Concierge autonomic testing · London
Private autonomic function testing in London, by a consultant specialist.
Proper autonomic and tilt-table testing for POTS, unexplained faints and orthostatic intolerance — not a smartwatch reading in a spreadsheet.
Why patients choose us
- 01
The right test, not the quick one
We match the panel of manoeuvres to the pattern of your symptoms — not a generic screen.
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Read by a consultant
A consultant autonomic neurologist or cardiologist interprets your trace — not just an automated printout.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private autonomic function testing costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A stand test with a basic screen: £250–£500; a tilt-table £600–£1,200.
| Test | Indicative range | Typical duration | Report turnaround |
|---|---|---|---|
| Active stand test + basic autonomic screen | £250–£500 | 45 min | Same visit |
| Head-up tilt table test | £600–£1,200 | 60–90 min | 3–5 days |
| Full autonomic battery | £900–£1,800 | Half-day | 5–7 days |
| POTS work-up | £700–£1,400 | 90 min | 5–7 days |
| Autonomic + sweat testing | £1,000–£2,000 | Half-day | 7–10 days |
| Follow-up autonomic review | £250–£500 | 30 min | Same visit |
Prices vary by clinic, panel of manoeuvres, and whether sweat testing or consultant review is included. We come back with a firm quote within one working day.
The problem
A smartwatch trace is not a diagnosis.
Orthostatic intolerance, POTS and vasovagal syncope look similar on a wrist-based heart-rate graph and are treated completely differently. Formal testing with beat-to-beat BP and continuous ECG is what tells them apart.
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Fainting or near-fainting?
A tilt-table reproduces the episode safely, in a monitored setting.
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Wrist HR rising on standing?
A formal active stand or tilt is what separates POTS from deconditioning.
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Long-COVID dizziness?
POTS is common post-COVID. A targeted screen tells you whether you have it.
The journey
From enquiry to report — what happens, in order.
One clinician from first message to explained result — typically within a week for a stand test, a little longer for a full battery.
Phase 1 · Before your test
Concierge, off-stage for you
Phase 2 · On the day
~45 min to half a day at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Symptoms, timeline, referral or insurer if you have them.
- 02
Before
We come back with a recommendation
Within one working day: which test, which clinic, indicative price. If a test is not the right step, we say so.
- 03
Before
We arrange the appointment
Often within the week, including evenings and Saturdays. Insurer pre-authorisation handled.
- 04
On the day
Arrival and preparation
You arrive well hydrated after a light meal. Medications sometimes paused — we tell you what to stop, and when.
- 05
On the day
The testing
Manoeuvres range from an active stand test to a full tilt-table with beat-to-beat blood pressure and cardiovagal reflex tests. Half a day for a full battery.
- 06
On the day
Straight home
No recovery time. You may feel briefly wobbly after a tilt — someone drives you if needed.
- 07
After
Report and next steps
Consultant report in 3–10 days depending on the panel. We route it to your GP or specialist, and to a POTS clinic if indicated.
Typical end-to-end: 5–10 days. Urgent cases: within the week.
What it shows
Find the test that matches your symptom.
Autonomic symptoms differ enormously in pattern. These are the questions we are asked to answer most.
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POTS
Postural orthostatic tachycardia — a sustained heart-rate rise on standing, without a drop in blood pressure.
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Vasovagal syncope
The most common cause of fainting — reproduced safely on the tilt table.
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Orthostatic hypotension
A sustained drop in blood pressure on standing — a classic autonomic red flag.
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Recurrent unexplained faints
When ECG and cardiology have been clear, autonomic testing is the next step.
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Small-fibre neuropathy screen
Cardiovagal and sudomotor tests pick up small-fibre involvement missed by standard nerve studies.
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Diabetic autonomic neuropathy
Detects early autonomic involvement in long-standing diabetes.
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Parkinson’s autonomic features
Blood pressure, sweating and heart-rate responses inform Parkinsonian diagnoses.
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Red flag: syncope with exertion
Fainting during exertion is different — arrange urgent cardiology, not an autonomic screen.
Autonomic tests
Not all autonomic tests are the same.
What each option on your referral is actually for.
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Active stand test
Simple, quick — heart rate and blood pressure recorded lying, then over ten minutes standing.
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Head-up tilt table test
The reference test for unexplained faints, with beat-to-beat BP and continuous ECG.
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Full autonomic battery
Combines tilt, Valsalva, deep breathing and, where indicated, sweat testing.
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POTS work-up
Structured protocol for postural orthostatic tachycardia, with a symptom diary and hydration review.
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Autonomic + sweat testing (QSART)
Adds quantitative sudomotor axon reflex testing for small-fibre and sweating disorders.
