← All topics

POTS & Dysautonomia

Practical guidance for postural orthostatic tachycardia syndrome and broader dysautonomia, from daily patterns to what actually moves recovery.

Kinga Howard / Unsplash
Austin Spaeth September 1, 2026 POTS

Inappropriate Sinus Tachycardia vs POTS: How to Tell Them Apart

Inappropriate sinus tachycardia (IST) and POTS both make your heart pound, but they differ in when it happens. IST is a fast resting heart rate, over 100 bpm at rest or a 24-hour average over 90 bpm, that is present whether you are lying down, sitting or standing. POTS is a heart rate that is roughly normal while you rest but rises at least 30 bpm (40 for teens) within ten minutes of standing. The way to tell them apart at home is to measure your heart rate at rest and again after standing, on several calm days, and read the two numbers together. Confirming either one needs a clinician, an ECG and usually a 24-hour monitor.

Read the full story
Vitaly Gariev / Unsplash POTS

Aug 31, 2026 · Austin Spaeth

Why Are All My Test Results Normal When I Feel This Sick?

Your ECG, bloodwork and echo came back normal, but you can barely stand up without your heart pounding. Here is why 'normal' and 'this sick' can both be true, what standard tests miss in dysautonomia, and the exact evidence to bring back to your clinician.

Read article →
Ethan Sykes / Unsplash POTS

Aug 28, 2026 · Austin Spaeth

The Water Bolus for POTS: How Fast Drinking Water Raises Blood Pressure

Drinking about 500 ml of plain water quickly can raise blood pressure and steady standing heart rate within minutes. Here is the physiology behind the water bolus, how to use it, and how to test whether it works for you.

Read article →
Camila Seves Espasandin / Unsplash POTS

Aug 27, 2026 · Austin Spaeth

Coat Hanger Pain: Why Your Neck and Shoulders Ache When You Stand

Coat hanger pain is the aching band across the back of the neck and shoulders that builds the longer you stay upright and eases when you lie down. Here is why it happens in POTS and orthostatic intolerance, how to tell it apart from ordinary neck tension, and how to track it.

Read article →
Unsplash POTS

Aug 26, 2026 · Austin Spaeth

Ivabradine for POTS: How It Lowers Heart Rate Without Touching Blood Pressure

Ivabradine slows the heart's own pacemaker directly, so it can bring down a racing standing heart rate in POTS without lowering blood pressure or blunting how hard the heart squeezes. Here is how it works, what the evidence shows, and what to actually track once it is in the picture.

Read article →
Unsplash Long COVID

Aug 25, 2026 · Austin Spaeth

Air Hunger in Long COVID and POTS: Why You Feel Short of Breath

Air hunger, the feeling that you can't get a full, satisfying breath, is one of the most frightening symptoms in long COVID and POTS. It usually isn't your lungs failing. Here is what actually drives it, why your oxygen reads normal, and how to track it without spiraling.

Read article →
Unsplash POTS

Aug 24, 2026 · Austin Spaeth

Tilt Table Test: What to Expect and How It Diagnoses POTS and Syncope

A tilt table test tips you upright on a motorized table while your heart rate and blood pressure are watched continuously. Here is what actually happens during the test, how it is read, and how it differs from the stand test you can run at home.

Read article →
Giulia Bertelli / Unsplash POTS

Aug 23, 2026 · Austin Spaeth

Heart Palpitations and Ectopic Beats in POTS: What They Mean and How They Affect HRV

Palpitations, that pounding, fluttering or skipped-beat feeling, are one of the most common and most frightening symptoms in POTS and long COVID. Here is what the different sensations actually mean, why most are benign, the red flags that are not, and how ectopic beats quietly distort your HRV readings.

Read article →
Unsplash POTS

Aug 22, 2026 · Austin Spaeth

Small Fiber Neuropathy in POTS and Long COVID: Symptoms, Testing, and What to Track

Small fiber neuropathy damages the tiny nerves that carry pain, temperature and autonomic signals, and it shows up surprisingly often in POTS and long COVID. Here is what it feels like, how it is tested, and the at-home metrics that mirror the autonomic side of it.

