Testing for POTS and Dysautonomia in Phoenix

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When the Nervous System Affects Heart Rate, Dizziness, Brain Fog, Fatigue, Sweating, Digestion, and Exercise Tolerance

Dizziness, rapid heartbeat, fainting, fatigue, brain fog, nausea, heat intolerance, weakness, and exercise intolerance can be frustrating symptoms, especially when routine testing does not explain what is wrong. Many patients are told they are dehydrated, anxious, stressed, or out of shape. Sometimes those factors can play a role, but they do not always tell the whole story.

For some patients, the problem may involve the autonomic nervous system.

When the autonomic nervous system does not regulate the body correctly, the condition is often called dysautonomia. One of the most recognized forms of dysautonomia is Postural Orthostatic Tachycardia Syndrome, also known as POTS.

At Center for Neurology and Spine in Phoenix, Arizona, we offer POTS testing and autonomic evaluation for patients with symptoms such as dizziness, rapid heartbeat, palpitations, fainting, near fainting, fatigue, brain fog, weakness, heat intolerance, and symptoms that worsen when standing.

CNS serves patients throughout Phoenix, North Phoenix, Biltmore, Arcadia, Scottsdale, Tempe, Mesa, Chandler, Gilbert, Glendale, Peoria, Paradise Valley, Ahwatukee, and surrounding Arizona communities.

What Is the Autonomic Nervous System?

The autonomic nervous system is the part of the nervous system that controls automatic body functions. These are the functions your body manages without you having to think about them.

The autonomic nervous system helps regulate:

Heart rate

Blood pressure

Blood vessel tone

Sweating

Temperature control

Digestion

Bladder function

Pupil response

Circulation when standing

Response to meals

Response to heat

Response to stress

Response to exercise

When the autonomic nervous system works properly, the body adjusts smoothly throughout the day. When it does not, normal activities can become difficult. Standing up, taking a shower, walking through a parking lot, eating a meal, exercising, or being outside in the Phoenix heat can trigger symptoms.

What Is Dysautonomia?

Dysautonomia is an umbrella term for conditions where the autonomic nervous system does not work normally. It is not one single disease. It is a category of problems involving abnormal regulation of automatic body functions.

Dysautonomia can cause symptoms in multiple body systems. That is one reason it can be difficult to diagnose. A patient may have heart rate symptoms, digestive symptoms, sweating changes, fatigue, dizziness, and brain fog, but each symptom may be evaluated separately before anyone connects them.

Common symptoms of dysautonomia may include:

Dizziness

Lightheadedness

Fainting or near fainting

Rapid heartbeat

Palpitations

Blood pressure changes

Brain fog

Fatigue

Weakness

Exercise intolerance

Heat intolerance

Cold intolerance

Nausea

Bloating

Abdominal discomfort

Constipation or diarrhea

Abnormal sweating

Dry eyes or dry mouth

Sleep disruption

Shakiness

Color changes in the hands or feet

Symptoms that worsen when standing

Symptoms that improve when lying down

Because dysautonomia can affect many parts of the body, patients may see cardiology, primary care, ENT, gastroenterology, urgent care, or emergency departments before they are referred for autonomic evaluation.

What Is POTS?

POTS stands for Postural Orthostatic Tachycardia Syndrome.

Postural means related to body position.

Orthostatic means related to standing upright.

Tachycardia means fast heart rate.

Syndrome means a group of symptoms that occur together.

In POTS, symptoms often worsen when a person moves from lying down to standing. The heart rate rises more than expected, and the patient may feel dizzy, weak, shaky, foggy, nauseated, short of breath, or close to fainting.

POTS is not simply anxiety. It is not simply dehydration. It is not simply being out of shape. POTS is a disorder involving autonomic regulation, circulation, and heart rate response to posture.

Common POTS symptoms include:

Rapid heartbeat when standing

Dizziness when upright

Palpitations

Fainting or near fainting

Lightheadedness

Fatigue

Brain fog

Weakness

Shakiness

Exercise intolerance

Shortness of breath when upright

Nausea

Headaches or migraine

Heat intolerance

Symptoms after showers

Symptoms after large meals

Symptoms that improve when lying down

Why POTS Symptoms Happen When Standing

When a person stands, gravity pulls blood toward the legs and lower body. A healthy autonomic nervous system responds quickly by tightening blood vessels and adjusting heart rate so blood continues returning to the heart and brain.

