Short answer · Medically reviewed summary · Last updated: 2026-04-06

The primary symptom of Postural Orthostatic Tachycardia Syndrome (POTS), a form of Dysautonomia, is an excessive increase in heart rate upon standing, typically accompanied by lightheadedness, fatigue, and palpitations. Common and Characteristic Symptoms While the hallmark of POTS is tachycardia—a heart rate increase of at least 30 beats per minute in adults within 10 minutes of standing—the clinical presentation is multisystemic. Patients frequently report brain fog, exercise intolerance, gastrointestinal distress (such as nausea or bloating), and temperature dysregulation.

17 people with Dysautonomia / POTS have shared their first-person experience on this question at DiseaseMaps.

Which are the symptoms of Dysautonomia / POTS?

Name: Which are the symptoms of Dysautonomia / POTS?
Creator: DiseaseMaps Editorial Team
Published: 2015-06-11UTC04:41:59.0000000

Symptoms of Dysautonomia / POTS reported by real patients, from the most common to the most limiting, plus a medically reviewed summary with sources.

The primary symptom of Postural Orthostatic Tachycardia Syndrome (POTS), a form of Dysautonomia, is an excessive increase in heart rate upon standing, typically accompanied by lightheadedness, fatigue, and palpitations.

Common and Characteristic Symptoms

While the hallmark of POTS is tachycardia—a heart rate increase of at least 30 beats per minute in adults within 10 minutes of standing—the clinical presentation is multisystemic. Patients frequently report brain fog, exercise intolerance, gastrointestinal distress (such as nausea or bloating), and temperature dysregulation. Because Dysautonomia affects the autonomic nervous system, which controls involuntary functions, symptoms often manifest as a domino effect across the cardiovascular, digestive, and neurological systems.

Early Warning Signs and Symptom Variability

Early warning signs often include persistent dizziness when rising from a seated position, unexplained exhaustion after minimal exertion, and "coat hanger" pain, which refers to aching in the neck and shoulders. The severity of POTS varies significantly; some individuals remain highly functional with minor lifestyle modifications, while others may be bedbound and unable to perform basic activities of daily living. Quality of life is most severely impacted by the unpredictable nature of these "flares," which can make maintaining employment or education challenging.

Progression and Seeking Care

Symptoms of Dysautonomia can fluctuate based on hormonal cycles, hydration status, stress, and viral infections. While many patients experience a chronic, relapsing-remitting course, some see improvement over several years with targeted treatment. You should seek immediate medical attention if you experience chest pain, fainting (syncope) with injury, shortness of breath at rest, or a heart rate that does not stabilize upon lying down.

Medical Disclaimer: This information is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

References

NIH Genetic and Rare Diseases (GARD) Information Center - Postural Orthostatic Tachycardia Syndrome

Dysautonomia International - Understanding POTS

Orphanet - Postural Orthostatic Tachycardia Syndrome

Author: DiseaseMaps Editorial Team

Reviewed against authoritative medical sources (NIH GARD, Orphanet, OMIM)

Last updated: 2026-04-06

Sources cited: NIH Genetic and Rare Diseases (GARD) Information Center - Postural Orthostatic Tachycardia Syndrome · Dysautonomia International - Understanding POTS · Orphanet - Postural Orthostatic Tachycardia Syndrome

Medical disclaimer: This information does not substitute professional medical advice. Always consult your doctor before making health decisions.

Source: DiseaseMaps.org

18 answers

Dizziness and Fainting
Gastrointestinal problems (e.g., abdominal pain, nausea, vomiting, constipation, diarrhea, etc.)
Tachycardia/Irregular Heartbeat
Hypotension/Hypertension
Problems regulating body temperature
Brain Fog

Posted Apr 19, 2017 by Nikki 2192

Light headedness and brain fog. If any I'd get rid of those two. Along with nausea these very much limit a person to do daily activities as a "normal" person would.

Posted Apr 27, 2017 by SaraW13 1050

Exhaustion, low blood pressure, migraines, inability to eat, hot/cold intolerance, increased heart rate, dizzyness, fainting, brain fog.

