What to know about POTS, a condition marked by dizziness and fatigue that’s often misdiagnosed

What to know about POTS, a condition marked by dizziness and fatigue that’s often misdiagnosed

Back in 2014, Hailey Hudson was a healthy, active 16-year-old.

She worked out several days per week and played competitive softball. Despite having Ehlers-Danlos syndrome (EDS), which caused her to have hypermobility in her joints, “I was in the best shape of my life,” she says.

Around that time, Hudson underwent surgery for her condition. During her first practice back after the operation, things felt…off. “I was running the bases and couldn’t breathe. It felt like my throat was closing up. I was dizzy and had spots in my vision,” she recalls.

As the season went on, things got more intense. She continued feeling dizzy at practice but also developed debilitating fatigue once she got home.

Hudson was misdiagnosed with anaemia, asthma, generalised chronic fatigue, fibromyalgia, and anxiety before learning what was actually happening: She had postural tachycardia syndrome (POTS) – a blood circulation disorder that affects your heart rate when you change positions (like going from sitting to standing). It can happen to anyone, but is way more common in women between 15 and 50.

The causes of POTS are unknown, but it can happen suddenly after a major health event, like surgery (as in Hudson’s case), pregnancy, puberty, or a bacterial or viral infection. That last one is a biggie given that research suggests some people can develop POTS after COVID-19.

“We have seen a huge uptick in people with this disorder, mostly women,” says Robert Wilson, DO, a neurologist.

It can be debilitating, and it has no cure, although a combo of lifestyle modifications and medications can help. But all too often, healthcare professionals mistake the symptoms for other issues. Here’s everything you need to know about POTS, including how to spot its symptoms and when to seek help.

What is POTS?

POTS is an acronym that stands for postural orthostatic tachycardia syndrome. It messes with your arteries’ ability to contract properly, which is known as vascular tone. As a result, “these people really cannot maintain blood flow,” Dr. Wilson notes.

Nikki Bart, MD, PhD, a cardiologist at St. Vincent’s Hospital says that POTS can interrupt some bodily functions you can’t control, like your heart rate, blood pressure, and body temp.

Normally when you stand up, gravity pulls the blood down to your legs, Dr. Bart explains, and your nervous system senses and corrects for that by getting your blood pumping up to your head. But if you have POTS, that doesn’t happen. “You might get this pool of blood in your legs and not enough blood to your brain, so you feel lightheaded, dizzy, or have palpitations,” she notes.

What are the symptoms of POTS?

This condition can manifest in subtle ways and masquerade as other conditions. For Hudson, it took six years after her first symptoms appeared before she was correctly diagnosed.

Here are some things that doctors see:

Fainting or dizziness, especially when standing up or staying in one position for a while

Because your body has a hard time moving blood around, when you maintain a certain posture for too long or switch things up suddenly, you might feel super dizzy or like you’re about to faint. Typically, this feeling will go away once you lie down.

Sleep problems

Dr. Wilson says that people with POTS frequently have issues with their sleep. The prolonged horizontal posture can be a problem, and it can lead to insomnia, sleep disturbances, and daytime sleepiness as a result.

Fatigue and brain fog

If you have POTS, you may not get dizzy or faint, but you most likely will feel physically and mentally depleted, Dr. Wilson explains.

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