Sudden dizziness when getting up? POTS Symptoms, Low Blood Pressure and Dizziness When Standing Explained

Suddenly dizziness when getting up can seem alarming, especially when it comes out of nowhere or keeps coming back. Many people wonder if this could be a sign of postural orthostatic tachycardia syndrome (POTS) or just low blood pressure.

What is POTS?

Postural orthostatic tachycardia syndrome (POTS) is an autonomic nervous system disorder that affects how the body regulates heart rate and blood flow when a person goes from lying or sitting to standing. It is characterized by an abnormally large increase in heart rate when standing, often accompanied by symptoms such as dizziness, lightheadedness and fatigue.

In POTS, blood can pool in the lower body when someone stands up, forcing the heart to beat faster in an attempt to maintain blood flow to the brain. This can cause a person to feel weak, unsteady, or as if their vision is diminishing, especially after standing for several minutes. POTS is more common in younger people and those who were assigned female at birth, but it can affect anyone.

How POTS Affects the Body

When a healthy person stands up, the body quickly constricts blood vessels and slightly increases heart rate to maintain upward blood flow against gravity, the study found. American Heart Association. In POTS, this adjustment is impaired, so that heart rate increases much more than normal while blood pressure often stays the same or fluctuates instead of dropping significantly. This abnormal response can make standing or even sitting upright seem exhausting or uncomfortable.

Because the autonomic nervous system is involved in many bodily functions, POTS can cause a wide range of symptoms beyond dizziness when standing. People may experience brain fog, nausea, tremors, palpitations, and exercise intolerance, making daily activities, school, or work more difficult to manage over time.

Common POTS Symptoms to Watch For

Typical Symptoms of POTS often cluster together rather than appearing in isolation. Common features include:

• Dizziness or dizziness after standing for a few minutes
• Noticeable heartbeat or palpitations when standing
• Generalized fatigue or feeling “burned out” after relatively minimal activities

Additionally, many people with POTS report symptoms such as brain fog, difficulty concentrating, headaches, nausea, shortness of breath, chest discomfort, tremors, or a feeling of internal “adrenaline.” Some notice that symptoms worsen with heat, prolonged standing, menstruation, or after viral illnesses, and improve when lying down.

How long does dizziness last with POTS?

With POTS, dizziness while standing often begins shortly after standing up and can persist as long as a person remains in that position, especially if they are standing still. Symptoms frequently improve when the person sits or lies down, because the effect of gravity on blood pooling is reduced.

Because symptoms can fluctuate from day to day, many people benefit from keeping a brief symptom diary. Noting when the dizziness occurs, how long it lasts, what position they were in, and whether they experienced other POTS symptoms can help clinicians see trends over time.

Low blood pressure and dizziness

Orthostatic, or postural, hypotension specifically refers to a significant drop in blood pressure when a person stands up. This drop in pressure can reduce blood flow to the brain, causing dizziness, blurred or tunnel vision, weakness, or fainting. The elderly, people taking blood pressure medications or diuretics, and those who are dehydrated are particularly vulnerable.

When low blood pressure is the primary problem, the heart rate may increase somewhat to compensate, but not to the same degree as typically seen in POTS. Measuring blood pressure and heart rate while lying down and again after standing can help distinguish these patterns, although formal testing should be guided by a healthcare professional, according to Mayo Clinic.

Can POTS cause low blood pressure?

POTS is primarily defined by changes in heart rate rather than a specific blood pressure pattern, but some people experience low or fluctuating blood pressure along with their POTS symptoms. In these cases, tachycardia and low blood pressure can contribute to dizziness when standing, making symptoms more intense.

Others may have normal or even slightly elevated blood pressure and still meet the criteria for POTS. This is why focusing solely on the term “low blood pressure” can sometimes be misleading and why a professional evaluation is essential when symptoms are frequent, severe, or worsening.

Why do people feel dizzy when standing?

Physiologically, standing draws blood to the legs and lower body. The body must quickly constrict blood vessels and adjust heart rate to maintain sufficient blood flow to the brain and vital organs. If this response is delayed, insufficient, or exaggerated in the wrong way, dizziness or dizziness can occur.

Simple triggers like getting up suddenly after sitting for a long time, taking a hot shower, or not drinking enough fluids can cause brief dizziness in otherwise healthy people. When dizziness is persistent or accompanied by other POTS symptoms, low blood pressurechest pain or fainting, this becomes more concerning and warrants evaluation.

Diagnosis and medical evaluation

When dizziness while standing is frequent or disabling, medical evaluation is important. Clinicians typically begin with a detailed history of symptoms, a physical exam, and measurements of heart rate and blood pressure while lying, sitting, and standing. If POTS is suspected, some people have a standing test or tilt table test to document changes in heart rate and blood pressure over time.

Additional blood tests, heart rate monitoring, or imaging may be ordered to rule out other causes such as anemia, thyroid disorders, structural heart disease, or neurological disorders. A diagnosis of POTS is made when characteristic changes in heart rate and symptoms are present, other major causes have been ruled out, and symptoms have persisted for a significant period of time (often several months).

Living with chronic orthostatic symptoms

For those who ultimately receive a diagnosis of POTS or chronic orthostatic hypotension, the impact on daily life can be significant. Daily routines, work schedules, and exercise programs often need to be adjusted to account for varying energy levels and symptom flare-ups. Scheduling breaks, using stools or chairs when tasks require prolonged standing, and pacing activities are common strategies.

Emotional and mental support is also important. Because POTS symptoms and dizziness while standing are often invisible to others, people may feel misunderstood or rejected. Education, support groups, and a validating medical team can make a substantial difference in long-term adjustment and quality of life.

Frequently Asked Questions

1. Can someone have POTS without feeling dizzy?

Yes. Although dizziness while standing is common in POTS, some people primarily notice extreme fatigue, brain fog, or a racing heart rather than obvious dizziness. They might not connect these symptoms to changes in posture until a clinician measures heart rate and blood pressure in different positions.

2. Does drinking more water always help with dizziness while standing?

Increased fluid intake can reduce dizziness in many people with orthostatic problems, but it is not a panacea and may not be suitable for everyone. People suffering from heart problems, kidney problems or certain endocrine diseases need personalized advice, so any major changes in their fluid or salt intake should be discussed with a healthcare professional.

3. Can POTS or orthostatic dizziness appear suddenly after an illness?

Yes. Some people report that POTS-like symptoms begin or worsen after viral infections, surgery, or periods of prolonged bed rest. In these cases, the autonomic nervous system may have been disrupted or deconditioned, and symptoms may progress over weeks or even months, rather than appearing all at once.

4. Is it safe to exercise if dizziness occurs while standing?

Many people with POTS or orthostatic dizziness can exercise safely, but the type and intensity often need to be modified. Clinicians generally recommend starting with supine or semi-recumbent activities and then progressing gradually under medical supervision, rather than abruptly engaging in upright, high-intensity workouts that could worsen symptoms.