POTS When You Are Sick: A Cold and Flu Day Log

Updated 10 October 2026

A cold or flu can change a POTS day in ways that are hard to sort out afterward. Fever, tiredness, a blocked nose and a racing heart on standing can all arrive together, and a week later it is difficult to say which day was worst or when the usual pattern returned.

This guide sets out what Johns Hopkins Medicine, the Cleveland Clinic, NINDS and Dysautonomia International say about POTS and infections, then offers a table of the statements, a cold and flu day log, a list of words, four steps and a one-page summary. The guide records the things you notice and what clinicians tell you. A clinician decides what any symptom means for you, and nothing here advises on fluids, medicines or when to seek care.

What Johns Hopkins, the Cleveland Clinic, NINDS and Dysautonomia International say about POTS and infections

Johns Hopkins Medicine says POTS symptoms may also get worse when you get a common cold or an infection. Dysautonomia International, in a question-and-answer page with Dr. Raj, says it is common for people with POTS to have a temporary worsening of their POTS symptoms, including more heart racing, when they have any infection. (Source: dysautonomiainternational.org.)

The Cleveland Clinic says each case of POTS is different, that you may see symptoms come and go over a period of years, that you can develop POTS suddenly or gradually, and that symptoms happen immediately or a few minutes after sitting up or standing. A second Dysautonomia International page lists infections such as mononucleosis, Epstein-Barr virus, Lyme disease, extra-pulmonary Mycoplasma pneumonia and hepatitis C among the underlying conditions known to cause or be associated with POTS, and lists fatigue, headaches, lightheadedness, heart palpitations, nausea and syncope among the symptoms many people experience.

NINDS, in its page on fainting, says knowing the warning signs of fainting can help prevent falls.

These pages describe what is known for groups of people with POTS. They give no way to tell how a particular illness will affect you, what to do on a sick day or when to seek care. A clinician can answer those questions, and a dated log of what each sick day was like gives that conversation a factual base.

The wording matters when you take the pages to a visit. "May get worse" and "temporary worsening" describe a tendency seen in groups, and they leave open how long a worsening lasts, how large it is or whether it will happen to you. A log with dates lets the clinician see your own pattern for one illness and set it beside what the sources report.

A sick day often raises questions, and the Daily Journal of POTS Journey (by Health Journey Labs) can keep each one in your own wording until the visit.

Illness and POTS: what each source covers and what kind of statement it is

The sources speak to different parts of a sick day, and the table sets out who says what.

Illness sources table, by POTS Journey

The table shows that the sources agree on the direction: an infection can make POTS symptoms worse for a while. They differ in what they stress, from the temporary worsening to the long course and to the signs that come before a faint. None gives a figure or a threshold for your own illness, which is why a clinician is the one to interpret it.

Reading across the rows, only one source mentions timing within a day, the Cleveland Clinic, and it ties symptoms to sitting up or standing. That is why the log asks about standing separately from the illness itself: the cold or flu has its own symptoms, and standing has another set, and a clinician may want to see them in separate columns.

For note-keeping, the aim is to record what each day was like, in your words, and let your team interpret. The guide to starting to track POTS symptoms describes a light way to begin.

Each sick day's standing symptoms can be entered in the Daily check-in of POTS Journey, so the days of illness are listed in one place beside your usual days.

A cold and flu day log for POTS: illness symptoms, standing symptoms and clinician notes

One row for each sick day lets a clinician read the course of the illness in order. Below, the columns record what you noticed and what you heard.

Sick-day table, by POTS Journey

Write the day, what the illness felt like, what standing felt like, what you were told and your question while it is fresh. Mark a temperature or heart rate only if you measured it, as the device read it. When in doubt about an item, include it and let the clinician decide.

After the illness, read down the rows. A clinician may see when the standing symptoms rose, how they ran beside the cold and when the usual pattern returned, which a single appointment cannot show. The log notes what happened, and what it means is for the clinician. The guide to getting through a POTS flare day without losing notes describes a similar way to keep notes on a hard day.

The log's parts find their places in POTS Journey: the Daily check-in for each day's symptoms, the Daily Journal for what happened and My Care Team for what each clinician said.

Words for sick days with POTS: illness, standing and follow-up

A clinician will ask what the illness was like and how standing went, and a short list of words helps you answer in the same terms each time.

Words for sick days

On sick days, POTS Journey adds illness words next to standing ones.

• Illness words: sore throat, cough, blocked nose, fever, aching, tired, queasy.
• Standing words: dizzy, lightheaded, racing heart, nearly fainted, sat down, steady.
• Timing words: on standing, a few minutes after, all day, came and went, eased by evening.
• Follow-up words: called, seen, advice given, asked to report back, recovered.
• Anything else: the wording that feels right to you.

Pick the words that match the day and write them with the date. Where a word fits just partly, add quotation marks to remind yourself it was a best guess.

These words follow the statements in the sources: a worsening during illness, symptoms that follow sitting up or standing and the signs that come before a faint. A clinician might use different terms and can tell you which. Fainting, chest pain or trouble breathing is a reason for urgent contact with a clinician or the emergency number, and the log can wait.

Your own phrasing for each sick day can go into the Daily Journal of POTS Journey, dated, so a clinician hears the day as you lived it.

POTS after a cold or flu: four steps to prepare the visit

A visit after an illness covers many topics in a short time. These four steps give your log a clear place in the visit.