Read article →
Kinga Howard / Unsplash Basics

Aug 21, 2026 · Austin Spaeth

Vasovagal Syncope: Why You Faint and How to Stop It

Vasovagal syncope is the most common reason people faint: a reflex that briefly drops your blood pressure and heart rate so your brain loses blood flow for a few seconds. Here is what the reflex is doing, how to read the warning signs, and the counter-pressure moves that can stop a faint before it lands.

Read article →
Kinga Howard / Unsplash POTS

Aug 18, 2026 · Austin Spaeth

Orthostatic Hypotension vs POTS: How to Tell Them Apart

Both make you dizzy when you stand up, but they are opposite problems on the monitor. Orthostatic hypotension is a blood-pressure drop; POTS is a heart-rate surge with the blood pressure holding. Here is how to read the difference at home without spiraling.

Read article →
Priscilla Du Preez / Unsplash HRV

Aug 17, 2026 · Austin Spaeth

Cold Exposure and HRV: Does Cold Water Really Boost Your Vagus Nerve?

Cold water can calm your heart through the vagus nerve, but only in a specific way. Cold on the face triggers a genuine vagal slowdown; a full ice plunge is a sympathetic stressor first. Here is what actually happens to your HRV, and how to try it safely with POTS.

Read article →
Maria Petersson / Unsplash POTS

Aug 16, 2026 · Austin Spaeth

Low Blood Volume in POTS: How Hypovolemia Drives the Racing Heart

Many people with POTS run on a genuinely smaller blood volume than average. Here is the physiology behind hypovolemic POTS, why it drives the standing tachycardia and low HRV, and the at-home fingerprints you can actually track.

Read article →
Dane Wetton / Unsplash POTS

Aug 15, 2026 · Austin Spaeth

Hypermobility, hEDS and POTS: Why Bendy Joints and a Racing Heart Travel Together

Joint hypermobility, hypermobile Ehlers-Danlos syndrome (hEDS) and POTS overlap far more often than chance. Here is the connective-tissue link, what the Beighton score does and does not tell you, and how tracking changes the management.

Read article →
Ethan Sykes / Unsplash HRV

Aug 13, 2026 · Austin Spaeth

Dehydration and HRV: Why Being Under-Hydrated Lowers Heart Rate Variability

Under-hydration is one of the quietest reasons your HRV reads low. Here is the physiology behind it, how much it moves the number, why it hits harder in POTS, and how to tell a hydration dip apart from a real trend.

Read article →
Unsplash POTS

Aug 12, 2026 · Austin Spaeth

Weather and POTS: How Barometric Pressure, Humidity, and Cold Shift Your Symptoms

Many people with POTS and dysautonomia swear their symptoms track the weather, and the physiology backs up a lot of it. Here is what barometric pressure, humidity, cold snaps, and passing fronts actually do to an autonomic nervous system, and how to tell whether the sky is really your trigger.

Read article →
Briana Tozour / Unsplash Recovery

Aug 11, 2026 · Austin Spaeth

Heart Rate Zones Explained: Z1 to Z5, and How to Read Them With Dysautonomia

Heart rate zones split effort into five bands off your estimated maximum heart rate. Here is what each zone actually does physiologically, why the age formula is only an estimate, and how to read time-in-zone when you have POTS, long COVID or post-exertional malaise.

Read article →
Ophelia Aldana / Unsplash Basics

Aug 10, 2026 · Austin Spaeth

Baroreflex Sensitivity: The Reflex That Keeps You Upright

The baroreflex is the fast feedback loop that steadies your blood pressure every time you stand, and its sensitivity is one of the clearest measures of how well your autonomic system responds. Here is what baroreflex sensitivity means, why it runs low in POTS and long COVID, and how your HRV and stand test give you a home-usable proxy.

Read article →
kike vega / Unsplash POTS

Aug 9, 2026 · Austin Spaeth

POTS vs Deconditioning: How to Tell the Difference

"You're just deconditioned" is one of the most common things people with POTS hear. Both can race your heart when you stand, but they behave differently over time. Here is how to read the difference at home without talking yourself out of care.

