Do you feel exhausted after standing for just a few minutes? Does standing in line, cooking, or even showering leave you wiped out? This type of position-dependent fatigue — called orthostatic fatigue — is one of the most debilitating symptoms of POTS.
Why Does Standing Make You So Tired?
In people with POTS, standing requires significantly more effort from the cardiovascular system. When your heart is working overtime just to keep blood flowing to your brain while upright, it's exhausting — even if you're not doing anything "active."
This happens because:
- Your heart rate increases dramatically (30+ bpm) when standing
- Blood may pool in your legs rather than circulating efficiently
- Your brain and muscles may not get optimal blood flow
- Your body is in a constant state of compensation
What Orthostatic Fatigue Feels Like
People with POTS-related fatigue often describe:
- Overwhelming tiredness that comes on when standing
- Feeling "wiped out" after activities involving upright posture
- Needing to sit or lie down to feel better
- Fatigue that doesn't improve with sleep
- Worse symptoms later in the day
- "Crashing" after seemingly simple activities
The Key Indicator
What distinguishes POTS fatigue from general tiredness is that it's position-dependent. You feel notably worse when upright and better when lying down. If your fatigue doesn't change with position, other causes may be involved.
Other Causes of Fatigue
Fatigue has many possible causes. It's important to consider:
- Sleep disorders
- Thyroid problems
- Anemia
- Depression
- Chronic fatigue syndrome (ME/CFS)
- Medication side effects
- Other medical conditions
A healthcare provider can help determine what's causing your fatigue and whether POTS might be a factor.
The Connection to Heart Rate
Fatigue in POTS is closely linked to the abnormal heart rate response. When your heart is beating 30-50 bpm faster than normal just to stand, it's like your body is constantly exercising — no wonder you're tired!
This is why measuring your heart rate response can provide valuable insight. POTS Check shows you exactly how much extra work your heart is doing when you stand up.
Managing Orthostatic Fatigue
If you have POTS-related fatigue, these strategies may help:
- Compression garments: Help prevent blood pooling in legs
- Increased fluids and salt: Help maintain blood volume
- Activity pacing: Alternate sitting and standing tasks
- Recumbent exercise: Exercise while lying down (swimming, recumbent bike)
- Smaller, frequent meals: Large meals can worsen symptoms
- Avoid triggers: Heat, alcohol, prolonged standing
Gathering Data for Your Doctor
When you tell your doctor "I'm tired when I stand," it can be hard to convey how serious the problem is. POTS Check provides objective data showing:
- Your heart rate while lying down vs. standing
- The exact increase in beats per minute
- Whether your response meets POTS criteria
Medical Disclaimer
Persistent fatigue should be evaluated by a healthcare provider. Many conditions can cause fatigue, and proper diagnosis is important for effective treatment. POTS Check is a wellness screening tool, not a diagnostic device.