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Connective tissue & hypermobility

EDS and POTS overlap

Postural orthostatic tachycardia syndrome affects a large minority of people with hypermobile EDS - recognising the overlap explains dizziness, racing heart and crushing fatigue that joints alone cannot.

Key points

The essentials at a glance.

What to look out for, which tests matter, who treats it, and what usually happens next.

  • POTS means a sustained heart-rate rise of 30 bpm or more on standing, with symptoms, and no blood pressure drop

  • It is substantially more common in people with hEDS than in the general population

  • Diagnosis uses an active stand test or tilt-table test - both measurable, neither subjective

  • Treatment spans fluids, salt, compression, graded reconditioning and, where needed, medication

  • An autonomic specialist or POTS-literate cardiologist is the right referral

Understanding it

About EDS and POTS overlap.

Stretchy connective tissue affects blood vessels as well as joints: on standing, blood pools in the legs and abdomen, and the heart compensates by racing. The result is light-headedness, palpitations, brain fog, tremulousness and exhaustion that worsens the longer you are upright. Many people with hEDS spend years being investigated for anxiety before anyone counts their heart rate lying and standing.

A ten-minute active stand test - heart rate and blood pressure lying, then standing - can be done in any clinic and is often diagnostic; tilt-table testing adds precision where the picture is unclear. Once named, POTS responds meaningfully to fluid and salt loading, compression garments, recumbent exercise programmes and drugs such as ivabradine or fludrocortisone when needed. In many parts of the UK, a routine NHS referral to the relevant specialist clinic currently means waiting many months - sometimes more than a year for the rarest conditions - whereas an initial appointment with a private consultant is typically available within around two weeks, with investigations arranged soon after.

Frequently asked

Common questions about EDS and POTS overlap.

Quick, plain-English answers to what people ask us most.

  • What does EDS and POTS overlap mean?

    EDS and POTS overlap is a condition your doctor may diagnose based on your symptoms, medical history and, where needed, examination or test results. Understanding exactly how it applies to your situation is best done with a clinician who can look at your full picture rather than relying on general information alone.

  • What are the risk factors for EDS and POTS overlap?

    EDS and POTS overlap can arise from several different underlying mechanisms, and in many cases more than one factor contributes. Identifying likely causes usually forms part of the initial specialist work-up.

  • What are the symptoms of EDS and POTS overlap?

    Symptoms of EDS and POTS overlap vary from person to person and can range from mild and easily missed to significant enough to affect daily life. Because overlapping conditions can produce similar symptoms, a clinical assessment is the most reliable way to confirm what's actually going on.

  • Can EDS and POTS overlap cause complications?

    Most cases of EDS and POTS overlap are manageable with appropriate care, though, like many conditions, it can occasionally lead to complications if left unassessed or untreated. Your clinician can give you a realistic sense of the risks based on your specific presentation.

  • Is EDS and POTS overlap hereditary or genetic?

    Many forms of EDS and POTS overlap have a genetic or inherited component, and some are linked to specific gene changes that can run in families. If there's a family history, genetic counselling can help clarify the pattern of inheritance and whether relatives might benefit from testing.

  • Is there a cure for EDS and POTS overlap?

    EDS and POTS overlap can often be managed effectively, and in some cases prevented or reversed, with the right combination of lifestyle changes, medication or other targeted treatment. A specialist will tailor the approach to your circumstances rather than applying a one-size-fits-all plan.

  • How is EDS and POTS overlap treated?

    Treatment for EDS and POTS overlap is usually built around the severity of your symptoms and any underlying cause found on assessment, and may involve lifestyle measures, medication, physiotherapy or, in some cases, a procedure. Your specialist will discuss the pros and cons of each option with you before agreeing a plan.

  • What's the outlook for EDS and POTS overlap?

    The outlook for EDS and POTS overlap varies widely depending on the underlying cause, how early it's diagnosed, and how it responds to treatment. Many people see significant improvement with appropriate care, and your specialist can give you a more personalised timeframe once they've reviewed your case.

  • Could EDS and POTS overlap be confused with another condition?

    Because several conditions can share similar symptoms to EDS and POTS overlap, clinicians often consider a short list of possibilities before confirming a diagnosis. This is one of the main reasons a proper assessment, and sometimes targeted tests, matters more than relying on symptoms alone.

  • When should I see a doctor about EDS and POTS overlap, and how quickly can I be seen privately?

    It's worth seeking medical advice if symptoms of EDS and POTS overlap are persistent, worsening, or affecting your daily life, rather than waiting for them to resolve on their own. NHS routine referrals for this kind of assessment can take anywhere from around 20 to 45+ weeks, whereas private consultants typically offer an appointment within about two weeks.