Read article →
Austin Spaeth Long COVID

Aug 7, 2026 · Austin Spaeth

From Daily Crashes to Living Again: What I Tracked, What I Changed, and What the Data Showed

A patient-founder's honest account of four years with long COVID and dysautonomia: the daily crashes and labile blood pressure, why I started measuring, the routine I built piece by piece, and what my own HRV and blood pressure data actually showed.

Read article →
Anna Pelzer / Unsplash POTS

Aug 6, 2026 · Austin Spaeth

Iron Deficiency and POTS: Why Ferritin Matters When Your Labs Look Normal

Low iron stores are common in POTS and can quietly amplify tachycardia, fatigue and lightheadedness, often while a standard blood count still reads normal. Here is how ferritin fits in, why the lab range can miss it, and what to track at home.

Read article →
Unsplash POTS

Aug 5, 2026 · Austin Spaeth

Compression Garments for POTS: What Actually Works and How to Wear Them

Compression is one of the few non-drug tools with real evidence behind it for POTS. The catch: where you compress matters far more than most people realize. Here is what the research shows and how to use it.

Read article →
Sage Friedman / Unsplash POTS

Aug 2, 2026 · Austin Spaeth

Is It POTS or Anxiety? How to Tell Them Apart

POTS and anxiety share almost every symptom: racing heart, dizziness, shortness of breath, that wired feeling. The one thing that reliably separates them is what your heart does when you stand up. Here is how to read the difference without spiraling.

Read article →
Marek Rucinski / Unsplash HRV

Jul 31, 2026 · Austin Spaeth

Beta Blockers and HRV: Why Your Heart Rate Variability Changes on Propranolol or Metoprolol

Starting a beta blocker usually lowers your resting heart rate and pushes your HRV numbers up, but part of that rise is the slower heart rate itself, not healed vagal tone. Here is how to read RMSSD, SDNN and your stand test honestly once a beta blocker is in the picture.

Read article →
Unsplash POTS

Jul 29, 2026 · Austin Spaeth

Blood Pooling in POTS: Why Blood Collects in Your Legs When You Stand (and What Helps)

When you stand, gravity pulls a large volume of blood down into your legs and belly. In POTS that pooling is exaggerated and slow to correct, so your heart races to compensate. Here is the physiology in plain terms, why your feet can turn dusky, and the practical moves that push blood back where it belongs.

Read article →
Kinga Howard / Unsplash POTS

Jul 28, 2026 · Austin Spaeth

Why Are POTS Symptoms Worse in the Morning? The Overnight Physiology and a Gentler Start

If your POTS symptoms are at their worst in the first hour after waking, there are real, well-understood reasons. Here is what happens to your blood volume, hormones and heart rate overnight, and a calmer, step-by-step way to get out of bed.

Read article →
Brooke Lark / Unsplash POTS

Jul 25, 2026 · Austin Spaeth

Why POTS Feels Worse After Eating: Postprandial Hypotension, Explained

If your heart races, your head swims, or you crash for an hour after a meal, that is not in your head. Digestion pulls a large share of your blood into the gut, and a struggling autonomic system cannot compensate. Here is the physiology and how to eat around it.

Read article →
Unsplash POTS

Jul 23, 2026 · Austin Spaeth

POTS Subtypes Explained: Hyperadrenergic, Neuropathic, and Hypovolemic

POTS is usually grouped into three overlapping patterns: neuropathic, hyperadrenergic, and hypovolemic. Here is what each one means, how they differ, and what your at-home stand-test numbers can hint about which pattern is driving your symptoms.

Read article →
Sage Friedman / Unsplash POTS

Jul 22, 2026 · Austin Spaeth

Adrenaline Dumps in POTS: Why Your Heart Races (and Why It Usually Isn't a Panic Attack)

That sudden racing heart, tremor and wave of dread, often at 3am or after standing, has a name patients use: an adrenaline dump. Here is the physiology behind catecholamine surges in POTS, how to tell them apart from panic attacks, and how to track and settle them.

