How to Check for POTS at Home: A Step-by-Step Guide Using the Poor Man’s Tilt Table Test

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that affects the autonomic nervous system, causing a rapid heart rate increase when standing up, along with symptoms like dizziness, fatigue, and brain fog. While a formal diagnosis requires a doctor and specialised equipment, you can get a preliminary idea of whether you might have POTS using a simple at-home method called the Poor Man’s Tilt Table Test. This test mimics the basic principles of a clinical tilt table test by measuring your heart rate response to standing. Here’s an easy, step-by-step guide to try it at home.

What You’ll Need

• A heart rate monitor (like a fitness tracker, smartwatch, or pulse oximeter)

• A clock or stopwatch (your phone works fine).

• A flat surface to lie on (like a bed or the floor).

• A wall or sturdy surface to lean against or stand near for safety.

• A notebook or phone to record your results.

  
  

Step-by-Step Instructions

Follow these steps carefully to perform the Poor Man’s Tilt Table Test at home:

• Step 1: Rest and Prepare

  Lie down flat on your back on a bed, couch, or the floor. Stay relaxed and still for at least 5-10 minutes. This resting period helps your body settle into a baseline state. Avoid distractions, and don’t eat, drink, or exercise right before starting.

• Step 2: Measure Your Resting Heart Rate

  After resting, check your heart rate while still lying down. If you’re using a heart rate monitor, note the number it shows. If you’re checking manually, place two fingers (not your thumb) on your wrist (radial pulse) or neck (carotid pulse), count the beats for 30 seconds, and multiply by 2 to get beats per minute (BPM). Write down this number as your “resting heart rate.”

• Step 3: Stand Up Slowly

  Carefully stand up and position yourself upright. Stand still with your back against a wall or near something sturdy for support if you feel unsteady. Don’t move around or shift your weight excessively—stay as still as possible.

• Step 4: Measure Your Standing Heart Rate

  Immediately after standing, start monitoring your heart rate again. Check it at the following intervals:

  • 30 seconds after standing  

  • 2 minutes after standing  

  • 5 minutes after standing  

  • 10 minutes after standing (optional, but helpful for a fuller picture)

    Record each measurement in BPM

• Step 5: Note Any Symptoms

  While standing, pay attention to how you feel. Jot down any symptoms like lightheadedness, dizziness, palpitations, shakiness, brain fog, or fatigue. These can be just as important as the numbers.

• Step 6: Analyse Your Results

  Compare your resting heart rate (from Step 2) to your standing heart rates (from Step 4). Here’s what to look for:

  • In POTS, the heart rate typically increases by 30 beats per minute (BPM) or more within 10 minutes of standing, without a significant drop in blood pressure.

  • For example, if your resting heart rate was 70 BPM and it jumps to 100 BPM or higher while standing, that’s a sign to discuss with a doctor.

  • Symptoms like dizziness or feeling faint alongside the heart rate spike are also key clues.

• Step 7: Rest and Repeat (Optional)

  After finishing, sit or lie down to recover. If you felt unwell or the results were unclear, you can repeat the test another day to confirm your findings. Consistency matters, so try to do it under similar conditions (e.g., same time of day, no caffeine).

You will produce a table like this:

Tips for Success

• Stay Safe: If you feel extremely dizzy or like you might faint, stop the test and sit down immediately. Have someone with you if possible.

• Timing Matters: Do this test in the morning if you can, as POTS symptoms are often worse early in the day.

• Hydrate First: Dehydration can skew results, so drink water beforehand unless you’re testing how dehydration affects you.

• Avoid Triggers: Skip coffee, big meals, or intense activity right before testing.

What’s Next?

The Poor Man’s Tilt Table Test isn’t a replacement for a doctor’s diagnosis, but it can give you useful data to share with a healthcare provider. If your heart rate jumps by 30+ BPM and you feel symptomatic, it’s worth consulting a doctor with a specialist interest in POTS. They might order a formal tilt table test or other assessments to confirm.

Tracking your results over time can also help you spot patterns and manage symptoms. POTS is manageable with lifestyle changes (like increasing salt and fluid intake) and medical support, so don’t hesitate to seek answers if this test raises red flags.

Take charge of your health, one step at a time—and start with this simple test today!