Does POTS Go Away? What Recovery Can Look Like, Plus 6 Myths That Keep People Stuck
Written and reviewed by Dr. Sam McDonald, DC · Colorado License CHR.0007574 · NPI 1770001588 · Omega Functional Health
“Does POTS go away?” It is one of the first questions people ask after a diagnosis, and one of the hardest to get a straight answer to.
Some people are told they will grow out of it. Others are told it is lifelong and the best they can do is manage it. Neither answer tells the whole story.
Here is an honest look at what recovery from POTS can realistically look like, along with six common myths that can keep people stuck.
The short answer
POTS can improve, sometimes a great deal. Many people reach a point where symptoms are mild or rarely show up, which is often called remission. What we cannot honestly promise is that POTS disappears completely for everyone and never returns.
A useful way to think about it: we all have areas where we are more susceptible. For some people, the nervous system’s response to standing, heat, illness, or stress is one of those areas. Symptoms can quiet down substantially, but that susceptibility may still be worth respecting for life, especially during big stressors like a viral illness, surgery, or loss of a loved one.
What the research says about recovery
Long-term studies of POTS are still limited, but they show a mixed and generally hopeful picture. In a one-year follow-up study of POTS patients at Mayo Clinic, many reported improvement, while others continued to have significant symptoms. Expert consensus statements describe POTS as a condition that often improves with treatment, especially when it starts after a clear trigger like a viral illness, but that can also persist or come and go.
Factors that may affect the outlook include what triggered it, how long symptoms have been present, whether other conditions like hypermobile Ehlers-Danlos syndrome are involved, and whether the underlying drivers are addressed.
What remission can look like day to day
Remission rarely arrives all at once. More often, people notice a series of small wins that add up:
- Standing in line or cooking dinner without needing to sit down
- Taking a normal shower without feeling wiped out afterward
- Fewer bad days, and shorter ones when they do happen
- Thinking more clearly through the afternoon
- Getting back to exercise, work, or school with fewer limits
Some people describe remission as forgetting they have POTS for weeks at a time. Others describe it as having a reliable baseline again, where they know what their body can handle and can plan around it with confidence.
What can bring symptoms back
Even in remission, certain stressors can stir symptoms up again. Common ones include viral illnesses, poor sleep, dehydration, long periods of inactivity, surgery, hormonal shifts, and significant emotional stress. Heat is a big one, too.
For those of us in Colorado, altitude and dry air are worth keeping in mind. They can make it easier to get dehydrated, and some people notice symptoms more on a trip to the mountains. That does not mean avoiding them. It means planning ahead with extra fluids, salt as recommended by your doctor, and a slower pace on the first day.
A flare after a stressor does not mean you are back to square one. In our experience, people who have done the work to stabilize their nervous system tend to recover from setbacks faster.
How long does improvement take?
There is no single timeline. With standard care, some people notice changes within weeks of starting fluids, salt, compression, and exercise, while others need months to build tolerance.
In our office, the pace depends on what your testing shows and how your body responds to care. Because we re-measure along the way, you are not left guessing whether things are changing. You can see it in your numbers, and most people start to feel it too.
6 myths that keep people stuck
Myth 1: “Your tests are normal, so it is probably anxiety.”
This is the one we hear most. In a survey of nearly 5,000 people with POTS, the median time to diagnosis was two years, and many were told along the way that their symptoms were psychological.
Anxiety and POTS can overlap, and a racing heart can feel like panic. But normal bloodwork and imaging do not rule out a nervous system problem. Those tests look for disease and damage, not for how well the brain is processing balance and posture information.
Myth 2: “There is no way to test what is going on in your nervous system.”
The tilt-table test confirms POTS, but it does not explain why your nervous system is overreacting. Other tools can measure parts of that. Eye movement testing with video goggles, balance platform testing, and posture measurements can show how your brain is handling gravity and body position. In our experience, those results are often clearly abnormal in people who have been told everything looks fine.
Myth 3: “Salt and water are all there is.”
Fluids and salt help many people, and they are an important part of care. But they mostly support blood volume. They do not address how the brain decides when to tighten blood vessels or speed up the heart. Research shows the inner ear’s gravity sensors play a role in that decision. In our clinical model, a mismatch between the left and right balance sensors may be part of why the system overreacts. You can read more in our article on dysautonomia treatment and the balance system.
Myth 4: “You will just grow out of it.”
Some teens and young adults do see POTS ease over time. But waiting is not a plan, and not everyone outgrows it. Many adults have had symptoms for years. Improvement is more likely when the drivers are identified and worked on.
Myth 5: “Exercise will make it worse.”
Pushing too hard, too fast can absolutely trigger a flare. But carefully graded exercise, often starting seated or lying down, is one of the most consistently recommended parts of POTS care. The key is pacing. In our office, we test each brain exercise in person first and only send home what we have seen improves your results.
Myth 6: “If you need medication, you will need it forever.”
Not necessarily. Many of our patients stay on their medication while they work with us, and some are eventually able to reduce or stop it. That is not guaranteed, and any change should always be made with the doctor who prescribed it. Medication can be a useful support while the underlying patterns are being addressed.
How we look at what is driving your POTS
We do not diagnose POTS, but we work alongside your cardiologist or other medical doctor. Our role is measuring how your brain is processing balance and posture, then working on what we find with vestibular therapy and upper cervical chiropractic care. We may test you seated or lying down, depending on when your symptoms are strongest.
That testing gives us a baseline. As care goes on, we re-test, so you can see what is changing instead of wondering.
Does this replace traditional POTS care?
No. Diagnosis, medication, and medical monitoring belong with your medical team. Our work is meant to add to that care, not replace it.
When to see a doctor first
- Fainting that causes an injury
- Fainting during exercise
- Chest pain or pressure
- A racing heart that does not settle when you lie down
- POTS-like symptoms with no diagnosis yet
What this does and does not claim
We are not claiming POTS can be cured, or that our care works for everyone. We are saying that POTS often improves, that remission is a realistic goal for many people, and that the brain’s processing of balance and posture may be one piece worth measuring. Parts of our approach are based on what we see clinically and are ahead of the published research, and we try to be clear about which is which.
Where to go from here
If you are trying to figure out who to see next, our guide to choosing a POTS specialist near you covers the questions worth asking any provider.
You can also learn more about POTS and dysautonomia care in Denver at Omega Functional Health. We see patients from Wheat Ridge, Denver, Arvada, Lakewood, Golden, Littleton, and surrounding Colorado communities.
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References
- Kimpinski K, Figueroa JJ, Singer W, et al. A prospective, 1-year follow-up study of postural tachycardia syndrome. Mayo Clinic Proceedings. 2012;87(8):746-752.
- Sheldon RS, Grubb BP, Olshansky B, et al. 2015 Heart Rhythm Society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12(6):e41-e63.
- Shaw BH, Stiles LE, Bourne K, et al. The face of postural tachycardia syndrome: insights from a large cross-sectional online community-based survey. Journal of Internal Medicine. 2019;286(4):438-448.
- Fu Q, VanGundy TB, Galbreath MM, et al. Cardiac origins of the postural orthostatic tachycardia syndrome. Journal of the American College of Cardiology. 2010;55(25):2858-2868.
- Yates BJ, Bolton PS, Macefield VG. Vestibulo-sympathetic responses. Comprehensive Physiology. 2014;4(2):851-887.
- Miller AJ, Stiles LE, Sheehan T, et al. Prevalence of hypermobile Ehlers-Danlos syndrome in postural orthostatic tachycardia syndrome. Autonomic Neuroscience. 2020;224:102637.
