POTS (postural orthostatic tachycardia syndrome) and low blood sugar (hypoglycemia) can cause similar symptoms, including dizziness, shakiness, and fatigue. This overlap can make it difficult to tell what’s causing your symptoms, particularly if they occur after eating.

But is there a direct connection between POTS and blood sugar regulation, or do the two conditions simply share similar symptoms?

In this article, we explore what the research tells us about the possible connection, how to distinguish between symptoms, and when further investigation may be helpful.

What’s the connection between POTS and blood sugar?

Early research suggests there may be a connection between POTS and blood sugar regulation, but it’s not yet clear whether the condition directly affects blood sugar levels.

POTS affects the autonomic nervous system, which controls involuntary functions such as heart rate, blood pressure, and digestion. This system also helps regulate the release of insulin and other hormones involved in controlling blood sugar levels.

In a 2022 study, researchers found that people with POTS had reduced insulin sensitivity and increased levels of certain digestive hormones after consuming glucose. Their standing heart rate also increased, despite having similar blood sugar levels to participants without POTS. However, the study involved just 12 people with POTS, so the findings may not apply to everyone with the condition.

A small observational study involving 17 people with POTS found that some participants experienced substantial drops in blood sugar several hours after consuming glucose. This raises questions about a possible connection between POTS and reactive low blood sugar (hypoglycemia), but larger studies are needed to establish whether the two conditions are linked.

A more recent 2026 study also found a possible link between insulin levels and blood pressure in people with POTS. However, average blood sugar levels were similar in people with and without POTS.

What does this mean for you? Research suggests that POTS may affect how your body processes glucose, but this doesn’t necessarily mean your blood sugar is too high or too low. You can also experience symptoms that resemble low blood sugar, such as dizziness and shakiness, even when your blood sugar levels are normal.

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Why might POTS symptoms be mistaken for low blood sugar?

POTS and low blood sugar (hypoglycemia) can cause similar symptoms, including dizziness, shakiness, fatigue, and a rapid heartbeat. This overlap can sometimes make it difficult to distinguish between them.

For example, POTS can cause dizziness, weakness, and a rapid heartbeat when standing because blood pools in the lower body. Symptoms can also worsen after eating, particularly following large or carbohydrate-rich meals, as digestion affects circulation. Neither situation necessarily involves low blood sugar.

However, having POTS doesn’t rule out other conditions that can affect blood sugar levels, including:

• Diabetes: A condition that causes blood sugar levels to become too high
• Reactive hypoglycemia: A drop in blood sugar that occurs within a few hours after eating
• PMOS (polyendocrine metabolic ovarian syndrome): A condition commonly associated with insulin resistance and an increased risk of type 2 diabetes

If you experience new or unexplained symptoms, or have concerns about your blood sugar levels, speak to your doctor. They can assess whether blood glucose testing or further investigation is appropriate.

Keeping track of when symptoms occur, such as after standing or eating, can also provide useful information to discuss with your doctor.

Shared symptoms of blood sugar fluctuations & POTS

Because both POTS and blood-sugar changes affect circulation and energy balance, their symptoms can overlap. You might notice several of these sensations, especially after eating or standing for long periods.

1. Dizziness and lightheadedness

Feeling dizzy or faint is one of the most common POTS symptoms. Standing can cause blood to pool in the lower body, which reduces blood flow to the brain and leads to lightheadedness. When this happens after eating, it may feel similar to a blood-sugar drop and leave you unsteady or off balance.

2. Shakiness or trembling

When blood sugar falls, the body releases adrenaline to restore balance. That same adrenaline response can make POTS symptoms stronger, causing trembling, a faster heartbeat, or feelings of anxiety.

3. Fatigue after meals

Feeling tired or needing to rest after eating may be linked to how the body redirects blood to the digestive system. Some studies suggest that glucose intake can temporarily increase heart rate in people with POTS, which might explain the wave of fatigue that follows larger meals.

4. Rapid heartbeat

Both blood-sugar changes and POTS can raise your heart rate. When glucose levels shift quickly, stress hormones rise and may further speed up the heartbeat, adding to the circulatory changes already present in POTS.

5. Nausea or stomach discomfort

The autonomic nervous system helps control digestion, and in POTS it may not always function smoothly. This can slow stomach emptying and cause nausea or fullness after meals. When combined with blood-sugar changes, these effects can make eating feel uncomfortable.

Noting when these sensations occur (after eating, standing, or during stress) can help your healthcare provider understand patterns and guide next steps.

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Practical tips for managing symptoms after eating

Some people with POTS experience worsening symptoms after meals, even when their blood sugar levels are normal. Certain dietary changes may help reduce these symptoms, particularly if you notice a connection between what you eat and how you feel afterward.

1. Eat smaller, balanced meals

Large meals can worsen POTS symptoms because digestion redirects a significant amount of blood to the gut, causing more pooling and reduced circulation elsewhere.