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Cardiovagal reflex tests
Deep breathing and Valsalva manoeuvre — the classic parasympathetic screen.
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Diabetic autonomic screen
Focused panel for people with long-standing diabetes and suggestive symptoms.
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Post-COVID autonomic screen
Tailored panel for long-COVID dysautonomia — POTS is common in this group.
Our vetted London network
A small panel of clinics, we picked them.
Autonomic units across central London, with proper tilt facilities. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every clinic in our network.
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Consultant autonomic neurologists or cardiologists interpreting every study
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Tilt-table facility available on site, not improvised
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Combined ECG with beat-to-beat blood pressure — not intermittent cuff readings
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A direct pathway into specialist POTS clinics when the diagnosis is confirmed
Safety and eligibility
Safe, monitored, but not a substitute for your history.
Autonomic testing is safe in experienced hands. The practical points are hydration, caffeine and medication — and knowing what a normal test does and does not rule out.
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A tilt test may provoke a faint
That is the point — safely, in a monitored setting, with staff at hand to lower you back down.
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Hydration and food
Well hydrated on the day, but keep to a light meal only.
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Avoid caffeine
No coffee, tea, cola or energy drinks for 24 hours before the test.
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Medication pause
Some drugs are paused before testing — check with us first, do not stop anything without advice.
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Compression stockings
Bring your compression stockings if you use them, so we can test with and without.
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Interpreted with a symptom diary
The trace only makes sense alongside what you feel and when — keep a diary in the run-up.
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Not diagnostic on their own
Autonomic tests support a diagnosis; they do not make one in isolation from your history.
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Repeat testing sometimes needed
Autonomic function can vary — a borderline study occasionally needs repeating on a different day.
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A smartwatch is not enough
Wrist-based heart rate is a screening prompt, not a diagnosis. Proper testing is different.
Reading your report
An autonomic report can look intimidating. It isn’t.
Whether an active stand alone or a full battery, the report keeps to the same four parts.
A quiet reminder
A borderline study does not mean you imagined the symptoms.
If you would like us to talk you through the report before your follow-up, just ask.
- 01 Header
Your symptoms and medications
The reason for testing, current medications, and anything paused for the study.
- 02 Technique
Which manoeuvres were performed
Active stand, tilt, Valsalva, deep breathing, sweat testing — each answers a different question.
- 03 Findings
Heart rate and blood pressure responses
The numeric responses to each manoeuvre, alongside symptoms recorded at the time.
- 04 Impression
The conclusion: read this first
Normal, POTS, orthostatic hypotension, vasovagal syncope, or small-fibre features — and what to do next.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about autonomic testing.
Quick answers on cost, referrals, medications, comfort and results.
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What is autonomic function testing?
A set of manoeuvres that measure how your heart rate and blood pressure respond to standing, breathing and the Valsalva effort. It looks at the nervous system that runs blood pressure, heart rate and sweating — the bit you do not consciously control.
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What is POTS?
Postural orthostatic tachycardia syndrome — a sustained rise in heart rate of at least 30 beats per minute within ten minutes of standing (40 in teenagers), without a drop in blood pressure, alongside symptoms of orthostatic intolerance.
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Is this different to what my smartwatch shows?
Yes. A smartwatch can prompt the conversation, but wrist-based heart rate is not diagnostic and does not measure blood pressure beat-to-beat. Formal testing uses continuous ECG and a beat-to-beat BP cuff in a controlled setting.
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How much does autonomic testing cost in London?
An active stand test with a basic screen is £250–£500. A full tilt-table is £600–£1,200 and a full autonomic battery £900–£1,800. We confirm a firm figure within one working day.
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Do I need a referral?
Most centres accept self-referral for autonomic testing. If you would like the result interpreted in a consultation, we arrange a consultant appointment alongside the test.
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Do I need to fast?
No formal fast — a light meal is fine — but no caffeine for 24 hours and no large meal in the two hours before the test.
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Will I need to pause my medications?
Sometimes. Beta-blockers, ivabradine, midodrine and some antidepressants affect the trace. We give you a specific list once the clinic confirms your booking — never stop a medication without checking.
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How quickly will I get results?
An active stand test is often discussed on the day. Tilt-table and full battery reports take 3–10 days, because responses across multiple manoeuvres are analysed together.
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What does "borderline POTS" mean?
A response that only just meets, or narrowly misses, the diagnostic threshold. It usually means repeating the test on a different day, or looking harder at hydration, salt intake and deconditioning.
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When should I see a GP urgently instead?
Fainting during exercise, faints with chest pain or palpitations, a family history of sudden cardiac death, or any new severe symptoms — call your GP or 999 rather than waiting for autonomic testing.