McDonald, Claire, Koshi, Sharon, Busner, Lorna et al. · BMJ open · 2014 · DOI
This study looked at 136 people in the UK with postural tachycardia syndrome (PoTS)—a condition where your heart rate increases too much when you stand up—and found that it causes serious tiredness and functional problems, especially in young women. The researchers compared two groups of PoTS patients and found their symptoms and quality-of-life impacts were similar to those in people with chronic fatigue syndrome (ME/CFS). Importantly, there was no consistent treatment approach across patients, with some taking no medication and others on different drug combinations.
This study demonstrates that PoTS causes substantial functional impairment comparable to ME/CFS, validating the serious impact of autonomic dysfunction on quality of life. For ME/CFS researchers, it highlights the overlap in symptom burden between these conditions and underscores the need for better understanding of shared mechanisms and optimized treatment protocols for both disorders.
This study does not establish causation or mechanisms underlying PoTS or its relationship to ME/CFS—it only documents symptom associations in two populations. The cross-sectional design cannot determine whether symptoms cause functional impairment or vice versa, nor does it evaluate treatment efficacy or identify which interventions work best for individual patients.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
McDonald, Claire, Koshi, Sharon, Busner, Lorna, Kavi, Lesley, & Newton, Julia L (2014). Postural tachycardia syndrome is associated with significant symptoms and functional impairment predominantly affecting young women: a UK perspective.. BMJ open. https://doi.org/10.1136/bmjopen-2013-004127
BibTeX
@article{mecfsatlas-mcdonald-2014-postural-tachycardia,
author = {McDonald, Claire and Koshi, Sharon and Busner, Lorna and Kavi, Lesley and Newton, Julia L},
title = {Postural tachycardia syndrome is associated with significant symptoms and functional impairment predominantly affecting young women: a UK perspective.},
journal = {BMJ open},
year = {2014},
doi = {10.1136/bmjopen-2013-004127},
note = {PubMed: 24934205},
url = {https://www.mecfsatlas.com/evidence/mcdonald-2014-postural-tachycardia},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/mcdonald-2014-postural-tachycardia
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