You stand up to grab something from the fridge. Your heart starts pounding, your head feels light, and your vision dims for a second. You sit down, and it passes.
If that happens a lot, POTS could be the reason. Postural orthostatic tachycardia syndrome (POTS) is a condition where your heart rate climbs too fast when you stand up. One recent review estimates that 1.73% of people had it before COVID-19 and 3.42% after.
Key Takeaways
- POTS means a sustained heart rate jump of 30+ bpm (40+ for teens under 19) within 10 minutes of standing.
- It affects roughly 9 times more women than men and often starts between ages 12 and 50.
- Symptoms go beyond a fast heartbeat, including fatigue, headaches, and nausea.
- Tracking your heart rate before your appointment can speed up answers.
What Is POTS Syndrome?
POTS is a disorder of the autonomic nervous system. That’s the part of your body that handles things you never think about, like heart rate, blood pressure, and digestion.
When you go from lying down to standing, gravity pulls blood toward your legs and belly. In POTS, your body doesn’t adjust well. Johns Hopkins Medicine explains that symptoms come from lower blood volume, blood pooling below the heart, and higher levels of hormones like adrenaline. In most patients, the heart itself is structurally normal. It’s speeding up to make up for the problem.
The Numbers Doctors Look For
A POTS diagnosis rests on a few clear measurements:
- A heart rate increase of at least 30 beats per minute within 10 minutes of standing, or 40 for people under 19, lasting longer than 30 seconds.
- No major blood pressure drop. A 2026 JACC Advances study defines POTS as an increase of at least 30 bpm without orthostatic hypotension.
- Symptoms that last at least three months.
Here’s a simple example. Say your heart beats 72 times a minute while you lie down. Within a few minutes of standing, it hits 105. That’s a 33-beat jump, which fits the adult cutoff.
Why POTS Looks Different From Person to Person
Two people can share the same diagnosis and feel very different. A 2026 review in Frontiers in Neurology describes POTS as one clinical definition with multiple underlying drivers. That’s why doctors tailor care to the person instead of using one fixed plan.
How Common Is POTS?
Exact counts are hard to pin down. Earlier estimates say POTS affects 0.2% to 1% of teens and adults in developed countries. Newer research points higher, especially since the pandemic.
Who Gets POTS?
POTS affects far more women than men, at a ratio of about 9 to 1, and it usually starts between ages 12 and 50. The same review lists common triggers; a viral infection, hormonal changes like puberty, pregnancy, or perimenopause, a growth spurt, a concussion, or surgery.
Common Symptoms of POTS
Heart and Blood Flow Symptoms
- A racing or pounding heartbeat when you stand
- Lightheadedness or dizziness
- Feeling faint, or actually passing out These often show up in everyday moments, like standing in a checkout line or getting out of bed.
Symptoms Beyond the Heart
POTS doesn’t stop at the heart. Dysautonomia International notes that patients often deal with fatigue and headaches too. Stomach trouble is common as well. In a 2026 JACC Advances study of people with post-COVID POTS, 63.3% reported nausea and 58.5% had near-fainting or fainting.
Some symptoms, like a fast heartbeat and palpitations, overlap with anxiety. That causes confusion. But according to Dysautonomia International, POTS is not caused by anxiety.
POTS and Long COVID
Since the pandemic, POTS has been closely tied to COVID-19. A 2026 meta-analysis of 21 studies found a pooled POTS prevalence of 36.2% among people with lingering post-COVID symptoms.
A separate study published in late 2025 found that 22 of 75 people (29%) evaluated after a COVID-19 infection were diagnosed with POTS.
One caution. These people were already being evaluated for ongoing symptoms. The numbers don’t mean a third of everyone who had COVID-19 will develop POTS.
How Is POTS Diagnosed?
Doctors usually start with a tilt table test or a simple bedside stand test. For the stand test, a nurse checks your heart rate and blood pressure lying down. Then they repeat it 2, 5, and 10 minutes after you stand.
Your doctor will also look for other reasons your heart might be racing. That includes things that can raise heart rate, such as stimulants and diuretics.
How to Prepare for Your Appointment
- Check your pulse after lying down for five minutes. Then check it at 2, 5, and 10 minutes after standing. A home pulse monitor or smartwatch works. Write the numbers down.
- Keep a short log of when symptoms hit, what you were doing, and what made them better or worse.
- List your medications, supplements, and daily caffeine.
- Mention relatives with similar symptoms, since POTS can run in families.
Living With POTS
There’s no cure yet. Still, Dysautonomia International says some patients see their symptoms improve over time.
Most plans combine extra fluids and salt, compression garments, gradual exercise, and sometimes medication. Your doctor can tailor these to you, and we break them down in our guide to POTS syndrome treatment.
Some people also add daily circulation support to their routine, alongside their doctor’s plan. Real Science Nutrition’s Venous Miracle is one example. It’s a leg and vein circulation supplement with Vinitrox, which supports the body’s natural nitric oxide production, plus vitamins C, D, K, B6, B12, and folate. It isn’t a treatment for POTS, so check with your healthcare provider before adding any supplement.
When to See a Doctor
Book an appointment if you often feel dizzy or your heart races when you stand, especially if it has gone on for weeks. Get emergency care if you faint and get hurt, or if you have chest pain.
Parents, take note: teens are held to the higher 40-bpm cutoff, so a teen’s numbers can look different from an adult’s. If your child gets dizzy or faint on standing, ask for a stand test.
The Bottom Line
POTS is more than a racing heart. It’s a real condition with clear diagnostic criteria, a wide range of symptoms, and growing recognition since the pandemic. If you notice dizziness or a pounding pulse every time you stand, track your numbers and see your doctor. A clear answer is the first step toward feeling better.