Steps to prepare for the visit, by POTS Journey

1. Fill the log with every sick day you recall, marking the days you are unsure of.
2. Mark the days when standing was hardest and the day the usual pattern returned.
3. Write a three-line summary: how the illness began, how standing went and when things settled.
4. Lead with the question about sick days, such as how much fluid and salt to aim for when a cold makes symptoms worse.

From POTS Journey, we recommend finishing the summary the day before the visit (POTS Journey checklist), so the log is current.

Say at the start that you have been keeping a sick-day log and hand over the page. Begin with the summary and let the clinician ask questions. If you took any measurements, bring them with their dates and mention any you could not take.

Keep the summary short. A page with the main days and three lines is easier to read than every row, and the full log stays available if the clinician wants more. The checklist of what to bring to a 15-minute POTS visit covers the rest of the preparation. Add any answers to the page, with the date, so you can pick up from what was said at the next visit.

By appointment day, POTS Journey already holds the sick days, standing episodes and questions in one history, so the three lines come from entries already made.

One summary page for the clinician: sick days, standing symptoms and your questions

A single page lets a clinician see how the illness went before the first question is asked.

Summary page for the clinician, by POTS Journey

• The day the illness began and the day it eased, as you recall them.
• How standing went on the worst days, in your words.
• Any measurements you took, with their dates, as the device read them.
• What you were told by any clinician, with the date.
• When your usual pattern returned.
• Two or three questions for this visit.

Pass the page across when you sit down and say what it covers. If the clinician suggests a plan, add it to the page with the date, so it travels with you. Retain a copy and record the answers on it under the clinician's name.

This page sets down what happened and what you were told. How the illness affected your POTS, what should be done on a sick day and when to seek care are for your clinician to decide, and the sources here describe groups without giving instructions. A tidy page makes the clinician's task easier.

A page of sick days, standing symptoms and questions comes out of the Doctor Report in POTS Journey for you to hand across, and My Care Team holds what each clinician said.

How POTS Journey can help

A day log on paper is enough to begin. If you want sick days, standing symptoms and visit questions in one dated history, the best POTS apps guide compares the options.

POTS Journey is a personal pots tracker from Health Journey Labs on the App Store and Google Play. A week of dated rows gives a follow-up visit more to work with than memory can. Your clinician makes the calls, and your log supplies the days, words and measurements as they happened. Below is what you can use and how each part helps.

• Daily check-in — Logs physical symptoms, emotional state, nutrition, sleep, exercise, meds, external factors; app-specific items: upright load, heart-rate context, heat, fluids, fog, recovery; read together with the rest of the logged history.
• Daily Journal — Logs free-text notes, voice entry; app-specific items: what upright time cost, heat context, partner talks, visit debriefs, leftover guilt after you canceled, a look-fine mismatch line; read together with scores and other logged history (adds context).
• Flare Tracker — Logs flag a day clearly worse than the usual hard week, onset, intensity, short note; app-specific items: upright dizziness, racing heart, heat crash, fog; read together with history across weeks (one-off spike vs repeating pattern).
• Weekly Goals — Logs one small aim, whether it held; read together with real check-ins.
• My Meds — Logs medicine names, timing, dose; app-specific items: options you already take as prescribed — fluids/salt plans your clinician set, compression notes, other treatments; read together with upright weeks, sleep, heat days, the rest of the tracked history.
• My Labs — Logs result dates; app-specific items: tilt-table notes, blood counts, iron, thyroid, other tests; read together with upright symptoms, fog, function.
• My Care Team — Logs clinicians, short visit notes; app-specific items: tends to ask mainly about heart rate rather than function; read together with logged history; used for: visit prep (what to ask and bring); notes during the visit; review afterward.
• Doctor Report — Logs one-page summary exported from logged history; app-specific items: dates, upright symptoms, heat, fluids, fog, how you functioned; read together with the history already logged; visit type: cardiology or neurology.
• Learn — Logs short education topics, prompts; app-specific items: upright load, heat, pacing, visit prep, upright symptoms on days that look fine; read together with your own logged weeks.
• AI companions — Logs Clara (general chat), specialist companions; app-specific items: knowledge, fitness, nutrition, relationships; read together with your logged history (companions already see it); used for: visit wording; a calm partner script; a soft rain-check line; a listening ear after a hard upright or heat day.
• Food Tracker — Logs meal or drink lines, caffeine, alcohol; read together with energy and symptoms.
• Weight Tracker — Logs scale or body notes; read together with the rest of the logged history.
• Period Tracker — Logs start and stop dates, flow, how heavy or light bleeding felt; read together with upright symptoms, fog, heat, everything else logged.
• My Assessments — Logs structured check-ins beyond daily scores, onboarding life and social context; read together with ongoing history.

Everything you log builds one history, and insights get stronger as it grows. Custom symptoms let you add your own labels.

Sources

• Johns Hopkins Medicine: postural orthostatic tachycardia syndrome
• Cleveland Clinic: postural orthostatic tachycardia syndrome
• NINDS: syncope
• Dysautonomia International: coronavirus and POTS Q&A with Dr. Raj
• Dysautonomia International: postural orthostatic tachycardia syndrome

FAQ

The answers below draw on the sources cited in this guide, and the app they mention is POTS Journey (by Health Journey Labs).