Lipoedema and POTS
As explored in our previous blog, ‘Lipoedema & Co-Existing Conditions’, living with lipoedema often involves more than just the isolated changes in body shape, swelling, and discomfort. In addition to many other potential co-existing conditions, many individuals with lipoedema experience symptoms such as dizziness, rapid heart rate, fatigue, brain fog, temperature intolerance, and feeling unwell when standing for prolonged periods.
These symptoms can be consistent with a condition known as Postural Orthostatic Tachycardia Syndrome (POTS), a form of autonomic nervous system dysfunction. While not everyone with lipoedema will experience POTS, these conditions often co-exist. Understanding the overlap can help guide comprehensive management of both conditions.
What is POTS?
Postural Orthostatic Tachycardia Syndrome (POTS) is a type of dysautonomia, meaning it affects the autonomic nervous system – the system responsible for regulating automatic body functions such as heart rate, blood pressure, circulation, digestion, and temperature control.
POTS can affect people differently, with symptoms ranging from mild to severe and often fluctuating over time. When someone with POTS stands, their autonomic nervous system has difficulty adjusting to the change in posture, leading to an excessive increase in heart rate and reduced blood flow to the brain and other organs. This can cause a wide range of symptoms affecting multiple body systems.
Common symptoms include:
- Rapid heart rate, palpitations, and/or chest discomfort
- Dizziness or light-headedness upon standing or when standing for long periods
- Fatigue that worsens with upright posture
- Brain fog and reduced concentration
- Exercise intolerance
- Shortness of breath
- Near-fainting or fainting episodes
- Heat intolerance and symptoms worsening in warm environments
- Digestive symptoms such as nausea, abdominal pain, bloating, and bladder/bowel changes
- Fatigue and weakness, often worsening with activity or prolonged standing
- Vision changes such as blurred or light-sensitive vision
- Sweating abnormalities, either excessive or reduced
Symptoms often improve when lying down and may fluctuate day to day depending on hydration, heat, illness, stress, and activity levels.
What is the Connection Between POTS and Lipoedema?
Although there is currently no evidence that lipoedema directly causes POTS, the two conditions appear to occur together more frequently than would be expected by chance. Researchers believe this may be because they share several underlying features that can affect circulation, connective tissue, and the autonomic nervous system. These shared mechanisms may increase the likelihood of some people developing both conditions.
Potential links include:
- Connective tissue changes and hypermobility, which can make blood vessels more elastic and less able to return blood efficiently to the heart
- Venous pooling, where blood collects in the legs when standing, reducing blood return to the heart and contributing to dizziness and a rapid heart rate
- Altered vascular function, affecting the body’s ability to constrict blood vessels and maintain normal blood pressure during changes in posture
- Autonomic nervous system dysfunction, which can impair the body’s automatic regulation of heart rate, blood pressure, and circulation.
- Fatigue and exercise intolerance, which are common in both conditions and may reflect these shared physiological changes.
This overlap is particularly important to recognise because symptoms such as dizziness, light-headedness, brain fog, palpitations, and feeling faint when standing are not typically explained by lipoedema alone. Identifying co-existing POTS can lead to more targeted management of both conditions.
How is POTS Managed?
While there is no cure for POTS, there are some treatments which can help to manage symptoms and improve quality of life. Strategies focus on a combination of lifestyle changes, supportive therapies, and medications.
Key management strategies include:
1. Lifestyle modifications (first-line) – can help stabilise symptoms and improve daily functioning
Avoid triggers such as heat, prolonged standing, alcohol, caffeine, and stimulants
Maintain regular sleep and consistent eating routines
2. Hydration – boosting fluid and salt intake helps expand blood volume and improve circulation
Increase fluid intake to about 2–3 litres per day
Increase salt intake to around 10 g/day (under medical supervision)
Electrolyte drinks can be useful
3. Compression garments – apply gentle pressure to the legs and lower abdomen to support blood flow and reduce blood pooling
Ideally with coverage from waist to ankle and with 20mmHg of pressure
A compression garment assessment and individualised prescription is required for those experiencing both POTS and lipoedema
4. Exercise and movement – muscle contractions help push blood back up to your heart, which can reduce symptoms like light-headedness, fatigue, and brain fog
Focus on gradual, tailored activity (often starting with recumbent or seated exercise)
Aim to improve muscle strength and daily function
Pacing is important to avoid symptom flares
- Consult a physiotherapist for an individualised exercise program
5. Medications (if needed)
Used when lifestyle changes don’t improve your symptoms
May include drugs to improve blood vessel tone, reduce heart rate, or increase blood volume
6. Complementary strategies
Some people find benefit from breathing exercises, mindfulness, humming/singing, and vagal nerve–supportive techniques
These are supportive, not primary treatments
Speak with your healthcare team before starting new therapies, especially if you’re unsure how your body may respond
Overall approach: POTS is managed through a personalised, multi-layered plan combining lifestyle measures, symptom-targeted treatments, and sometimes medication, with the goal of improving daily function and quality of life.
When Should You Seek Assessment?
If you have lipoedema and are also experience the above symptoms, you should discuss this with your healthcare team. These symptoms do not automatically indicate POTS, but they may warrant further assessment for autonomic dysfunction, circulatory issues, or other contributing factors.
In Summary
Lipoedema and POTS are distinct conditions, but they may overlap in some individuals through shared mechanisms involving connective tissue function, vascular regulation, and autonomic nervous system control.
While research is still evolving, awareness of this overlap is increasing, and recognising symptoms beyond swelling alone is an important step in comprehensive care. With appropriate assessment and individualised management, including compression, pacing strategies, and circulatory support, many people can achieve meaningful improvements in daily function and quality of life.
References
Australian POTS Foundation. (2026). Postural Orthostatic Tachycardia Syndrome (POTS) information and resources.
Peebles, K. C., et al. (2024). Exercise and hypermobility in postural orthostatic tachycardia syndrome: a scoping review. Macquarie University / Autonomic Neuroscience.
Seeley, M.-C., et al. (2025). Postural orthostatic tachycardia syndrome in Australia: symptom burden and diagnostic journey. Medical Journal of Australia
Disclaimer
This content is general in nature and provided for educational purposes only. It is not a substitute for individualised medical advice, diagnosis, or treatment. If you have concerns about symptoms or your health, consult a qualified healthcare professional.