Read article →
Giorgio Trovato / Unsplash POTS

Jul 21, 2026 · Austin Spaeth

Heat Intolerance and POTS: Why Hot Weather Wrecks Your Numbers (and How to Track It)

Heat is one of the most reliable triggers in POTS and dysautonomia. Here is the physiology behind why hot weather raises your heart rate, drops your HRV, and worsens standing symptoms, plus the practical cooling and tracking moves that actually help.

Read article →
Gabi Miranda / Unsplash HRV

Jul 20, 2026 · Austin Spaeth

Alcohol and HRV: Why a Few Drinks Lower Your Overnight Numbers (and Flare POTS)

Unlike caffeine, alcohol reliably lowers your overnight HRV, and the effect scales with how much you drink and how late. Here is the physiology, honestly, plus why it hits POTS and dysautonomia harder, and how to test your own response.

Read article →
Jared Rice / Unsplash HRV

Jul 19, 2026 · Austin Spaeth

The Menstrual Cycle and HRV: Why Your Numbers Dip (and POTS Flares) Before Your Period

HRV tends to run higher in the follicular half of your cycle and lower in the luteal half, while resting heart rate does the opposite. Knowing where you are in your cycle keeps a normal luteal dip from reading like a crash, and explains why POTS symptoms so often flare before and during your period.

Read article →
Nathan Dumlao / Unsplash POTS

Jul 18, 2026 · Austin Spaeth

Caffeine and POTS: How Coffee Affects Your Heart Rate, HRV, and Standing Symptoms

Does coffee make POTS worse? Caffeine is a stimulant that raises heart rate and sympathetic drive, but it can also nudge blood pressure up and its effect on HRV is genuinely individual. Here is the physiology, honestly, plus how to test your own response.

Read article →
Recovery from Post-Viral Dysautonomia: Turning Data Into Decisions Recovery

Jul 7, 2026 · Austin Spaeth

Recovery from Post-Viral Dysautonomia: Turning Data Into Decisions

Recovery from POTS and post-viral dysautonomia is slow, noisy and non-linear, which is exactly why it's so easy to lose hope in the day-to-day. Here's how to pace, read your trends, and turn months of scattered data into decisions that actually bend the curve.

Read article →
POTS, Long COVID & MCAS: Why They Travel Together Long COVID

Jul 5, 2026 · Austin Spaeth

POTS, Long COVID & MCAS: Why They Travel Together

POTS, long COVID, ME/CFS and MCAS overlap so much that many people are told they have several at once. Here's what actually connects them, how they differ, and which parts of each you can track at home.

Read article →
The Autonomic Nervous System & Dysautonomia: A Complete Guide Basics

Jul 2, 2026 · Austin Spaeth

The Autonomic Nervous System & Dysautonomia: A Complete Guide

Your autonomic nervous system runs everything you never think about: heart rate, blood pressure, digestion, temperature. When it stops regulating properly, that's dysautonomia. Here is how it works, what goes wrong, and why it's measurable.

Read article →
Opeoluwa Fasanya / Unsplash POTS

Jun 30, 2026 · Austin Spaeth

The Best Wearables & Home Tools for Tracking POTS

A practical guide to the affordable devices that capture POTS at home (chest straps, rings, watches, blood-pressure cuffs and pulse oximeters), plus the one test that needs no gadget at all.

Read article →
Nik / Unsplash Long COVID

Jun 27, 2026 · Austin Spaeth

Is It Long COVID or POTS? How to Tell Them Apart

Long COVID and POTS are not competing labels: one is a broad umbrella and the other a specific, measurable diagnosis that often sits inside it. Here is how to tell what you are actually dealing with.

Read article →
engin akyurt / Unsplash Food

Jun 23, 2026 · Austin Spaeth

SIBO, Histamine & Why Dysautonomia Wrecks Digestion

Dysautonomia doesn't stop at your heart rate, it slows your gut, invites bacterial overgrowth, and can stir up histamine problems. Here is how POTS, SIBO and MCAS feed each other, and the dietary tools that actually help.

