POTS Symptoms Checklist: Full List for Women, Men and Teens

The main symptoms of POTS are light-headedness, a racing or pounding heart and feeling close to fainting when you stand up, which ease when you sit or lie down. Many people also have tiredness, brain fog, headaches, nausea, shakiness and poor sleep. A checklist helps you describe them, but only a doctor can diagnose POTS.

What are the symptoms of POTS?

POTS (postural tachycardia syndrome) symptoms start or get worse when you are upright, and ease when you sit or lie down. Light-headedness, a racing heart, nearly fainting, headaches and trouble thinking clearly are the most common.¹³

POTS is a problem with the autonomic nervous system. This is the part of your nervous system that runs things you don’t think about, like heart rate and blood pressure. Problems with it are sometimes called dysautonomia.¹¹

Symptoms can be mild or severe. They are often worse in the morning and can change from day to day.¹²

This list cannot tell anyone whether they have POTS. Other conditions cause the same symptoms, and the NHS says having them does not mean you definitely have POTS.¹

In a 2019 survey of 4,835 people diagnosed with POTS, these were among the symptoms reported most often.³

Fainting is less common than many people think. About a third of people in the survey had fainted, and PoTS UK says it is not true that everyone with POTS faints.²³

What does POTS feel like day to day?

It often feels like your body struggles to stay upright. Showering, standing to cook or walking up stairs can bring symptoms on.⁷

A bad spell, often called an episode, usually starts straight away or within a few minutes of sitting up or standing. It can bring a racing heart, dizziness, shakiness and sweating. Lying down may help it pass.⁷

Some symptoms don’t stop when you lie down. Brain fog can carry on after lying down, and tiredness can last a long time after a flare.²

A 2022 review says headaches and poor sleep are almost universal in POTS, and more than 90% of people have chronic fatigue.⁴ Many people feel much worse after exercise, and it can take hours or days to recover.²

Less obvious symptoms

Some symptoms surprise people because they don’t seem linked to standing up. These include purple feet when upright, cold hands, tingling, dry eyes, needing to pee often and feeling worse after eating.¹²³ PoTS UK says purple hands and feet affect around half of people with POTS.²

The effect on life varies a lot. Some people keep working and studying. For others, bathing, eating or sitting upright is hard.⁸

What are the early or mild signs of POTS?

Medical guides do not list separate early signs. Mild POTS has the same symptoms, such as light-headedness or a fast heartbeat when you stand, with less effect on daily life. The NHS says some people have mild symptoms, while for others POTS has a big effect on daily life.¹

POTS can start suddenly or build up slowly.¹ Experts describe two patterns: a sudden start after a trigger, or symptoms that creep up over a longer time.⁵

In the 2019 survey, 41% said their symptoms began within 3 months of a specific event. The most common were an infection, surgery or pregnancy.³ Almost two in three felt they had always tended to have POTS-like symptoms.³

Mild symptoms are still worth checking. The NHS advises seeing a GP if you have symptoms of POTS.¹

Are POTS symptoms different in women, men and teenagers?

The main medical guides give one list of symptoms for everyone, not separate lists for women and men. What differs is who gets POTS, when it starts and what makes it worse.

Women

POTS is much more common in girls and women.⁴ In the 2019 survey, 94% of people were female.³ It mainly affects people aged 15 to 50.⁶

Periods can make symptoms worse.¹ Some people report more POTS episodes just before their period.⁶ Pregnancy is one of the events that can come before POTS starts.³⁶

Men

Men get POTS too, though less often.⁴⁶ In the survey, 6% of people were male. On average, men waited about 3 years for a diagnosis, and women about 5 years.³

Teenagers

POTS often starts in the teenage years. In the survey, the most common age it began was 14, and about half started in adolescence.³ For ages 12 to 19, doctors look for a bigger heart rate rise on standing: at least 40 bpm rather than 30.⁴

Teenagers and young adults also often get a short dizzy spell straight after standing that settles within 45 seconds. This is called initial orthostatic hypotension, and on its own it is not POTS.⁴

Can POTS symptoms come and go?

