PoTS in ADHD and Autism

Postural orthostatic tachycardia syndrome and neurodivergence

What is P.o.T.S ?

PoTS stands for postural orthostatic tachycardia syndrome. Orthostatic refers to standing up and tachycardia means a fast heart-rate.

The most common symptoms are dizziness or feeling faint upon standing from a sitting or lying position, however it is much more complex than that.

There are multiple types and health impacts of PoTS, but the exact cause is unknown.

PoTS can impact blood flow to vital organs, such as the lungs, heart, and brain. It can also affect temperature regulation, digestion, and blood pressure.

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Symptoms

There is a long list of possible symptoms, and their severity can vary significantly:

• Lightheadedness

• Faintness

• Syncope (fainting)

• Short term memory loss

• Mental clouding (brain fog)

• Difficulty finding words

• Difficulty with depth perception

• Sensory integration issues

• Migraine headaches

• Fatigue

• Paresthesia (tingling, prickly, pins and needles sensation)

• Exercise intolerance

• Heat intolerance

• Temperature dysregulation

• Abnormal tears

• Abdominal pain

• Nausea

• Constipation

• Diarrhea

• Reflux (severe heartburn)

• Flushing

• Circulation issues

• Palpitations

• Difficulty breathing

• Vomiting

• Muscle weakness

• Anxiety or depression

• Tinnitus (ringing in the ears)

• Weight gain

• Panic attacks

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Co-occurring disorders

PoTS is considerably more common in the ADHD and Autistic population compared to the neurotypical population.

PoTS is significantly more prevalent in people with hypermobility disorders (i.e. hEDS), and ADHDers and Autistics are also substantially more likely to have hypermobility disorders.

ADHDers and Autistics are more like to experience the following:

• Autonomic disorders (i.e. syncope, fainting, PoTS, etc.)

• Joint pain

• Hypermobility and hypermobility spectrum disorders (HSD)

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How is PoTS diagnosed?

PoTS diagnosis can be complicated because the symptoms can affect a wide range of organ systems. The most common diagnostic test is the tilt table test.

During the tilt table test, the patient is secured on a table while lying flat. Then the table is raised to an almost upright position. The patient’s heart rate, blood pressure and often blood oxygen and exhaled carbon dioxide levels are measured during this test.

A patient might have PoTS if they meet all three of these criteria:

• Their body produces an abnormal heart rate response to being upright

• Their symptoms worsen when upright

• They don’t develop orthostatic hypotension in the first three minutes of testing