In POTS, that response does not work smoothly. Blood may pool in the lower body, and the heart rate may rise too much as the body tries to compensate. This can make the patient feel dizzy, weak, foggy, shaky, or faint.

Many patients say they feel normal while lying down but feel sick when standing.

Examples include:

Feeling dizzy after getting out of bed

Heart racing while brushing teeth

Feeling faint in the shower

Getting weak while standing in line

Brain fog after walking through a store

Fatigue after mild activity

Symptoms becoming worse in the Arizona heat

This positional pattern is one of the biggest clues that autonomic dysfunction may be involved.

Why Dysautonomia Is Often Missed

Dysautonomia can be difficult to recognize because routine testing may be normal.

A patient may have:

Normal blood work

Normal EKG

Normal heart rhythm at rest

Normal imaging

Normal blood pressure while sitting

Normal exam while lying down

But symptoms may appear when the patient stands, walks, showers, eats, exercises, or becomes overheated.

Dysautonomia may be missed when:

Heart rate is checked only while sitting

Blood pressure is not checked during position changes

Symptoms are blamed on anxiety without autonomic testing

The patient appears healthy during the appointment

Symptoms come and go

Cardiology testing is normal

The patient has multiple symptoms across different body systems

The symptoms are worse at home than in the office

This is why POTS testing and autonomic evaluation can be helpful.

How Dysautonomia Can Affect the Whole Body

Dysautonomia can feel confusing because it may affect more than one body system.

Heart and circulation symptoms may include rapid heartbeat, palpitations, blood pressure changes, fainting, and dizziness.

Brain symptoms may include brain fog, poor concentration, mental fatigue, headaches, migraine, and feeling disconnected.

Digestive symptoms may include nausea, bloating, abdominal discomfort, constipation, diarrhea, or feeling worse after meals.

Temperature and sweating symptoms may include heat intolerance, sweating too much, sweating too little, cold hands and feet, or feeling unable to regulate temperature.

Exercise symptoms may include shortness of breath, racing heart, weakness, fatigue, dizziness, and delayed crashes after activity.

Because these symptoms may not seem connected at first, patients may not realize they could be part of one autonomic pattern.

Dysautonomia, POTS, and Brain Fog

Brain fog is one of the most common symptoms patients describe. It may feel like difficulty concentrating, slow thinking, trouble finding words, poor short-term memory, mental fatigue, or reduced ability to work at a computer.

Brain fog may worsen when upright because the body is struggling to regulate circulation and autonomic function. It may also be affected by poor sleep, migraine, dehydration, medication effects, fatigue, or post-viral symptoms.

Patients may say:

I think better when I lie down.

My brain fog gets worse when I stand too long.

I feel mentally exhausted after simple errands.

I cannot focus during long workdays.

The Phoenix heat makes my brain fog worse.

At CNS, brain fog is evaluated in context. The goal is to determine whether symptoms may be related to POTS, dysautonomia, migraine, sleep problems, medication effects, seizures, memory disorders, or another neurologic condition.

Dysautonomia, POTS, and Migraine

Migraine and dysautonomia can overlap. Many patients with POTS also report headaches, light sensitivity, nausea, dizziness, fatigue, and brain fog.

Migraine is a neurological disorder, not just a headache. It can involve sensory sensitivity, blood vessel signaling, nausea pathways, pain processing, and autonomic symptoms.

Shared triggers may include:

Heat

Dehydration

Poor sleep

Skipped meals

Stress

Hormonal changes

Overexertion

Weather changes

For Arizona patients, heat and dehydration can worsen both migraine and autonomic symptoms. Patients with dizziness, migraine, rapid heartbeat, and brain fog may benefit from a neurologic evaluation that looks at the full picture.

Dysautonomia, POTS, and Neuropathy

Some patients with dysautonomia also report symptoms of nerve dysfunction. These may include burning pain, numbness, tingling, abnormal sweating, sensitivity to touch, or color changes in the hands and feet.

These symptoms may suggest involvement of peripheral nerves or small nerve fibers.