Yes. Symptoms can come and go over time, sometimes over years. This is called a relapsing-remitting pattern.⁶⁷

They also change from day to day and are often worse in the morning.¹² Common things that make them worse include heat, standing for a long time, not drinking enough, alcohol, meals (especially starchy ones), being ill and periods.¹⁷

How POTS changes over many years is not well studied.⁴ Some people recover a lot. Most report ongoing symptoms with flare-ups.⁵ Our guide to POTS flare-ups covers what to do during one.

Do symptoms differ by type of POTS?

Sometimes, but the types overlap. They describe what may be going on in the body, and many people have features of more than one.⁵

• Hyperadrenergic POTS: the body’s “fight or flight” system is overactive. People often report tremor, anxiety, migraine and chest pain that feels like heart pain (angina).⁴⁵
• Neuropathic POTS: nerves that tighten blood vessels work less well, so blood pools in the legs and belly. Signs of small fibre neuropathy (damage to tiny nerves) may be present.⁵⁷
• Hypovolemic POTS: you have less blood than expected for your size.⁵⁷

There is no evidence yet that the type changes the long-term outlook or which treatment works.⁵

What else could cause these symptoms?

Several other conditions cause a fast heart rate or dizziness when you stand. Doctors rule these out before diagnosing POTS.⁴⁵

• Dehydration or blood loss⁴
• Anaemia (not enough healthy red blood cells)⁴
• An overactive thyroid⁴
• Medicines that raise heart rate, such as stimulants and water tablets (diuretics)⁴
• Orthostatic hypotension: a blood pressure drop of 20/10 mmHg or more when you stand. If this happens, it is not POTS⁴
• Fever, pain, infection or a long time in bed⁴
• Panic attacks and severe anxiety⁴
• Inappropriate sinus tachycardia: a fast heart rate all the time, not only when standing⁴
• Vasovagal syncope: fainting spells, usually with normal standing readings⁴

Our guide to feeling dizzy when standing up covers more common causes.

Is it anxiety?

A racing heart and shakiness can feel like anxiety, but POTS is not caused by anxiety.⁸ In the 2019 survey, 77% of people had been told their symptoms were psychiatric or psychological before their POTS diagnosis. After diagnosis, 37% were still told this.³

What conditions often come with POTS?

Several conditions often turn up alongside POTS. In the 2019 survey, 83% of people had at least one other diagnosis.³ The figures vary between studies, and experts say the evidence behind them is weak.⁴⁵

People with POTS who have signs of mast cell activation often report flushing, hives, breathlessness, headache, peeing a lot and stomach symptoms like diarrhoea, nausea and vomiting.⁵ Our MCAS symptoms checklist covers these. POTS is also one form of dysautonomia.¹¹

Having POTS does not mean you will get any of these conditions.

How do doctors check for POTS?

Doctors look for a heart rate rise of at least 30 beats per minute (bpm) within 10 minutes of standing, or 40 bpm at ages 12 to 19. They also check for no big blood pressure drop, symptoms for 3 months or more, and no other cause.⁴

It usually starts with an active stand test: heart rate and blood pressure before and after you stand. You may also have blood tests and an ECG (a heart tracing). Some people have a tilt table test.¹

Heart rate on standing varies from day to day and is higher in the morning. If a doctor still suspects POTS after a normal first test, the 2022 review says a later retest is sensible, ideally in the morning.⁴

You can record lying and standing heart rate at home with our standing test timer. A home test is not a diagnosis. If you feel faint, lie down and raise your legs.¹ Our guide to getting diagnosed with POTS has the full steps.

What should you write down before an appointment?

Write down what happens, when, and what you were doing. A short, dated record is easier to share than memory on a bad day.

• Your ticked checklist from above
• When symptoms start: standing up, standing still, after meals, in heat, in the morning
• How long they last, and what helps, like sitting or lying down
• Lying and standing heart rate, if you have checked it, with the date and time
• Any faints or near-faints, and what came before them
• Where you were in your cycle, if you have periods
• Medicines you take, including new ones
• What symptoms stop you doing, like work, school, showering or cooking

Juno (our app) lets you note symptoms by text or voice as they happen and turns them into a summary for appointments. It does not diagnose POTS or tell you what is causing your symptoms. A paper list works too. For other options, see the best apps for POTS.

When is it an emergency?

POTS is not life-threatening, but the biggest physical risk is getting hurt if you faint and fall.⁷ Some symptoms need urgent help.

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 13 November 2026