POTSTests to Ask For When You Suspect POTS
The workup a clinician typically orders to confirm a postural heart rate rise and rule out look-alikes: stand test, ECG, labs, rhythm monitor and when tilt or autonomic testing fits.
This list comes from published reviews (CMAJ 2022, JAMA 2026). Your doctor decides which tests fit you. Use it to start the conversation.
CONFIRM THE PATTERN
RULE OUT LOOK-ALIKES
ONLY IF SPECIALTY TESTING HELPS
10-minute active stand. Heart rate and blood pressure at set minutes, lying then standing.
Confirm the pattern
Ask for orthostatic vitals or a 10-minute active stand, with heart rate and blood pressure at set minutes, and ask for the readings in writing. A head-up tilt table helps when the stand is unclear or fainting is the main problem.
Rule out look-alikes
The CMAJ 2022 review lists a core set: complete blood count, electrolytes and kidney function, ferritin, TSH, morning cortisol when adrenal insufficiency seems possible, and a 12-lead ECG.
Depending on your story
YOUR STORY
TEST TO ASK ABOUT
- Ambulatory rhythm monitor (patch or Holter)
- Echocardiogram
- Plasma metanephrines
- Medication review
The 2026 JAMA review adds tests when the history points that way. Pheochromocytoma, one reason for plasma metanephrines, is rare but treatable.
Specialty autonomic testing
Autonomic reflex screens measure sweat output and responses to breathing and the Valsalva maneuver. In the Mayo series of 152 patients, abnormal sweat testing supported a neuropathic subtype. Diagnosis does not require these tests. They help when the picture is complicated or treatment is not working.
Bring your own data
Take a few stand tests at home on different mornings. Check your numbers first and print the visit checklist.
This page informs and does not diagnose. Only a clinician who can examine you and see your whole history can interpret your numbers.
- What Is POTS? A Plain-Language Explanation
- How to Test for POTS at Home: The 10-Minute Stand Test
- POTS Symptoms: The Common Ones and What They Mean
- How POTS Is Diagnosed: Criteria, Stand Test and Tilt Table
- NASA Lean Test for POTS: How to Do It at Home
- Do I Have POTS? What to Check Before You See a Doctor
- Why Does My Heart Race When I Stand Up?
- POTS Heart Rate: How to Graph It with Apple Watch
- Orthostatic Intolerance: Types and How POTS Fits In
- Why Blood Pressure Matters in a POTS Stand Test
- What Is Dysautonomia, and How Does It Relate to POTS?
- What Causes POTS? Subtypes, Triggers and What the Evidence Shows
- POTS and Long COVID: What the Research Shows
- POTS in Teens, Young Adults and During Pregnancy
- POTS Treatment Overview: What Guidelines Recommend First
- Fluids and Salt for POTS: What the Trials Show
- Compression and Exercise for POTS: Two First-Line Treatments
- POTS Medications: What Each One Does and What the Trials Show
- Living With POTS: Triggers, Pacing, Heat, Meals and Sleep
Want a record to bring to your visit? The POTS app guides the stand test at home and graphs your heart rate. See the app