Symptoms that may need evaluation include:

Burning pain in the feet

Tingling in the hands or feet

Numbness

Electric shock sensations

Reduced sweating

Excessive sweating

Color changes in the feet or hands

Balance problems

Weakness

CNS evaluates neuropathy symptoms and may recommend additional testing depending on the patient’s history and exam.

Dysautonomia After COVID or Viral Illness

Some patients develop symptoms of dysautonomia after COVID or another viral illness. They may report that they were functioning normally before the illness, but afterward developed dizziness, rapid heartbeat, fatigue, brain fog, and exercise intolerance.

This is sometimes described as post-viral dysautonomia.

Post-viral symptoms may include:

Rapid heartbeat when standing

Dizziness

Fatigue

Brain fog

Exercise intolerance

Weakness

Shortness of breath with activity

Symptoms after exertion

Symptoms that improve when lying down

Not every patient with long COVID symptoms has POTS, and not every patient with POTS has long COVID. However, when symptoms are posture-related, autonomic testing may help clarify whether POTS or another form of orthostatic intolerance is present.

Why Arizona Heat Can Make POTS and Dysautonomia Worse

Phoenix heat can be a major trigger for patients with POTS and dysautonomia. Heat causes blood vessels to widen and increases sweating. This can worsen blood pooling, dehydration, dizziness, fatigue, and rapid heartbeat.

Arizona patients may notice symptoms worsen during:

Summer heat

Hot showers

Outdoor events

Walking through parking lots

Standing in lines

Exercising in warm weather

Getting into a hot car

Dehydration from dry air

Monsoon humidity changes

Long travel days

A treatment plan for POTS and dysautonomia in Arizona should account for real life in the desert climate.

Helpful strategies may include:

Planning errands early in the morning

Avoiding outdoor activity during peak heat

Using cooling towels or portable fans

Sitting when waiting in lines

Hydrating before leaving home if medically appropriate

Avoiding very hot showers

Exercising indoors or in water

Using shaded parking when possible

Discussing compression garments with your clinician

Talking with your clinician before increasing salt intake

These strategies should be individualized, especially for patients with high blood pressure, heart disease, kidney disease, or other medical conditions.

What Is POTS Testing?

POTS testing evaluates how the body responds to position change. The goal is to measure heart rate, blood pressure, symptoms, and autonomic responses when the body moves from lying down to standing or upright positioning.

Testing may include:

Orthostatic vital signs

Tilt table testing

Heart rate monitoring

Blood pressure monitoring

Autonomic reflex evaluation

Symptom tracking during testing

Medication review

Neurological examination

The goal is not just to confirm or rule out POTS. Testing can help identify the pattern behind symptoms and guide treatment.

What Is Tilt Table Testing?

Tilt table testing is commonly used to evaluate POTS, dizziness, fainting, and orthostatic intolerance.

During a tilt table test, the patient lies on a special table while heart rate and blood pressure are monitored. The patient is secured safely, and the table is tilted upright to simulate standing. The care team monitors how the body responds.

Tilt table testing can help evaluate:

POTS

Vasovagal syncope

Orthostatic hypotension

Orthostatic intolerance

Unexplained fainting

Unexplained dizziness

Heart rate response to standing

Blood pressure response to standing

For many patients, tilt table testing provides objective information about symptoms they have been experiencing for months or years.

What Else Can Look Like POTS?

Many conditions can mimic or overlap with POTS and dysautonomia.

These may include:

Anxiety or panic symptoms

Dehydration

Anemia

Thyroid disease

Medication side effects

Vasovagal syncope

Orthostatic hypotension

Cardiac rhythm disorders

Vestibular disorders

Migraine

Long COVID

Chronic fatigue syndrome

Small fiber neuropathy

Ehlers-Danlos syndrome

Autoimmune disease

Sleep disorders

Because symptoms overlap, accurate testing and clinical interpretation are important.

How POTS and Dysautonomia Are Treated

Treatment depends on the patient’s symptoms, test results, heart rate response, blood pressure pattern, medical history, medications, and daily triggers.

Treatment may include:

Education about dysautonomia

Fluid optimization when appropriate

Salt guidance when medically appropriate

Compression garments

Heat avoidance

Slow position changes

Smaller meals

Sleep improvement

Gradual exercise conditioning

Migraine treatment if needed

Medication review

Medications for heart rate or blood pressure support in selected patients

Treatment of overlapping neuropathy symptoms if present

Follow-up monitoring

There is no one-size-fits-all treatment plan. The goal is to improve function, reduce symptom flares, prevent fainting, and help patients understand how to manage symptoms in daily life.

