Testing and Diagnosis Articles

A tilt table can show that something goes wrong when you stand. It rarely shows why. Start with how POTS gets diagnosed, then why results can look normal while you feel awful, and what else our team measures, including blood flow to your brain.

How is POTS diagnosed?

  1. Tilt Table Test for POTS: Everything You Need to Know

    Biggest misconceptions about the tilt table test for POTS: the 45-minute myth, nitroglycerin fears, and what a good tilt test should actually measure.

  2. Beyond the Tilt Table: Comprehensive Autonomic Testing

    A positive tilt table test confirms POTS, but it doesn't tell you why. Learn about comprehensive autonomic testing that finds the actual mechanism.

  3. POTS vs OCHOS: Why the 30 BPM Line Doesn't Mean What You Think

    POTS and OCHOS share one core problem: reduced cerebral blood flow. The 30 BPM threshold dividing them is a 40-year-old artifact, not a biological boundary.

  4. POTS Without the T: When You Have Every Symptom But Don't Qualify

    If your blood pressure looks normal and your heart rate doesn't quite qualify, you've been told nothing is wrong. Here's what the standard test misses.

Why did my tests come back normal?

  1. POTS Symptoms: Why They Don't Match Your Autonomic Test Results

    A 2024 study of 2,627 patients found POTS and dysautonomia symptom surveys don't match objective autonomic testing. Here's what that gap really means.

  2. Your Tests Came Back Normal. You're Clearly Not.

    Free guide: the 4 mechanisms your doctors aren't testing for, and how to find which one is keeping you sick. From The Keiser Clinic.

  3. What Doctors Are Missing in POTS Cases

    Why so many POTS cases get dismissed, why clean labs don't mean you're fine, and how a brain-first approach finds what standard workups miss.

  4. Orthostatic Cerebral Hypoperfusion Syndrome: When Your Brain Loses Blood Flow but Every Test Looks Normal

    Orthostatic cerebral hypoperfusion syndrome (OCHOS) is a measurable drop in brain blood flow on standing. Learn how it differs from standard POTS.

  5. Why So Many Dysautonomia Patients Are Misdiagnosed and Mistreated

    A POTS diagnosis can be a relief, but for many the treatments still don't work. Here's why, and what understanding your specific mechanism changes.

What else can be measured?

  1. Why We Use Transcranial Doppler for POTS

    Heart rate is only part of the POTS story. Transcranial Doppler ultrasound reveals what's really happening to blood flow in your brain when you stand.

  2. Carbon Dioxide: One of the Most Important Metrics for Brain Blood Flow

    CO2 isn't a waste product. It's a key signal your brain uses to regulate blood flow. Why we measure ETCO2 on the tilt table, and what low CO2 feels like.

  3. Hypocapnic Cerebral Hypoperfusion (HYCH): How Low CO2 Cuts Blood Flow to the Brain

    Hypocapnic cerebral hypoperfusion (HYCH) is low brain blood flow on standing from low CO2, without the POTS heart rate. Symptoms, POTS link, tests, treatment.

  4. Dysautonomia Physical Exam: The Bedside Neurological Tests

    The bedside neurological exam our team pairs with autonomic testing: pulses, reflexes, eye movements, and what each reveals about POTS and dysautonomia.

  5. What Your Eye Movements Reveal About Your Brain

    Eye tracking is one of the most powerful diagnostic tools in neurology. Learn how eye movements reveal which brain areas aren't functioning properly.'t.

  6. Proof That the Brain Controls the Autonomic System

    Proof that the brain controls the autonomic system: using eye movements, cerebral blood flow data, and real patient outcomes from targeted brain rehab.

What about ME/CFS and other labels?

  1. How to Actually Diagnose Chronic Fatigue Syndrome

    ME/CFS isn't just fatigue. How chronic fatigue syndrome is properly diagnosed, what testing reveals about the brain, and why finding the mechanism matters.

  2. Why Your Diagnosis Label Might Be Holding You Back

    CFS, POTS, and ME/CFS syndrome labels describe symptoms, not causes. Moving from syndrome to mechanism is the key to effective treatment.

  3. POTS or Anxiety? How to Tell the Difference

    How to tell POTS from anxiety. Learn 3 evidence-based ways to figure out if anxiety drives your symptoms or your physiology drives the anxiety.

  4. Functional Neurological Disorder and POTS

    FND is one of the most misunderstood diagnoses. Learn what it actually means, how it connects to POTS, and why 'it's psychological' misses the mechanism.

How do I know if treatment is working?

  1. How to Know If Your POTS Is Actually Improving

    How to know if your POTS is actually improving using cerebral blood flow data, not just symptoms. A case study shows why BP meds may worsen perfusion.

To see the testing itself, take the 3D tour of autonomic testing.

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