Posted Apr 27, 2017 by sweindorf00 250

Dizziness, fatigue, sweating,

Posted Apr 27, 2017 by Melissa 1100

Tachycardia, chest pain, low BP and syncopal episodes. Nausea, heat Intolerance, dizziness, fatigue and trying to find a doctor that knows how to treat your condition.

Posted May 23, 2017 by Teresa 104

The dizziness and the fainting are the worst symptoms

Posted Jun 4, 2017 by Richelle 1750

The chronic fatigue and tachycardia.

Posted Aug 17, 2017 by Chelsea 2335

Fog brain and fatigue are the absolute worst. It keeps me from doing things and it makes me look really dumb at times because I can't remember things.

Posted Aug 17, 2017 by Miranda 2150

The fatigue is defiantly the worse.

Posted Sep 27, 2017 by Lbond94 4100

Chronic fatigue, headache, GI issues

Posted Oct 27, 2017 by Lori 100

For POTS, NCS, OH, and neurally regulated hypotension: The most obvious would be if someone tends to pass out or come close to passing out (lightheaded/pre-syncope) when they're getting out of a shower or hot tub, or just going from lying down to standing. Sometimes this pre-syncope might show as a less obvious headache/subtle lightheadedness. Not everyone passes out though and for many it can improve over time if you can find the cause or what might be called the subtype or other comorbidities you have. You might notice you just become really fatigued much sooner in the day and all you did was wait in line somewhere, eat a carby meal, or just happen to get up and down out of your desk a lot. If you notice a lot of major systemic issues or passing out you'll want to start with a poor man's tilt table test and keep an eye on your pulse. If you notice your pulse is a little off from the normal range you'll want to see a cardiologist and make sure you don't have an arrhythmia or anything structurally problematic that could be causing this. Fatigue is a big one, not registering temperature correctly is another one, lightheadedness and brain fog are another big two. Your pulse going up +40 or more when you stand also is CONSTANT even if you don't feel that bad sometimes when you're standing or walking, it's the one consistent physiological feature.

For gastroparesis: you'll feel starving, go to eat, and after only a bite or two feel so full that you might throw up if you take another bite. You also will feel hypoglycemic even if you just ate and should be fine, have a general feeling that none of your food is really digesting (or seeing it in your poop or vomit), and any scans might show you're constipated even if you don't feel like it.

SFPN, also how this relates to POTS and sometimes autoimmune diseases or genetic anomalies: I could write a book on this one so if you have questions, do your homework first and then ask me.

Posted May 26, 2018 by Danielle 1500

Tachycardia (Rapid Heart Rate) - which increases on changing posture - from laying down to sitting, to standing, sometimes from shifting in bed or in the lounge chair you are sitting in. Any exertion can change your heart rate anywhere from 30 to 100 or more BPM which can be quite scarey. Chest pains and feeling like you are having a heart attack is not unusual and it is difficult to get doctors to take you seriously once they know you have POTS and you present with chronic chest pains, severe dizziness, pooling of blood in the legs and hands, etc - they kind of brush you off and go 'its just a POTS episode' - the scarey part is that there is that one time it may NOT be a POTS episode!
There are a lot of POTS patients who are too dizzy and too weakened to even walk and spend their entire time in a chair or with a feeding tube, while there are others who will be able to ALMOST function on a good day and seem 'normal' to the general public - however the 'general public' dont see what it took to get ready to go out of the house, or that it then takes a few days to a couple of weeks to get over that short trip to the grocery store or the pharmacy.
The crazy part is that POTS seems to cross over a lot with things like Fibromyalgia and there are bits of each that are the same and bits that arent - so it is important to know which is which and actually recognise your symptoms and note them down at times - particularly if you have a 'strange one' come up to discuss with your treating professional.
My personal most limiting symptom is the dizziness, the breathlessness and the tachycardia - I also get brachycardia which also interferes with my breathing and my heart rate can range from 35 to 145 within the space of about 5 minutes at times..... that is NOT fun.... the body pains and chest pains, not being able to stand up in a shower (warm water hits and the BP drops and so do I - so shower chair isnt a 'want' it is a 'need'), and as soon as the weather changes and in particular warms up - I am in big trouble and live with the air conditioning on all year round almost.

Posted Dec 3, 2018 by Shell 800