POTS TESTING
Updated: Oct 20
POTS can be difficult to diagnose because so many symptoms show up in the body over time. Before diagnosis, many patients see a lot of doctors and live with symptoms for months, like I did.
Short on time or energy? A quick-view graphic with the key points is at the bottom of this post.
Want to know the signs first? See my POTS CAUSES AND SYMPTOMS post:
HOW POTS IS DIAGNOSED
-POTS is diagnosed with a 10-minute standing test or a tilt table test (Johns Hopkins). Cleveland Clinic calls the tilt table test the main way providers diagnose POTS.
-For adults, the heart rate rises at least 30 beats per minute (at least 40 for ages 12 to 19) within 10 minutes of standing, without a big drop in blood pressure (CMAJ 2022, Johns Hopkins).
-Symptoms happen often when upright, get better lying down, and last at least 3 months.
-In the US, doctors can use the POTS diagnosis code G90.A, starting October 1, 2022 (Dysautonomia International).
TESTS YOUR DOCTOR MAY USE
-Tilt table test: checks your heart rate and blood pressure as your position changes.
-10-minute standing test: heart rate and blood pressure are checked lying down, then standing.
-Blood and urine tests: look for other causes or conditions that can look like POTS.
-QSART: tests the nerves that control sweating.
-Deep breathing and Valsalva tests: check your heart rate and blood pressure during certain breathing patterns (not during exercise).
-Thermoregulatory sweat test (TST): checks how well your body sweats in a warm room.
-Skin biopsy: can check for small fiber neuropathy, which a 2024 Johns Hopkins review says has been reported in some people with long-lasting Lyme symptoms. Dr. Tania Dempsey uses it to see whether POTS is nerve-related, and notes that Mayo Clinic has reported small fiber neuropathy behind more than half of POTS cases.
-Holter monitor: Dr. Dempsey lists this, along with a tilt table test and echocardiogram, as tests a specialist may order.
-Heart tests like an ECG or echocardiogram, when your doctor feels they're needed.
Take my Cardiologist Letter with you to your appointment:
Our POTS discussion in the Rise Above Lyme group:
RELATED POSTS
POTS - Possible Solutions
POTS Causes and Symptoms
POTS / Dysautonomia
Cardiology (Lyme Carditis and POTS)
Cardiologist Letter
POTS Directory (all my POTS posts in one place)
SOURCES
Dr. Tania Dempsey - Lyme Disease and Postural Orthostatic Tachycardia Syndrome (2019, updated November 2023) - older source, still worth reading
Johns Hopkins Medicine - POTS (2026)
Cleveland Clinic - POTS (reviewed 2026)
CMAJ - Diagnosis and Management of POTS (March 2022)
Dysautonomia International - New ICD-10 Code for POTS (June 2022)
MedlinePlus (NIH) - Autonomic Testing (September 2024)
The Dysautonomia Project - Overview of the Autonomic Reflex Screening (July 2023)
Frontiers in Neurology - Dysautonomia Following Lyme Disease (Johns Hopkins, February 2024)
Disclaimer: Rise Above Lyme makes no claims about any possible benefit of using any product mentioned within this site. Always consult with your doctor before adding anything. The information shared is based on personal experience, years of accumulated researched resources from Lyme Literate doctors and polls conducted within Lyme groups from actual patient experience using these solution ideas.
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