Reynolds, G K, Lewis, D P, Richardson, A M et al. · Journal of internal medicine · 2014 · DOI
This study looked at patients with ME/CFS to see how many also have POTS (a condition where heart rate increases too much when standing). The researchers found that about 1 in 9 ME/CFS patients also had POTS, and these patients were younger, got sick more recently, and found it much harder to stand for long periods compared to ME/CFS patients without POTS.
Many ME/CFS patients experience POTS-like symptoms, and identifying this as a common comorbidity (affecting ~11% in this cohort) helps clinicians recognize and screen for it. Understanding that CFS-POTS patients form a distinct subgroup with different haemodynamic characteristics may lead to more targeted, personalized treatment approaches and better recognition of which patients may benefit from POTS-specific interventions.
This study does not prove that POTS causes ME/CFS or vice versa—only that they frequently occur together. The cross-sectional design means we cannot determine whether autonomic dysfunction leads to fatigue or whether chronic fatigue itself produces autonomic changes. Results are limited to this Australian clinic population and may not generalize to all ME/CFS patients globally.
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
Reynolds, G K, Lewis, D P, Richardson, A M, & Lidbury, B A (2014). Comorbidity of postural orthostatic tachycardia syndrome and chronic fatigue syndrome in an Australian cohort.. Journal of internal medicine. https://doi.org/10.1111/joim.12161
BibTeX
@article{mecfsatlas-reynolds-2014-comorbidity-postural,
author = {Reynolds, G K and Lewis, D P and Richardson, A M and Lidbury, B A},
title = {Comorbidity of postural orthostatic tachycardia syndrome and chronic fatigue syndrome in an Australian cohort.},
journal = {Journal of internal medicine},
year = {2014},
doi = {10.1111/joim.12161},
note = {PubMed: 24206536},
url = {https://www.mecfsatlas.com/evidence/reynolds-2014-comorbidity-postural},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/reynolds-2014-comorbidity-postural
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