Orthostatic Intolerance
POTS, Dizziness, and Orthostatic Intolerance in Hypermobility
This page isn't medical advice. We're not clinicians, and it's meant to summarize research you can take into a conversation with a doctor, not replace one. Lightheadedness or dizziness when standing up is common enough among people with hEDS/HSD that it's become one of the more studied overlaps between hypermobility and POTS (postural orthostatic tachycardia syndrome).
The two conditions aren't the same thing, and not everyone with one has the other. But the overlap is well-documented enough that it's worth understanding what's actually been measured.
How Common Is POTS in hEDS and Hypermobility?
A 2020 study by Miller and colleagues looked at 91 people diagnosed with POTS and found that 28 of them (31%) also met clinical criteria for hEDS. That's a meaningful minority, not a majority. It's also a different figure from other dysautonomia statistics you might see elsewhere for hEDS in general: this one specifically describes how many POTS patients also qualify for an hEDS diagnosis, not the reverse.
Do Compression Garments Help POTS-Related Dizziness?
A 2021 randomized controlled trial published in JACC (Bourne et al., n=30) tested abdominal and lower-body compression during tilt-table testing, which deliberately provokes orthostatic symptoms under monitored conditions. Heart rate during tilt averaged 109±19 bpm with no compression, compared to 92±14 bpm with full compression. The study reported that difference as statistically significant (p<0.001). A 2026 follow-up study (n=25) using commercial abdominal compression garments found similar reductions in heart rate and improvements in symptoms, both immediately after putting the garment on and after several hours of wear.
These are among the more rigorously tested interventions on this site: a randomized design, tilt-table measurement, and a follow-up study replicating the effect with commercially available garments.
Other Approaches to Orthostatic Dizziness
The research in this area also points to fluid and electrolyte strategies and graded, recumbent exercise programs (exercise done lying down or reclined before progressing to upright positions) as management approaches. These involve individual medical judgment: how much fluid or sodium is appropriate varies by person and by other health conditions. That's something to work out with a doctor rather than a general guideline to follow on your own.
Compression Products: What's Actually Been Tested
The compression used in the trials above was medical-grade, waist-high, in the 20-30+ mmHg range. That's the kind of pressure gradient found in brands like Jobst and 2XU, a meaningfully different product than everyday shapewear. Some patients report using Spanx as a lower-cost substitute, but that's an anecdotal, off-label use we haven't found tested in any study. It may or may not provide comparable pressure or placement, and it hasn't been evaluated the way the medical-grade garments above have.
What to do with this
If standing brings on dizziness, a racing heart, or lightheadedness, that's worth describing to your doctor in detail: when it happens, how long it lasts, and whether it eases when you sit or lie down. A tilt-table test is the standard way POTS is formally evaluated, and it's reasonable to ask whether that's appropriate for you.
If compression is something you're considering, ask about being fitted for medical-grade compression rather than guessing at pressure and coverage yourself. The trials above used specific, measured garments, and the benefit was tied to that specificity.
Sources referenced on this page
- 01Miller et al., 2020 — cohort study, n=91 POTS patients
- 02Bourne et al., JACC, 2021 — randomized controlled trial, n=30, tilt-table testing
- 03Follow-up study, 2026 — n=25, commercial abdominal compression garments (link not yet sourced)