Myth 1: “It’s just anxiety”
Reality: POTS is a legitimate physiologic disorder with measurable autonomic abnormalities.
Although anxiety can coexist with POTS, physiological testing consistently shows autonomic dysfunction distinct from psychological causes. (NPJ Primary Care Respiratory Medicine) Mislabeling it as anxiety can delay accurate diagnosis and effective treatment. One survey found that over 80 % of patients were initially misdiagnosed with psychiatric conditions.
Myth 2: “POTS is not serious”
Reality: While not usually life-threatening, POTS can be profoundly disabling.
Up to half of patients report being unable to work or attend school due to symptoms. (POTS UK) The fluctuating nature of POTS can severely limit activity, cause chronic fatigue, and reduce quality of life. Although the condition rarely shortens lifespan, its day-to-day impact can be substantial.
Myth 3: “You must faint to have POTS”
Reality: Fainting is not required for diagnosis.
POTS is defined by an excessive heart-rate increase upon standing without a major drop in blood pressure. (Johns Hopkins Medicine) While some patients do experience syncope, many only feel dizzy or weak without actually fainting. Requiring syncope for diagnosis excludes a majority of true cases.
Myth 4: “Low blood pressure causes POTS”
Reality: POTS is characterized by tachycardia, not necessarily hypotension.
A defining criterion of POTS is that blood pressure remains relatively stable on standing. A substantial drop indicates orthostatic hypotension—a separate condition. (Awareness for POTSies) Misinterpreting this distinction leads to unnecessary confusion between different autonomic disorders.
Myth 5: “Just drink more water and you’ll be fine”
Reality: Hydration helps, but sodium intake, compression garments, and gradual conditioning are also critical.
Increasing fluid intake without increasing sodium often fails to correct low blood volume. Sodium helps retain fluids in the bloodstream, improving blood pressure stability. (Normalyte) However, individual plans must account for blood-pressure and kidney health.
Myth 6: “Exercise cures POTS”
Reality: Exercise helps manage symptoms but is not a cure.
Structured, gradual reconditioning programs—starting with recumbent exercise like rowing or cycling—can improve cardiovascular tone and reduce symptoms over time. Yet, POTS is multifactorial, and exercise alone rarely resolves it completely. (JustAddBuoy POTS Resources) Medical oversight is essential to avoid overexertion.
Myth 7: “POTS only affects teenage girls”
Reality: POTS can affect all ages, genders, and backgrounds.
Although it is most common in women aged 15–50, men and older adults are also affected. (NHLBI) Dismissing adult or male patients based on demographics leads to missed diagnoses and inadequate care.
Myth 8: “You’ll never get better”
Reality: Many patients improve significantly with proper treatment.
Studies suggest that 50–60 % of people with POTS experience meaningful symptom improvement within several years when managed appropriately. (Wikipedia summary of clinical data) A combination of hydration, medication, graded exercise, and lifestyle adaptation can restore functionality and quality of life for many.
Why Myth-Debunking Matters
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Delays in diagnosis: Patients often see multiple clinicians before recognition of POTS.
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Inadequate treatment: Misconceptions lead to oversimplified or incorrect management.
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Stigma reduction: Recognizing POTS as a legitimate physiological disorder validates patient experiences and encourages research funding.
Postural Orthostatic Tachycardia Syndrome is more than an “invisible illness.” Misconceptions—from dismissing it as anxiety to assuming it’s untreatable—have long undermined care. By grounding our understanding in evidence, clinicians and patients alike can move toward earlier diagnoses, better management, and improved quality of life.
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