How to Get Diagnosed With POTS: Tests, Doctors and What to Bring

What do doctors look for to diagnose POTS?

POTS stands for postural tachycardia syndrome. Your heart rate goes up a lot when you stand, and you feel unwell when upright. Symptoms ease when you sit or lie down. [1]

A 2022 review in the Canadian Medical Association Journal sets out the criteria doctors use. All of these must be true: [4]

• Your heart rate rises by at least 30 beats per minute (bpm) within 10 minutes of standing. For ages 12 to 19, the rise must be at least 40 bpm. These cut-offs are not used for children under 12, who need a paediatrician to assess them
• The rise is sustained, not a short spike. It should show on at least 2 standing readings
• Your blood pressure does not drop a lot when you stand (a drop of 20/10 mmHg or more points to something else)
• You have symptoms most days that are worse upright and ease quickly when you lie down
• You have had symptoms for at least 3 months
• No other cause explains the fast heart rate, such as anaemia, dehydration, an overactive thyroid, infection, anxiety or certain medicines

Your heart rate on standing can change from day to day. It is usually higher in the morning. The same review says morning tests are likely to pick it up better, and that a repeat test is sensible if a doctor still suspects POTS after a normal first result. [4]

Where do you start?

For most people, it starts with a GP or primary care doctor. The NHS says to see a GP if you have symptoms of POTS. [1] The first test is simple. Your doctor checks your heart rate and blood pressure before and after you stand up. If they repeat the readings several times, this is called an active stand test. [1]

PoTS UK’s guide for GPs describes how to do it. You lie down and rest, and your heart rate and blood pressure are recorded. Then you stand, and they are recorded every 2 minutes for 10 minutes. [2] The CMAJ review suggests lying down for 5 to 10 minutes first, then readings at 1, 3, 5, 8 and 10 minutes of standing. [4]

You may also have blood tests and an ECG to look for other causes. [1] [2] The CMAJ review says this basic check is usually enough to make a diagnosis and start treatment, and that primary care doctors and paediatricians can do it. [4]

The NHS says you may be referred to a specialist if: [1]

• changes to your lifestyle do not help
• you are very unwell
• it is not clear what is causing your symptoms

It is common to need more than one visit. The NHS notes it can take time to get a diagnosis because the symptoms are like those of other conditions. [1] If you want to see your own pattern before the appointment, our guide to feeling dizzy when standing up covers other common causes too.

Which tests might you have?

You will not need all of these. Most people have the first three. The rest depend on your symptoms and where you are seen.

A tilt table test is not essential. The CMAJ review says it can be used, but a stand test is enough. It also says that, apart from an ECG, heart and nerve tests are not routinely needed. Further tests should depend on what your doctor finds. [4]

Which doctor diagnoses POTS?

PoTS UK says people are often diagnosed by a cardiologist, a neurologist, a medicine for the elderly consultant or a paediatrician. A GP can also diagnose POTS. [3]

• GP or primary care doctor: the first stand test, ECG and blood tests
• Cardiologist: a heart specialist, often seen for a racing heart, palpitations or fainting
• Neurologist: a nerve and brain specialist
• Paediatrician: for children and teenagers
• Autonomic or specialist POTS clinic: for tilt table and autonomic tests

PoTS UK keeps a list of clinics and doctors with an interest in POTS. [2] The CMAJ review says a referral to a POTS expert makes sense if you do not respond well to first treatment. [4] When you are referred, it is fine to ask whether the specialist sees people with POTS.

How long does it take to get diagnosed?

Often a long time. In 2013, Dysautonomia International surveyed over 700 people with POTS. They found: [5]

• The average time to diagnosis was 5 years and 11 months
• Only 25% were diagnosed within the first year of symptoms
• 27% saw more than 10 doctors before diagnosis
• 50% travelled more than 100 miles from home for POTS care

This is an older survey of people who chose to answer it, so it may not match your experience today. But it shows that a slow diagnosis is common. It is not a sign that you are doing something wrong.

What if a doctor says it is anxiety?

This happens a lot. In the same survey, 59% of people were told by a doctor that their symptoms were “all in your head” before their POTS diagnosis. 69% were diagnosed with an anxiety disorder first. [5] The CMAJ review says POTS is often misdiagnosed as anxiety at first, partly because anxiety can also cause a fast heart rate, palpitations and lightheadedness. [4]

Anxiety is one of the things a doctor should rule out. [4] The stand test reading is only one part of this: your doctor looks at it together with your symptoms and history. A small Vanderbilt study compared 21 people with POTS with healthy volunteers. People with POTS did not have higher rates of anxiety disorders than the general population. [6]

• Ask for the stand test to be done, or repeated in the morning
• Ask for your readings to be written in your notes
• Bring your own dated lying and standing readings
• Ask for a second opinion or a referral if you are not being listened to

Our guide to handling medical gaslighting has more on speaking up in appointments.

What should you bring to your appointment?

A short, dated summary is easier for a doctor to use than a long diary. Tick off what you have ready.

Juno’s free standing test timer walks you through lying and standing readings and lets you print them. Only do it if you can stand safely, with someone nearby. The free symptom tracker worksheet and appointment one-pager help you put it all on one page. If you already have a diagnosis, our guide to POTS flare-ups covers bad days.

Juno can also help. You log symptoms by text or voice, and Juno turns them into a short summary for your doctor. Juno does not diagnose POTS. See the POTS symptom tracker page.

When should you get urgent help?

Most POTS symptoms are not an emergency. But do not assume every new symptom is POTS.

This article is for general information only and does not replace advice from your own clinician. Juno is a health assistant, not a medical provider.

Last updated 23 October 2026