  • Deconditioning or prolonged bed rest
  • Alcohol which dilates blood vessels
  • Exercise (occasional exercise can cause one to feel worse, but an ongoing exercise program can improve symptoms)
See Living with PoTS section of the website for further information

Written by: PoTS UK Team
Medically approved by: Dr John Purvis and Dr Satish Raj
Review date: 1/2/18
version 4