The most useful things you can do for someone with POTS are logistical, not medical. Keep their drinks, salty food and compression garments stocked and within reach. Plan outings around the things that reliably set them off, which in practice means checking the forecast, booking seats instead of standing, keeping an exit in view and leaving the next day clear for recovery. If they feel faint, get them lying down with their legs raised and do not try to hold them upright. Call emergency services if they lose consciousness and do not come round quickly, or if they are injured, and follow local emergency guidance over anything you read online. Take their word for how they feel, every time. They are the expert on their own condition, and your job is to make the day easier to get through, not to manage it for them.
This guide is written for you, the person doing the supporting. It assumes the person you are helping already knows their own condition better than you ever will.
The one rule everything else sits under
They are the expert. You are the logistics.
Clinical detail matters less than this: someone living with POTS has spent years learning what a bad day feels like at hour two, what warning signs they get, what they can push through and what they cannot. They will have been doubted by employers, by teachers, sometimes by doctors. Being believed without having to argue for it is genuinely one of the most valuable things you can offer.
So the default is simple. When they say they need to sit down, they sit down. When they say they are fine, they are fine. You do not audit it, you do not ask if they are sure, and you do not announce to the room what is happening to them. If you disagree about something, you raise it privately and once.
Cleveland Clinic describes POTS as a condition that causes the heart to beat faster than normal when a person goes from sitting or lying down to standing up, and calls it a type of orthostatic intolerance. If you want the fuller picture of the mechanism, the subtypes and the symptom list, read our page on electrolytes and POTS, which covers the background properly. You do not need to become an amateur specialist. You need to know enough to be useful.
What to do if they feel faint
This is the situation most carers are quietly anxious about, so take it first. What follows is general practical guidance, not first aid training. Follow local emergency guidance and anything their own clinician has told them over what is written here, and take a recognised first aid course if you can get on one.
If they tell you they feel lightheaded, grey, hot, tunnel-visioned or "about to go", act immediately rather than asking follow-up questions.
Get them horizontal. Floor, sofa, back seat, grass. Lying flat with the legs raised is the position that helps, because the whole problem is blood not getting back up to the brain. A folded coat or your own knees under their calves is fine.
Do not hold them upright. The instinct to prop someone up or walk them to a chair is the wrong one here. Keeping the head above the heart is what prolongs it, and if they do faint while you are holding them, they fall from standing height. If they are already going down, your job is to guide them to the floor and get their head protected, not to keep them on their feet.
Give them space and quiet. Loosen anything tight at the neck. Move people back. Do not crowd them or fire questions at them while they are trying to come round.
Let them get up on their own timeline. Sitting up too early often restarts the whole thing. Wait until they say they are ready, then let them sit before they stand.
Call emergency services if they lose consciousness and do not come round quickly, if they hit their head or are otherwise injured, if they have chest pain or trouble breathing, if they are having a seizure, or if anything about this episode is different from what they have described to you as normal for them. Local emergency guidance always takes precedence.
Most people with POTS will have told you what their own episodes look like. Ask once, on a good day, so you are not learning it in real time.
What to keep in the house
Stock the house so the answer to "do we have any" is always yes. Running out is a bigger deal than it sounds, because the alternative is a shopping trip that itself costs them a day.
- Whatever they drink, in quantity. If they use an electrolyte drink, know the flavour they actually like and reorder before it runs out. Preference is not a small detail when someone has to drink the same thing every day.
- Salty food they can eat without cooking. Cleveland Clinic suggests salty snacks such as broth, pickles, olives, sardines and nuts, and specifically says not to over-rely on chips and crackers for salt. Broth is worth keeping in the cupboard because it is warm, easy and requires nothing. There are more ideas for salty food that is easy to keep in for a bad day in how to reach a high sodium target without hating it.
- A full water bottle beside the bed, refilled by you at night without being asked.
- Their compression garments, clean and findable. Both the 2015 Heart Rhythm Society consensus statement and NINDS list compression garments among the standard non-drug measures for POTS. Two pairs in rotation means there is always a clean one.
- A shower chair or a stool in the bathroom. Hot showers are one of the most commonly named triggers, and standing in one is the hard part.
- Food that survives a bad day. Things that need no chopping, no standing at a hob and no decisions. Bad days are also low-capacity days.
- A chair anywhere they have to stand. Kitchen, bathroom, laundry. It sounds like nothing and it changes what a day costs.
They may also be working with a clinician on how much fluid and sodium they take in. Published guidance on that varies a lot between organisations and is stated in different units, so we keep it in one place: how much sodium doctors recommend for POTS. That is a conversation for them and their doctor, not a target for you to enforce.
What to keep in the car and in the bag
The go-bag exists so that leaving the house does not require a planning session.
- A drink they can actually stomach, plus a spare
- Salty snacks that do not melt
- A cold pack or a cheap handheld fan for heat
- Sunglasses and a hat
- A folding stool or seat cane if queues are likely
- A blanket or jumper for the after-effects, which often include feeling cold and wiped out
- Their medication, if they take any
- Sick bags, because nausea is common and the fear of it is worse than the thing itself
Keep a duplicate of the core items in the car permanently. The bag you forgot is the bag you needed.
Planning an outing around the real triggers
Cleveland Clinic lists the common symptom triggers as warm environments such as a hot day or a hot bath or shower, frequent or prolonged standing such as waiting in line or shopping, strenuous exercise, being ill, and being on your period. NINDS also notes that some medications, including diuretics, can cause or worsen POTS symptoms, and says people with POTS should speak to a healthcare provider before starting any new medication.
Practically, this turns into a short set of questions to ask before you commit to something.
