OpenHealth Q&A

Get answered by medical professionals

Could This Be POTS?

7/1/2025, 11:20:22 PMMale25-34

I'm a 47-year-old female with a history of Type 2 Diabetes, and my A1C has recently improved to 6.3. I've been grappling with depression, panic disorder, and insomnia. Although I previously dealt with high blood pressure, shedding some pounds has helped reduce it significantly. In March, I began experiencing episodes of lightheadedness, prompting a visit to the emergency room where I underwent several tests, including an EKG, blood tests, and a chest X-ray. Fortunately, nothing abnormal was found during those examinations. Following a brief period of relief, the symptoms have returned. Last week, I consulted my doctor again, who measured my blood pressure and found it to be fairly low: - Lying down: 142/86 - Sitting: 118/82 - Standing: 116/80 I also observed that my heart rate consistently exceeds 100 beats per minute. My physician suspects that I might have Postural Orthostatic Tachycardia Syndrome (POTS). Notably, I begin to feel lightheaded after walking just about ten steps. To further investigate, I checked my blood pressure while seated and just before experiencing lightheadedness: - Sitting: 106/80, heart rate 111 - After roughly ten steps: 96/82, heart rate 121 These readings and symptoms have led me to consider the possibility of POTS.

DiabetesCrohn's DiseaseThyroid Disorders

Answers (1)

Cony

7/1/2025, 11:20:41 PM

OpenHealth AI

It sounds like you are experiencing concerning symptoms that may suggest Postural Orthostatic Tachycardia Syndrome (POTS). Your lightheadedness after standing or walking short distances, along with a sustained elevated heart rate and lower blood pressure upon standing, align with POTS characteristics. Let's discuss these issues further and explore actionable steps.

Explanation

POTS is characterized by an excessive increase in heart rate when transitioning from lying down to standing, leading to symptoms like lightheadedness or fainting. Given your history of diabetes, it's important to manage symptoms and ensure you maintain stability in your overall health.

Next Steps

  1. Increase Fluid and Salt Intake: Aim to stay well-hydrated, which can help increase blood volume and improve symptoms. You might also consider increasing your salt intake (if no contraindications exist) to help retain fluid, but consult with a healthcare professional beforehand to ensure it's safe for your condition.

  2. Gradual Position Changes: Practice moving from lying down to standing slowly. When standing, try to flex your leg muscles to improve blood circulation and prevent pooling.

  3. Compression Garments: Wearing compression stockings can help reduce blood pooling in your legs when you stand, thereby alleviating some symptoms of lightheadedness.

  4. Physical Activity: Engage in gentle, regular exercise that focuses on building cardiovascular endurance and strength without making the symptoms worse. Consider exercises that can be done while seated or lying down and gradually increase intensity as tolerated.

  5. Monitor Symptoms: Keep a daily log of your heart rate, blood pressure, and any symptoms. This can help identify patterns and triggers that worsen your condition, which can be valuable for discussions with your healthcare provider.

  6. Regular Follow-ups: Since you are already in touch with your physician, make sure you continue these conversations and discuss any new symptoms or concerns. They might suggest further evaluations or adjustments to your current management plan.

Reassurance

It's understandable to feel anxious about these symptoms, especially when they affect your daily life. You're taking important steps by tracking your condition and seeking clarity on your health. If your symptoms increase in severity or new concerning signs arise, ensure you reach out promptly for further evaluation.