What to Track Before Your Appointment

Tracking symptoms can help your neurologist understand your pattern.

Helpful details include:

Heart rate lying down

Heart rate standing

Blood pressure lying down and standing if available

Time of day symptoms are worst

Symptoms after showers

Symptoms after meals

Heat exposure

Fluid intake

Exercise tolerance

Fainting or near-fainting episodes

Migraine or headache patterns

Sleep quality

Medication and supplement list

Recent illness or COVID history

Prior cardiology testing

Prior emergency room visits

Bring any previous test results, including EKGs, heart monitor reports, blood work, imaging, or prior tilt table testing.

When to Seek Urgent Care

Some symptoms should not wait for a routine appointment.

Seek urgent medical care for:

New or severe chest pain

Sudden weakness on one side

Facial drooping

Trouble speaking

Sudden severe headache

New seizure

Fainting with injury

Severe shortness of breath

Sudden vision loss

Persistent confusion

Rapidly worsening neurological symptoms

POTS and dysautonomia can cause significant symptoms, but emergency warning signs should always be taken seriously.

Why Choose Center for Neurology and Spine for POTS and Dysautonomia Testing?

Center for Neurology and Spine offers neurologist-led evaluation for POTS and dysautonomia in Phoenix, Arizona.

Patients choose CNS because we offer:

POTS testing in Phoenix

Autonomic testing in Arizona

Tilt table testing

Evaluation for dizziness and fainting

Evaluation for rapid heartbeat when standing

Evaluation for brain fog and fatigue

Care for migraine and headache overlap

Care for neuropathy symptoms

Neurologic interpretation of complex symptoms

Personalized treatment planning

CNS serves patients across Phoenix, North Phoenix, Biltmore, Arcadia, Scottsdale, Tempe, Mesa, Chandler, Gilbert, Glendale, Peoria, Paradise Valley, Ahwatukee, and nearby Arizona communities.

Frequently Asked Questions

What is dysautonomia?

Dysautonomia is a term used when the autonomic nervous system does not regulate automatic body functions properly. It can affect heart rate, blood pressure, sweating, digestion, temperature control, and circulation.

Is POTS a type of dysautonomia?

Yes. POTS is one type of dysautonomia. It involves symptoms that worsen when standing, along with an abnormal heart rate response to upright posture.

What are common symptoms of POTS?

Common symptoms include dizziness, rapid heartbeat, palpitations, lightheadedness, fainting, fatigue, brain fog, weakness, shakiness, exercise intolerance, nausea, and heat intolerance.

Can POTS cause brain fog?

Yes. Many patients with POTS report brain fog, poor concentration, slowed thinking, and mental fatigue, especially when upright.

Can dysautonomia affect digestion?

Yes. Because the autonomic nervous system helps regulate digestion, some patients with dysautonomia report nausea, bloating, constipation, diarrhea, or abdominal discomfort.

Can anxiety mimic POTS?

Yes. Anxiety can cause rapid heartbeat and shakiness, but POTS symptoms are often posture-related and can be measured with heart rate and blood pressure testing during standing or tilt.

Does Arizona heat make POTS worse?

Yes. Heat can worsen blood pooling, dehydration, sweating, dizziness, fatigue, and rapid heartbeat in patients with POTS or dysautonomia.

What is tilt table testing?

Tilt table testing monitors heart rate and blood pressure while the body is moved from lying down to upright positioning. It is commonly used to evaluate POTS, fainting, and orthostatic intolerance.

Does CNS offer POTS testing in Phoenix?

Yes. Center for Neurology and Spine offers POTS testing and autonomic evaluation in Phoenix, Arizona.

Schedule POTS and Dysautonomia Testing in Phoenix

If you are living with dizziness, rapid heartbeat, fainting, brain fog, fatigue, heat intolerance, weakness, palpitations, exercise intolerance, or symptoms that worsen when standing, Center for Neurology and Spine can help.

CNS offers POTS testing and dysautonomia evaluation in Phoenix for patients across the Valley.

Visit cnsofaz.com or centerforneurologyandspine.com to request an appointment and take the next step toward understanding your symptoms.

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