How hot will it be, inside and out? Heat is the trigger that ruins the most plans. Aim for early mornings, air conditioning, and shade. A restaurant table by a radiator is a bad table.
How much standing is involved? Queues, galleries, receptions, train platforms and supermarkets are all standing events. Book seats, join the queue on their behalf, or pick the venue with somewhere to sit. Slow walking with stops is usually easier than standing still.
Where is the exit? Knowing there is a way out, and a place to lie down if it comes to that, makes the whole thing more doable. Sit near the door.
What happens tomorrow? Recovery time is part of the cost. Do not stack two demanding days together, and do not treat a cancelled plan as a failure. The person cancelling is more disappointed than you are.
Have you asked, rather than decided? Presenting a plan as fixed forces them to either accept it or perform their illness to get out of it. Offer options and let them choose.
Timing across the day matters too, and they may already have a routine for it. If it is useful, we cover the shape of a day in spacing fluids and sodium across the day with POTS.
Helping without taking over
The line between support and control is thinner than most of us think, and crossing it is the most common way well-meaning people make things worse.
Offer specifics, not open questions. "Let me know if you need anything" hands them the work. "I am going to the shop, do you want anything" or "I will do the stairs" is help.
Do the invisible tasks. Refill the bottle. Carry the bags. Take the driving. Handle the phone calls. None of it needs discussing.
Do not medicalise every conversation. Not every interaction has to be a symptom check-in. Ask about their day. Watch something. Being treated as a whole person is part of the support.
Do not police their intake, their rest or their pacing. Reminders land as surveillance very quickly. If they have asked you to remind them about something specific, that is different, and it is worth agreeing the wording in advance.
Do not offer cures. Everyone with a chronic condition has heard the yoga suggestion. Assume they have researched it more thoroughly than you have.
Say the thing out loud. "I believe you" and "this is not in your head" are worth more than most practical help, particularly for someone recently diagnosed or still fighting for a diagnosis.
If you are the parent of a teenager with POTS
Teenagers have an extra problem: their independence and their illness arrive at the same time, and adults keep merging the two.
Push for the school adjustments in writing rather than relying on individual goodwill: permission to carry a drink and to drink in class, permission to leave without asking, somewhere to lie down that is not the corridor floor, seating instead of standing at assemblies, a way to catch up missed work, and a plan for exams. Brief the people who will actually be present, which usually means the PE staff and the school office, not only the head of year.
Then hand the condition back to them as fast as they can carry it. Let them speak first at appointments. Let them decide who at school gets told. Let them make judgement calls about what they can do, including the ones you would not make. Being managed by a parent into your twenties has its own long-term cost.
And keep the friendships alive. Isolation does as much damage as the fainting does, and a friend who has been shown how to help is a friend who does not drift.
If you are supporting a partner
The hardest part is usually the imbalance, and the honest response to it is to name it rather than to pretend it is not there.
Say what you are picking up. Let them keep the things they still want to do, even the inefficient ones. Do not turn every conversation into a care review. Do not use their condition in an argument. And take your own support seriously, because carers who never get a break get resentful, and resentment is much harder to fix than a rota.
If you are also managing childcare, work and appointments, write the logistics down somewhere you both can see. Held in one person's head, it becomes an invisible job that nobody thanks you for.
Being useful at an appointment
You are there as the second pair of ears, not the spokesperson.
Before you go, help them write down the three things they most want addressed, in their order, and a short factual account of what has changed since the last visit. Frequency and impact are what clinicians act on, so "three near-faints a week, cannot stand long enough to cook" carries more than "she has been really unwell".
In the room, let them speak. Take notes. If a term goes past that neither of you caught, ask for the spelling. If they ask you to add something, add it. If they do not, do not fill silences on their behalf, and do not correct their account of their own symptoms in front of the doctor. Afterwards, read the notes back to them, because brain fog and a stressful appointment are a bad combination for recall.
If their clinician wants to see the underlying literature rather than a patient handout, send them to our POTS information for clinicians page, which lists the primary sources including the Garland and Raj 2021 JACC study, the 2015 Heart Rhythm Society consensus statement and the 2020 Canadian Cardiovascular Society position statement.
What nobody tells carers
You will get it wrong sometimes. You will suggest the wrong outing, refill the wrong bottle, say the reassuring thing that lands badly. That is normal, and it is recoverable. Ask what would have been more useful, and adjust.
So much of daily life with this condition comes down to management, planning and patience, and that is a heavy load for the person carrying it every day. Sharing the logistics is real help, and it is the help most people actually want.
You do not need to solve this. You need to be reliable, believe them, and keep the fridge stocked.
This article is general information and is not medical advice. Decisions about fluid, sodium, medication and activity belong to the person with POTS and their healthcare provider.
Sources
- Cleveland Clinic. "Postural Orthostatic Tachycardia Syndrome (POTS)." Cleveland Clinic Health Library, last updated June 8, 2026.
- National Institute of Neurological Disorders and Stroke. "Postural Tachycardia Syndrome (POTS)," last reviewed March 13, 2026.
- Sheldon RS, Grubb BP 2nd, Olshansky B, et al. 2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope. Heart Rhythm. 2015;12(6):e41-e63.
- Raj SR, Guzman JC, Harvey P, et al. Canadian Cardiovascular Society Position Statement on Postural Orthostatic Tachycardia Syndrome (POTS) and Related Disorders of Chronic Orthostatic Intolerance. Can J Cardiol. 2020;36(3):357-372.
- Garland EM, Raj SR, et al. "Effect of High Dietary Sodium Intake in Patients with Postural Tachycardia Syndrome." J Am Coll Cardiol. 2021;77(17):2174-2184.
