POTS symptom tracker template: a printable daily sheet
A POTS symptom tracker template is a one-page daily sheet with the same fields every day: salt and fluids against your targets, each symptom with its severity and trigger, medications taken, and the standing heart-rate test. Print the sheet below, fill one row per day for four weeks, and bring it to your appointment.
What a good POTS symptom tracker template records
Keep it small enough to fill on a bad day. These are the fields most POTS clinics ask about, in the order you would fill them:
- Date and sleep: hours slept and whether you woke unrefreshed.
- Salt and fluids: the amounts you actually had, next to the targets your clinician set with you.
- Symptoms: chosen from a fixed list (dizziness, brain fog, racing heart, fatigue, nausea, near-fainting or fainting), each with a 1 to 5 severity.
- Trigger: one main suspect (heat, standing, a large meal, a hot shower, exertion, your cycle, illness), or none.
- Medications: each scheduled dose ticked when taken.
- Stand test, if you do one: lying heart rate, standing peak, and the rise.
The printable template
Print this page (the sheet prints on its own, landscape works best). One row per day; a week per sheet.
| Day | Sleep (h) | Salt (g) / target | Fluids (L) / target | Symptoms (1–5) | Main trigger | Meds taken | Lying HR | Standing HR | Rise | Notes |
|---|---|---|---|---|---|---|---|---|---|---|
| Mon | / | / | ||||||||
| Tue | / | / | ||||||||
| Wed | / | / | ||||||||
| Thu | / | / | ||||||||
| Fri | / | / | ||||||||
| Sat | / | / | ||||||||
| Sun | / | / |
Severity scale, written down once: 1 = noticed it, carried on; 3 = had to slow down or sit; 5 = had to stop and lie down. Keep the same scale for the whole period.
How to fill it in so the weeks stay comparable
- Same time every day, ideally the evening, with the stand test in the morning before caffeine.
- Record what happened, not what it meant. "Hot day, stood in a queue, dizzy 4" is data; "flare from low salt" is a guess.
- Mark missed days as missed. Backfilling from memory bends toward the worst days.
- Never invent numbers. An empty heart-rate box is better than an estimated one.
From paper to a POTS symptom tracker app
Paper works, but the adding-up is the hard part: averages, how often symptoms land on low-salt days, the biggest standing rise in a month. A POTS symptom tracker app does that arithmetic for you. Upright logs the same fields as this sheet (salt and fluid rings, symptoms with a trigger, a medication checklist and the stand test) and turns 30 days into a one-page summary. See also how to keep a POTS symptom diary, the POTS heart rate chart and the appointment checklist.
Track it in Upright
Upright is a POTS app that keeps this record for you: salt and fluids, symptoms and triggers, medications and the stand test, with a 30-day summary for your doctor. Free to log, on your phone or in your browser. Learn more about Upright.
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