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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.

A stethoscope on a clinical desk

Indicative pricing

What private autonomic function testing costs in London.

Indicative ranges across UK private providers.

In short

A stand test with a basic screen: £250–£500; a tilt-table £600–£1,200.

Test Indicative range
Active stand test + basic autonomic screen £250–£500
Head-up tilt table test £600–£1,200
Full autonomic battery £900–£1,800
POTS work-up £700–£1,400
Autonomic + sweat testing £1,000–£2,000
Follow-up autonomic review £250–£500

Prices vary by clinic, panel of manoeuvres, and whether sweat testing or consultant review is included.

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.

  • Fainting or near-fainting?

    A tilt-table reproduces the episode safely, in a monitored setting.

  • Wrist HR rising on standing?

    A formal active stand or tilt is what separates POTS from deconditioning.

  • Long-COVID dizziness?

    POTS is common post-COVID. A targeted screen tells you whether you have it.

What it shows

Find the test that matches your symptom.

Autonomic symptoms differ enormously in pattern. These are the most common questions.

  • POTS

    Postural orthostatic tachycardia - a sustained heart-rate rise on standing, without a drop in blood pressure.

  • Vasovagal syncope

    The most common cause of fainting - reproduced safely on the tilt table.

  • Orthostatic hypotension

    A sustained drop in blood pressure on standing - a classic autonomic red flag.

  • Recurrent unexplained faints

    When ECG and cardiology have been clear, autonomic testing is the next step.

  • Small-fibre neuropathy screen

    Cardiovagal and sudomotor tests pick up small-fibre involvement missed by standard nerve studies.

  • Diabetic autonomic neuropathy

    Detects early autonomic involvement in long-standing diabetes.

  • Parkinson’s autonomic features

    Blood pressure, sweating and heart-rate responses inform Parkinsonian diagnoses.

  • 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.

  • Active stand test

    Simple, quick - heart rate and blood pressure recorded lying, then over ten minutes standing.

  • Head-up tilt table test

    The reference test for unexplained faints, with beat-to-beat BP and continuous ECG.

  • Full autonomic battery

    Combines tilt, Valsalva, deep breathing and, where indicated, sweat testing.

  • POTS work-up

    Structured protocol for postural orthostatic tachycardia, with a symptom diary and hydration review.

  • Autonomic + sweat testing (QSART)

    Adds quantitative sudomotor axon reflex testing for small-fibre and sweating disorders.

  • Cardiovagal reflex tests

    Deep breathing and Valsalva manoeuvre - the classic parasympathetic screen.

  • Diabetic autonomic screen

    Focused panel for people with long-standing diabetes and suggestive symptoms.

  • Post-COVID autonomic screen

    Tailored panel for long-COVID dysautonomia - POTS is common in this group.

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.

  • 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.

  • Hydration and food

    Well hydrated on the day, but keep to a light meal only.

  • Avoid caffeine

    No coffee, tea, cola or energy drinks for 24 hours before the test.

  • Medication pause

    Some drugs are paused before testing - check with the clinic first, do not stop anything without advice.

  • Compression stockings

    Bring your compression stockings if you use them, so the test can be done with and without.

  • Interpreted with a symptom diary

    The trace only makes sense alongside what you feel and when - keep a diary in the run-up.

  • Not diagnostic on their own

    Autonomic tests support a diagnosis; they do not make one in isolation from your history.

  • Repeat testing sometimes needed

    Autonomic function can vary - a borderline study occasionally needs repeating on a different day.

  • 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 UK consultant reviewing an autonomic function trace

A quiet reminder

A borderline study does not mean you imagined the symptoms.

If anything is unclear, ask the reporting clinician to talk you through the report before your follow-up.

  1. 01 Header

    Your symptoms and medications

    The reason for testing, current medications, and anything paused for the study.

  2. 02 Technique

    Which manoeuvres were performed

    Active stand, tilt, Valsalva, deep breathing, sweat testing - each answers a different question.

  3. 03 Findings

    Heart rate and blood pressure responses

    The numeric responses to each manoeuvre, alongside symptoms recorded at the time.

  4. 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

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Frequently asked

Common questions about autonomic testing.

Quick answers on cost, referrals, medications, comfort and results.

  • 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.

  • 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.

  • 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.

  • 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.

  • Do I need a referral?

    Most centres accept self-referral for autonomic testing.

  • 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.

  • Will I need to pause my medications?

    Sometimes. Beta-blockers, ivabradine, midodrine and some antidepressants affect the trace. The clinic will give you a specific list once your booking is confirmed - never stop a medication without checking.

  • 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.

  • 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.

  • 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.

Related tests

Looking for a different test?

In practice, in London

Where autonomic function sits in a private London pathway

With autonomic function, the London question is usually about report turnaround and the radiologist reading it - not whether the scan is available. The NHS route for autonomic function is thorough, but the queue is real. Many patients are told to expect anywhere from a handful of weeks to several months, depending on their local trust and how the referral is graded. Going private in London can often shorten that window to a matter of days - often the same week if the diary allows. It isn’t about jumping a queue so much as buying time back while you still have the flexibility to plan around it.

In practice, a private autonomic function appointment in London means a named consultant, a proper hour in the room (or the equivalent on a video call), and a report you can actually read. Many imaging suites and endoscopy units sit within a mile of Harley Street or in Chelsea and Fulham, and turnaround on findings is measured in days, not weeks. For autonomic function specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.

Honesty about expectations is part of the job. A private autonomic function appointment in London won’t change the underlying medicine - the guidelines, the consultants, and the equipment are largely the same as on the NHS. What it changes is speed, continuity, and the amount of time you get to actually talk through the findings. Check that any consultant you see is on the GMC specialist register and that the facility is registered with the CQC.