Related Questions

Seeking Guidance on Persistent Chest Discomfort After Extensive Testing

I'm a 43-year-old male, standing at 5'11" and weighing 180 pounds. My journey began around March to April of 2025 when, despite regularly hitting the gym four times a week, I was struck by severe chest pain along with frequent belching and a tight feeling in my diaphragm. At times, the pain became so intense that I feared it might be a heart attack. **Medical History:** In May 2019, I received a diagnosis of **PVS** and have since been under the care of a cardiac electrophysiologist. Upon experiencing these new symptoms, I consulted my EP, who conducted an EKG right then and set me up with a 7-day heart monitor. The results showed no irregularities. Subsequently, I was directed to a cardiologist, who carried out both a **stress test** and an **echocardiogram**, both of which yielded normal findings. Afterward, I returned to my primary care physician, who speculated that my gallbladder might be involved. An **ultrasound** was performed but revealed no issues. I then requested a **chest X-ray**, which also came back normal. My PCP then considered the possibility of a **hiatal hernia** and referred me to a gastroenterologist; unfortunately, that appointment took almost **five months** to materialize. In the meantime, my symptoms persisted, prompting me to cease weightlifting and switch my focus to **cardio and running**. Surprisingly, these activities didn’t exacerbate my symptoms, though the chest pain remained constant. When I finally saw the gastroenterologist, they suggested an **upper endoscopy**, which took another roughly three months to arrange. During this procedure, I was diagnosed with **Eosinophilic Esophagitis (EOE)**, a condition I had not previously experienced. The doctors also placed a pH monitoring device for acid reflux assessment, which indicated **no unusual acid exposure**. Following this, I began a treatment plan that included a swallowed steroid inhaler and an increased dosage of **omeprazole**. Sixty days later, I underwent another endoscopy, which showed that the EOE had largely resolved, with minimal residual symptoms. Unfortunately, my chest discomfort persisted without any improvement. It has now been about **a year** since these issues emerged, and I still have not found substantial relief. A recent chest MRI completed at a dedicated imaging center revealed no abnormalities. I entertained the idea of **costochondritis**, but again, the MRI did not support that hypothesis. The only minor relief I find comes from consciously pulling my shoulders back and expanding my chest. I continue to experience discomfort around my **diaphragm** and tenderness in the area of the **xiphoid process**. My PCP prescribed a steroid pack, which was somewhat beneficial for the pain but failed to alleviate the pressure or constant discomfort. At this juncture, I feel quite lost and uncertain about my next steps. I would greatly appreciate any insights or experiences from others who have faced similar issues. Additionally, if there are any physicians here willing to offer advice, I am open to traveling to find the answers or relief I'm desperately seeking.

FibromyalgiaThyroid DisordersInternal Medicine
Male25-34
11 minutes ago

Understanding Mild Uncomplicated Diverticular Disease

I am a 29-year-old female, standing at 5'7" and weighing 130 pounds. Recently, a CT scan revealed that I have mild diverticulitis. About a week ago, I experienced significant discomfort, particularly in the pelvic region, along with pain in my right leg and hip, and some mild discomfort on the left side. After undergoing a CT scan, which confirmed the presence of mild diverticular disease, I was surprised that no one from my medical team provided any follow-up or acknowledged the condition. My blood tests returned normal results, and I was discharged without further information. While the pain subsided after about three days, it has unfortunately reappeared four days later. Is this something I should be worried about? What does this mean for me? I had a colonoscopy around 11 months ago, which indicated no issues.

Crohn's DiseaseCOPDInternal Medicine
Male25-34
21 minutes ago

Understanding the Reality of End-Stage Pancreatic Cancer

Navigating the complexities of end-stage pancreatic cancer can be overwhelming, and I'm seeking clarity on what lies ahead. My mother, who is 59 years old and weighs about 115 pounds, received her diagnosis of terminal pancreatic cancer in October 2025. Unfortunately, she has largely rejected the option of chemotherapy and is consuming her pain relief medications—specifically oxycodone and morphine—at an alarming rate. While I’m not worried about the dosage, the severity of her pain has reached a level that is becoming unbearable. Despite this, she is adamant about avoiding any hospital treatment, even though that's where she would receive the most effective pain management. I’ve attempted multiple times to get her medical attention, calling both hospitals and emergency services. However, due to her refusal for assistance, they have also turned us down. It was explained to me that taking her against her will could be considered kidnapping. After consulting with various healthcare professionals, I have been informed that her time may be measured in days or weeks. There’s also a chance that she could slip into unconsciousness, leaving me deeply unsettled. I am already in a state of mourning, yet I am desperate to understand what to expect in the coming days. It is crucial for me to prepare myself—emotionally and mentally—so that I can help ensure her comfort in these final moments. Plans are underway to engage hospice care, but the uncertainty fills me with apprehension. This is my mother, and I want to alleviate my fear so I can provide her with the support she needs as she nears the end of her journey. I yearn to be present for her without being entirely consumed by grief before she passes away. Any guidance or insight you could provide would be invaluable. I'm at a loss for what steps to take next and truly desire to navigate this situation with as much grace and readiness as possible.