Read article →
Jacopo Maiarelli / Unsplash Food

Jun 16, 2026 · Austin Spaeth

The Low-Histamine Diet for MCAS: A Practical Food List

A low-histamine diet can calm the flares of MCAS and histamine intolerance by lowering your total histamine load. Here is a practical eat-versus-avoid list, the freshness rule that matters most, and why this is a short-term tool, not a way of life.

Read article →
Luke Chesser / Unsplash The app

Jun 15, 2026 · Austin Spaeth

Autonomic vs. Fitness Trackers: Built for Recovery, Not Performance

Fitness trackers are built for healthy people chasing performance. When you are recovering from POTS or long COVID, that framing can quietly mislead you. Here is what a recovery-first tool does differently.

Read article →
Rajasekhar R / Unsplash POTS

Jun 11, 2026 · Austin Spaeth

POTS Treatment: Salt, Fluids, Compression & Medication Explained

POTS treatment usually starts with volume, compression and a careful exercise ramp, and adds medication when those aren't enough. Here's how each piece works and why it's almost always a combination.

Read article →
Anna Pelzer / Unsplash Food

Jun 9, 2026 · Austin Spaeth

The POTS Diet: What to Eat, and Why Small, Salty Meals Help

There is no single POTS diet, but a few patterns reliably help: smaller and more frequent meals, generous sodium and fluids, and steady blood sugar. Here is what to eat, what tends to backfire, and why.

Read article →
Jordan Bauer / Unsplash Recovery

Jun 6, 2026 · Austin Spaeth

Pacing 101: How to Find and Expand Your Energy Envelope

Pacing is the single most important recovery skill for POTS, long COVID and ME/CFS. Here is how to find the edge of your energy envelope, stop the boom-and-bust cycle, and expand your capacity without triggering a crash.

Read article →
Maria Petersson / Unsplash Research

May 28, 2026 · Austin Spaeth

Salt & Fluids for POTS: What's Proven and What Isn't

"Drink more, salt more" is the most repeated advice in POTS. Here is the physiology behind it, what the evidence actually supports, and where the guidance runs ahead of the data.

Read article →
What HRV Actually Is, And Why It Matters for POTS Recovery HRV

May 28, 2026 · Austin Spaeth

What HRV Actually Is, And Why It Matters for POTS Recovery

Heart rate variability is one of the clearest windows into your autonomic nervous system. Here is what it measures, why it drops in POTS and post-viral illness, and how to read it without obsessing.

Read article →
Briana Tozour / Unsplash POTS

May 23, 2026 · Austin Spaeth

Exercise for POTS: The Levine Protocol & How to Start Safely

Upright exercise often backfires early in POTS. The recumbent-first approach (the Levine and CHOP protocols) trains your heart lying down first, then works toward standing over months. Here is how to start without crashing.

Read article →
The Orthostatic Stand Test: How to Do It at Home (and What the Numbers Mean) POTS

May 21, 2026 · Austin Spaeth

The Orthostatic Stand Test: How to Do It at Home (and What the Numbers Mean)

The lying-to-standing heart rate test is the single most useful at-home measurement for POTS. Here is how to run it consistently and how to read the rise and recovery.

Read article →
Stacey Koenitz / Unsplash Long COVID

May 16, 2026 · Austin Spaeth

Long COVID Symptoms That Point to Dysautonomia

Racing heart on standing, dizziness, brain fog, exertion crashes and temperature swings after COVID often share one root: a dysregulated autonomic nervous system. Here is how to recognize the pattern and what to do next.

Read article →
Vitaly Gariev / Unsplash POTS

May 9, 2026 · Austin Spaeth

How POTS Is Diagnosed: The 30-BPM Rule, the Tilt Table & What to Expect

POTS is diagnosed by a sustained heart-rate rise on standing without a big blood-pressure drop, symptoms lasting months, and other causes ruled out. Here is what the criteria mean and what the tests feel like.

Read article →

Browse all 50 articles in POTS & Dysautonomia →

Track your recovery with Autonomic

A private, offline journal that scores your daily HRV, BP and orthostatic readings against medical thresholds. Free to download on iPhone and Android, with $7.99/mo Pro when you want the deep-analysis tools.

Download free