As someone navigating life with POTS (Postural Orthostatic Tachycardia Syndrome), I wanted to answer some of your questions. Especially, how POTS diagnosed, what to expect with the infamous tilt table test, and why it sometimes takes forever to get a name for what’s going on.
Disclaimer: Hey there, friend! Just a quick reminder—I’m not a doctor, and this blog post isn’t medical advice (as much as I wish my Google searches made me a certified expert). This blog is all about sharing personal experiences and insights, not diagnosing or curing anything—so take what resonates, do your own research, and always prioritize your health.
What Is POTS?
POTS is a type of dysautonomia, meaning it’s a disorder of the autonomic nervous system, the part of us that runs things like heart rate, blood pressure, and temperature without us telling it to. In plain English: when I stand up, my heart races—at least 30 beats per minute (bpm) more within ten minutes, without a drop in blood pressure (if you’re under 19, the cutoff is ≥ 40 bpm).
I’m not alone—millions in the U.S. live with POTS, though it’s more common in young women.
My Symptoms Diagnosis Road
What started it for me?
I had incredibly horrible fatigue. The type of exhaustion I couldn’t nap away.
Then, over time, I began noticing new or worsening symptoms like dizziness, brain fog, palpitations, headaches, blurry vision, nausea, even that “wired and tired” anxiety feeling—after literally just standing up. I also had a new sensitivity to getting overheated outside and even had blurred vision.
With all of these symptoms, getting diagnosed felt like detective work because so many conditions look similar to POTS. I went through bloodwork, urine tests, EKGs, MRIs, CT scans, and even an echocardiogram to rule out heart problems.
Many with POTS see multiple specialists—on average seven doctors—and it takes about 4.7 years to land a diagnosis! It took me 10 years!
The Tilt Table Test: What It Is—And What “Failing” It Means
Once I landed at the right specialist (a cardiologist), he ordered a tilt table test based on my symptoms. He thought I had POTS right away and I’m thankful he took me seriously from the beginning.
Before calling it POTS, doctors like to check the hardware—meaning your heart itself. An echocardiogram (heart ultrasound) helps rule out other structural or functional issues like valve problems or weakened heart muscle. It’s usually part of the bundle of “other stuff” they want to rule out before landing on POTS. So, I had that done first and when it came back all-clear, my cardiologist ordered a tilt table test.
The tilt table test is basically a tilt-and-see what happens situation. You lie flat on a motorized table with straps, get hooked up to heart-rate and blood-pressure monitors; then the table slowly tilts you upright (often to ~70°) while everything is watched closely—heartbeat, blood pressure, and how your symptoms progress.
The point of the test is to cause your body enough stress so it reacts with POTS-like symptoms. Before we began the test, the cardiologist explained that “failing” this test could mean two things. Either I hit the POTS criteria (a big jump in heart rate with symptoms), or having such a dramatic response—like fainting or blood pressure crashing—that they’d have to snap the table back and intervene.
Thankfully, I didn’t pass out. But, I did get really distressed and my heart rate spiked, meaning I met the criteria for a POTS diagnosis.
The diagnosis came about two years ago and I’m still learning how to best manage symptoms and juggle chronic illness and daily life. My blog is me passing along helpful things as I learn them in real time. I hope you remember you aren’t alone and we’ll figure this out together.
Before You Go
Getting a POTS diagnosis can feel like you’ve run a marathon you didn’t sign up for—but trust me, finally having answers is worth it. Knowing what’s going on with your body opens the door to treatment, community, and hope. You’re not “making it up,” you’re not alone, and there are so many of us out here learning to live full, vibrant lives with POTS. You deserve every bit of care and compassion along the way.
Little Hope Notes 
Leave a comment