POTS. Hydration first.

Most POTS apps fixate on the heart-rate chart and skip the part that actually moves your day — getting enough fluid and sodium in. Leo flips the order. The hub leads with hydration, then surfaces your symptoms, your cycle phase, and the labs you're asked about, all on one screen.

Status · in app today·Engine · descriptive, on-device·Not · a tilt-table replacement
The condition

A form of dysautonomia with a heart-rate signature.

Postural Orthostatic Tachycardia Syndrome is defined by a sustained heart-rate rise of at least 30 beats per minute (40 for adolescents) within ten minutes of standing — in the absence of orthostatic hypotension. That definition is medical and it's the part most apps get fixated on. The lived condition is broader: brain fog, fatigue, blood pooling, exercise intolerance, heat sensitivity, chest discomfort, the post-shower crash.

Management leans heavily on three non-pharmacological levers — fluid (about 2 to 3 L/day for most adults), sodium (3 to 10 g/day, prescribed individually), and graded exercise. The hub is built around the first two. Exercise programs and clinical decisions belong with a cardiologist or autonomic specialist.

Sources · Vernino S et al. “Postural orthostatic tachycardia syndrome (POTS): State of the science and clinical care.” Auton Neurosci. 2021. · Dysautonomia International, “What is POTS?” (2024).
The core feature

Fluid and sodium — with your goals on it.

Open the hub and the first thing you see is two rings — fluid intake and sodium — against the goals you set. Defaults are 3000 mL of fluid and 5000 mg of sodium per day, which match the upper ends of the common POTS protocols. Edit them to whatever your specialist asked for. The rings update the moment you log.

Logging is preset-driven. You can either tap one of your saved presets, or quick-add from the catalog of intake types Leo recognizes:

Water

Plain water — the baseline.

Electrolyte drink

Anything containing measured electrolytes. You enter the sodium per serving.

Salt tablet

Capsule sodium. Log each dose and the mg.

Broth

Bone broth, vegetable broth — count the sodium.

IV saline

If you receive scheduled or as-needed IV fluids, log volume and any sodium.

IV Lactated Ringer's

Same — volume and any electrolyte contribution.

Subcutaneous fluid

For folks who receive SubQ hydration at home.

Enteral feed

Tube-feed contribution to your daily totals.

TPN

Parenteral nutrition entries get logged here too.

Branded products (LMNT, NormaLyte, Vitassium, Liquid IV, etc.) aren't pre-loaded — you save the ones you actually use as personal presets with their exact sodium and volume. Your shelf, your numbers.
Symptoms & episodes

Thirteen POTS-specific symptoms and three quick-start episodes.

The POTS pack pre-loads 13 symptoms so you're not scrolling a generic library to find the right one. Each log captures severity (1–10), timestamp, and any tags you want to attach — triggers, foods, context. The hub also has one-tap buttons for the red-flag events — log episode, log pre-syncope, and log syncope — that open the flare sheet with the right symptom already checked so you can capture them in the moment.

Symptom set

Tachycardia · Dizziness · Pre-syncope · Syncope · Brain fog · Fatigue · Palpitations · Chest discomfort · Tremor · Nausea · Exercise intolerance · Blood pooling · Heat intolerance

Three episode templates let you start a flare-log with the right symptoms already selected:

Standing episode

Pre-fills the symptom set most commonly logged when symptoms hit on standing. One tap to start, severity and duration when it resolves.

Heat-triggered episode

Same pattern, weighted toward heat-driven flares — hot shower, summer afternoon, kitchen stove.

Post-exertional crash

The downstream version. Lets you log the crash separately from whatever caused it so they're not double-counted.

If you track a menstrual cycle, the current phase is read from the Cycle hub and surfaced on the POTS dashboard with a plain-English note — blood-volume changes during menstruation often worsen orthostatic symptoms, and seeing the phase next to your symptom load makes that pattern visible.
Labs pinned for POTS

Five panels right on your hub.

Most POTS workups include the same handful of panels. The POTS pack pins them to your hub so trends sit alongside your hydration rings and symptom log. You log them when you have them — usually right after a draw — and they stay visible. Out-of-range values are flagged.

CBC

Complete blood count — flags anemia and platelet trends that affect orthostatic tolerance.

CMP

Comprehensive metabolic panel — sodium, potassium, kidney function, glucose.

Thyroid

TSH at minimum. Thyroid disease overlaps with autonomic symptoms.

Iron studies

Iron, ferritin, TIBC — low iron drives fatigue and tachycardia.

Inflammatory markers

ESR, CRP — useful baseline if comorbid inflammation is suspected.

What it isn't

The list of things we'd like to ship, and haven't yet.

Most POTS apps describe features that don't exist and call it “the future of POTS care.” This page tells you exactly where the POTS surface stops today. Every item below is on the feature-parity tracker, and the page gets updated as items ship.

◦ Not yet
Guided in-app standing / NASA Lean test

A timed standing protocol with Watch-side HR auto-capture is on the list — Watch-connectivity scaffolding is in place. The user flow itself isn't shipped.

◦ Not yet
Levine / CHOP exercise protocol scheduler

Both Dallas-Levine and CHOP graded-exercise programs are well-established. Leo doesn't yet ship them as structured plans.

◦ Not yet
POTS-specific PDF report card

Standing-test trend, hydration compliance, symptom heatmap as one shareable document. Not yet.

◦ Not yet
Position-tagged HR overlay (lying / sitting / standing)

iOS HealthKit doesn't expose body posture natively. Doable with custom Watch logic but not built yet.

◦ Not yet
Compression-garment logger

Compression at 20–30 mmHg is part of many POTS plans — Leo doesn't yet track which garments you wore for how long.

◦ Not yet
Dysautonomia ER card

An offline emergency card explaining POTS to ER staff. There's an ER card surface for gastroparesis today; POTS version is next.

◦ Not yet
Branded supplement preset library

LMNT, NormaLyte, Vitassium, Liquid IV — you save your own presets with exact sodium per serving. A pre-loaded brand library would be a nice-to-have.

◦ Not yet
Weather / barometric correlation on the POTS hub

Weather signals exist elsewhere in Leo and are useful for autonomic patients; the POTS hub doesn't yet overlay them.

Leo doesn't diagnose POTS, doesn't replace a tilt-table test, and doesn't prescribe hydration targets. The hub describes what you've logged against the goals you (or your specialist) set. Clinical decisions belong with your team.
POTS hub

Track what you can actually move — fluid, sodium, symptoms.

Two rings on the hub, 13 symptoms in the pack, five labs pinned, and a backlog we name out loud. Built for adults and kids with POTS, and the families who pour the Liquid IV.