POTS Symptom Tracking: How to Log Heart Rate, Dizziness and Flares

Published 16 April 2026

The diagnostic challenge: POTS (Postural Orthostatic Tachycardia Syndrome) is defined by a heart rate increase of 30+ bpm within 10 minutes of standing. But getting a tilt table test can take months. In the meantime, daily symptom and heart rate tracking gives you — and your cardiologist — hard evidence of what's happening.

POTS is a form of dysautonomia — a malfunction of the autonomic nervous system that controls heart rate, blood pressure, digestion, and temperature. It's chronically underdiagnosed, often dismissed as anxiety or deconditioning. The single best thing you can do before your specialist appointment is arrive with data.

What to track daily

Heart rate: lying, sitting, standing. Take your resting heart rate lying down for 5 minutes, then stand and record at 1, 5, and 10 minutes. A sustained increase of 30+ bpm (or over 120 bpm on standing) is the diagnostic criterion. Many patients find their HR jumps 40–60 bpm. Doing this at home daily and recording it gives your cardiologist a dataset that's more useful than a single in-clinic reading.
Dizziness and presyncope. Rate severity daily. Note what triggered it — standing up, showering, heat, eating, exercise. The triggers matter for management.
Fatigue. POTS fatigue is distinct from normal tiredness — it's often described as "bone-deep" and disproportionate to activity. Rate it daily and note whether rest helps (it usually doesn't with POTS fatigue).
Exercise tolerance. What you did, how long, and how you felt during and 24 hours after. POTS patients often crash the day after exercise, not during it. Tracking this helps you find your safe exercise threshold.
Fluid and salt intake. POTS management relies heavily on increasing blood volume through fluids (2–3 litres/day) and salt (3–10g/day depending on severity). Track whether you hit your targets — the correlation with better days is often dramatic.
Sleep. Quality, hours, position (some POTS patients sleep better with the head of the bed elevated). Poor sleep worsens POTS symptoms the next day — tracking it proves the link.
Temperature and weather. Heat is a major POTS trigger. Hot showers, warm weather, and overheated rooms can all cause symptom spikes. Log ambient temperature on bad days and the pattern often becomes clear.
Digestive symptoms. Nausea, early fullness, bloating, gastroparesis symptoms. The autonomic nervous system controls digestion — POTS patients frequently have gut involvement that goes unreported.

The poor-man's tilt table test

You don't need a hospital tilt table to demonstrate orthostatic intolerance. The NASA Lean Test or Active Standing Test — lying flat for 5 minutes, then standing still against a wall for 10 minutes while recording heart rate every minute — produces clinically valid data. Done daily for 2 weeks and graphed, it's powerful evidence.

Log each reading in your tracker. Most cardiologists will accept home standing-test data if it's consistent across multiple days, especially when paired with symptom logs.

Tracking treatment response

POTS treatment is highly individual — what works varies enormously between patients. Common interventions include compression garments, increased salt/fluid, beta-blockers (propranolol, ivabradine), midodrine, fludrocortisone, and graded exercise. Each takes 2–4 weeks to evaluate.

Without tracking, you're guessing. With tracking, you can see that compression stockings reduced your standing HR by 8 bpm on average, or that propranolol helped heart rate but worsened fatigue. That data drives better prescribing decisions.

Try Lunaire: POTS Tracker

Log heart rate, dizziness, fatigue, fluid intake and symptoms daily. Visual charts for standing tests and trend analysis. No account, no cloud.

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POTS and co-occurring conditions

POTS rarely exists alone. Common overlaps include EDS (Ehlers-Danlos Syndrome), MCAS (Mast Cell Activation Syndrome), ME/CFS, and autoimmune conditions. If you're tracking POTS symptoms and notice joint hypermobility, allergic-type reactions, or post-exertional malaise, mention these to your specialist — they may point to an underlying cause.