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Dysautonomia & POTS
Dysautonomia is frequently missed or misattributed, with patients told their symptoms are anxiety, deconditioning, or stress before the autonomic nervous system is ever assessed. Many spend years and see multiple specialists before POTS or another form of dysautonomia is recognized. Even after diagnosis, care often focuses on a single symptom rather than the dysregulated system producing them all.
Also known as
postural orthostatic tachycardia, autonomic dysfunction, orthostatic intolerance, syncope, fainting, tilt table, autonomic neuropathy, IST
ICD-10
G90.A (Postural orthostatic tachycardia syndrome [POTS] — dedicated code effective Oct 2022), G90.9 (Autonomic nervous system disorder, unspecified), G90.8 (Other autonomic disorders), I95.1 (Orthostatic hypotension)
How focused education closes the gap
Clinicians trained in autonomic assessment can recognize and address dysautonomia as a system-level problem.- Assess autonomic function, orthostatic response, and contributing drivers together- Identify dysautonomia early, before years of misattribution accumulate- Translate findings into a multi-modal plan addressing the whole system
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Dysautonomia is an umbrella term for dysfunction of the autonomic nervous system — the network that automatically regulates heart rate, blood pressure, digestion, temperature, and more. POTS (postural orthostatic tachycardia syndrome) is one of the most common forms, defined by an excessive rise in heart rate upon standing, along with lightheadedness, fatigue, and other symptoms. These conditions disproportionately affect younger women and frequently follow a viral illness, concussion, or period of physiological stress. Because the autonomic system touches nearly every organ, symptoms are wide-ranging and easily misattributed — which is a major reason diagnosis is so often delayed for years. A functional neurology approach assesses autonomic function directly and treats the dysregulated system as a whole rather than chasing one symptom at a time. For patients who have been told their racing heart and exhaustion are "just anxiety," having the underlying autonomic pattern recognized and addressed can be the turning point toward real management. Treating the dysregulated system as a whole, rather than chasing each symptom separately, is what makes lasting, meaningful management achievable.
Dysautonomia and POTS produce a broad, often fluctuating symptom picture:- Rapid heart rate and lightheadedness upon standing- Fatigue that is often profound and unpredictable- Brain fog and difficulty concentrating- Heat intolerance and excessive sweating, or the opposite- Digestive disturbances and bloating- Symptoms that worsen with standing, heat, or dehydration
The autonomic nervous system continuously adjusts heart rate, vascular tone, and blood distribution to keep the body stable — especially when changing position. In dysautonomia these reflexes misfire; in POTS, the body fails to adequately constrict blood vessels on standing, so the heart races to compensate. Because the autonomic system regulates so many organs at once, its dysfunction produces scattered, shifting symptoms that are easily blamed on anxiety or deconditioning. That is the heart of the diagnostic gap, and the reason recognition takes so long. Recognizing the pattern and assessing autonomic function directly, as functional neurology does, is what shortens the long road to diagnosis and effective, system-level management.
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