Try smaller, frequent meals with a mix of protein, fiber, and healthy fats to support gradual blood sugar release and reduce fatigue after eating.

2. Focus on low-glycemic foods

Choose low-glycemic foods (such as oats, quinoa, lentils, leafy greens) that release glucose more steadily, helping prevent sudden rises and crashes in blood sugar that may trigger dizziness or brain fog.

3. Stay hydrated and add electrolytes

Adequate hydration plays a key role in POTS management. Drinking water regularly and using electrolyte solutions that are low in added sugar can help maintain blood volume and support circulation. This, in turn, may lessen tachycardia and pooling, two common POTS-related challenges.

4. Limit added sugars and processed carbs

Highly processed or sugary foods can trigger quick blood-sugar rises followed by sharp drops. For people with POTS, these swings may intensify feelings of shakiness, weakness, or fatigue.

Replacing them with whole foods (like fruit, vegetables, and complex carbohydrates) can help maintain steadier energy.

5. Track symptoms and triggers

Keeping a record of what you eat, how you feel afterward, and when symptoms appear can uncover helpful patterns over time.

Take control of your daily data. Start logging your meals and symptoms with the Human Health app today to better understand what triggers your POTS flares.

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Understand your symptoms with Human Health

Dizziness, shakiness, and fatigue can have several possible causes, including POTS and blood sugar problems. Understanding what’s behind your symptoms isn’t always straightforward, particularly if they occur after eating.

Keeping track of when symptoms occur, what you’ve eaten, and any other changes you notice can help you identify patterns worth discussing with your doctor.

With the Human Health app, you can log your symptoms, meals, and daily routines in one place, building a clearer picture of your experiences over time.

You can also export organized health summaries to share with your doctor, giving them useful information to guide further investigation and care.

Download the Human Health app to start tracking your symptoms and bring a clearer picture to your next appointment.

Frequently asked questions

Does treating blood sugar problems help with POTS?

If you have POTS alongside a condition that affects your blood sugar, managing that condition may help reduce overlapping symptoms, such as dizziness, shakiness, and fatigue. However, there’s limited evidence that treating blood sugar problems directly improves POTS itself.

If you suspect blood sugar fluctuations are contributing to your symptoms, speak to your doctor. They can assess whether testing or further investigation is appropriate.

Can POTS cause low blood sugar after eating?

It’s not yet clear whether POTS directly causes low blood sugar after meals. Some small studies have identified changes in glucose regulation in people with POTS, but the evidence is limited.

POTS symptoms can also worsen after eating, particularly after large or carbohydrate-rich meals, even when blood sugar levels remain normal. If you suspect you’re experiencing low blood sugar, your doctor can assess whether testing is appropriate.

Should people with POTS monitor their blood sugar?

Having POTS doesn’t automatically mean you need to monitor your blood sugar levels.

However, your doctor may recommend blood glucose testing if you have symptoms that suggest a separate blood sugar problem, risk factors for diabetes or another condition affecting glucose regulation.

Keeping a record of your symptoms, meals and when symptoms occur can provide useful information for your doctor when deciding whether further investigation is needed.

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Disclaimer: Human Health is a health tracking platform and does not provide medical advice, diagnosis, or treatment. The information on this site supports, not replaces, conversations with qualified healthcare professionals.

Sources:

Gut hormones in POTS and their relation to hemodynamic parameters and gastrointestinal symptoms (2026)

Worsening Postural Tachycardia Syndrome is Associated with Increased Glucose Dependent Insulinotropic Polypeptide Secretion (2022)

A retrospective observational-cohort study of the relationship between reactive hypoglycaemia to postural orthostatic tachycardia syndrome (PoTS) (2016)

Heart Rate, Autonomic Function, and Future Changes in Glucose Metabolism in Individuals Without Diabetes: The Whitehall II Cohort Study (2019)

Metabolic targets in the Postural Orthostatic Tachycardia Syndrome: A short thematic review (2024)

Association of Fasting Blood Glucose Levels in Patients with Postural Orthostatic Tachycardia Syndrome (POTS): A Study Stratified by Age Groups (2021)

Adrenaline: insights into its metabolic roles in hypoglycaemia and diabetes (2016)

Gastric Emptying in Postural Tachycardia Syndrome: A Preliminary Report (2013)

Postural Orthostatic Tachycardia Syndrome (POTS), John Hopkins Medicine

Autonomic control of energy balance and glucose homeostasis (2022)

Peripheral innervation in the regulation of glucose homeostasis (2020)

Diet and Fluids, PoTS UK 

Diagnosis and management of postural orthostatic tachycardia syndrome: A brief review (2012)

Nutritional Strategies to Help Manage POTS, Standing Up to POTS

Gut hormones in POTS and their relation to hemodynamic parameters and gastrointestinal symptoms (2026)

Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2023)

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