FibromyalgiaCrohn's DiseaseEndocrinology
Male25-34
41 minutes ago

Prolonged Miscarriage: Over Four Weeks In

A 35-year-old woman managing Type 1 diabetes with an insulin pump has been experiencing a challenging period marked by a recent miscarriage. This occurred just shy of ten weeks into the pregnancy, following an extremely positive pregnancy test, although medical confirmation had not yet been obtained. The physical symptoms were quite severe, with substantial bleeding that included large tissue clumps and blood clots observed during a shower. The size of these clots was rather alarming, comparable to a fist, causing blockage in the drain. Initially, for the first three to four days, there was heavy bleeding, requiring three pads daily. After that, the situation gradually improved, and around a week ago, she reached a point where only a pantyliner might suffice. Despite the reduction, bleeding persisted intermittently, mainly noticeable upon wiping, with instances of no blood at all, leading to inconsistencies in her experience. Recently, she has been feeling bloated and has noticed a resurgence in bleeding, necessitating the use of pads twice daily. Additionally, she has been experiencing light cramps and has developed acne. A subsequent pregnancy test revealed continued positive results. Now, with over four weeks of bleeding, she reached out to her physician’s office. However, the response was not one of concern, suggesting that she could schedule a visit at her convenience if she felt the need. The cost of visiting a doctor or urgent care deters her from seeking immediate professional help unless absolutely warranted. Overall, she reports feeling generally well, but is seeking advice from others. Is there cause for alarm, or is it feasible to let things unfold naturally? Could this miscarriage have evolved into her menstrual cycle instead? Additionally, it's worth noting that she occasionally finds small blood clots on the toilet paper after wiping. Since the onset of this situation, she has abstained from sexual intercourse.

DiabetesEndocrinologyRheumatology
Male25-34
1 hour ago

Exploring Inositol and CoQ10 for Managing PCOS Symptoms

As a 28-year-old female, I have faced the challenges of polycystic ovary syndrome (PCOS) since my teenage years. Starting from the age of 16, I have dealt with highly irregular menstrual cycles, occurring anywhere from three to eight months apart. My diagnosis has been substantiated through two ultrasounds and blood tests revealing elevated androgen levels. Despite maintaining a healthy diet and leading an active lifestyle—balancing my work as an environmental biologist with gym sessions alongside my husband—I continue to wrestle with weight management. Other symptoms impacting my daily life include significant hair loss, unwanted facial hair, and persistent fatigue. In my journey to manage PCOS, I previously sought counsel from a gynaecologist, who primarily suggested hormonal birth control as the main approach to alleviate my symptoms. Although I adhered to this recommendation for several years, the hormonal changes negatively impacted my mood, leading me to discontinue its use. Another alternative proposed by my gynaecologist involved androgen blockers, but these are not suitable for me since my husband and I plan to start a family in the next two to three years. Recently, my research led me to discover that supplements like Inositol and CoQ10 might effectively combat insulin resistance and lower androgen levels. They are purported to improve various symptoms associated with PCOS, including the regulation of ovulation, all while boasting minimal adverse effects. I am curious about the viability of these supplements as alternatives to hormonal birth control or androgen blockers in managing my PCOS symptoms.

Crohn's DiseaseThyroid DisordersRheumatology
Male25-34
1 hour ago