POTS – an abbreviation for Postural Tachycardia Syndrome – are conditions that affect the involuntary nervous system. It causes the heart rate to increase abnormally when standing up, and symptoms include dizziness, fainting spells, and shortness of breath, headaches and fatigue.

POTS are particularly common in older children and adolescents and can be caused by a number of contributing factors. Common triggers include excessive heat, dehydration and standing up too quickly. Often, the condition develops following illness, surgery or a traumatic experience.

The different types of POTS

In order to understand whether your child might be affected by POTS, it’s helpful to know the different types.

Adolescence POTS

POTS are most common in teenagers, and will usually develop between the ages of 12 and 16, often following a growth spurt. Depending on the severity, the condition can be debilitating to daily life, preventing the sufferer from taking part in their usual activities. The good news is, most people will no longer experience symptoms by their early 20s.

Hyperadrenergic POTS

This form of POTS is less common and presents itself differently to other types. Sufferers usually experience tremors, anxiety, migraines and cold and sweaty hands and feet when standing. Unlike in the more common forms of the condition, blood pressure can also increase when standing.

As the symptoms of this kind of POTS are usually similar to pheochromocytoma (a type of tumour), it’s important to make sure tests are done for an accurate diagnosis.

Norepinephrine Transporter (NET) Deficiency and Blockers

Like Hyperadrenergic POTS, this kind of POTS is much rarer, caused by excessive norepinephrine in the body. Some drugs, such as antidepressants, can worsen this kind of POTS by blocking Norepinephrine Transporter in the body, so it’s important to consult a doctor if the sufferer thinks medication could be worsening symptoms.


This is the medical term for becoming physically unfit, usually as a result of reduced activity or bed rest following illness. Reduced fitness can mean the heart does not pump as efficiently as it used to, causing or worsening symptoms of POTS. This often means that sufferers reduce their activity level further, worsening the condition.

POTS are often poorly diagnosed, in part down to its links and similarities to other conditions. It’s commonly associated with Chronic Fatigue Syndrome, Joint Hypermobility Syndrome, low blood pressure and various autoimmune conditions, and it can even be a consequence of chronic illnesses such as cancer and diabetes.

Although there is no cure for POTS, there are many steps patients can take to improve their symptoms, usually involving lifestyle management to reduce stress and fatigue. If you think your child could be experiencing symptoms of POTS, make sure to take them to a paediatrician with expertise of management of POTS, as soon as possible for an accurate diagnosis and to learn how best to manage the condition.