Do you need a tilt table test to diagnose POTS? Not always. Tilt table testing can be helpful—and I sometimes use it when the diagnosis is unclear—but it’s not always necessary. If a patient describes orthostatic intolerance—things like dizziness, rapid heartbeat, brain fog, or fatigue that worsens when standing and improves with lying down—that often tells me a lot. That’s the core of POTS: symptoms triggered by upright posture. Instead of jumping straight to a tilt table test, I often have pat

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