What Should Happen to Your Heart Rate When You Stand Up
One of the many functions of the vagus nerve is it’s involvement in heart rate. And in these current times, with the explosion of cases of POTS (postural orthostatic tachycardia syndrome), I thought it would be a good time to look at what is SUPPOSED to happen with your heart rate when you stand up (from lying or sitting).
And if you have a smart watch? It would be handy to use it to check yourself.
Let’s start with normal responses, and then I’ll give you some hints about what an abnormal response might mean. As always, this does not replace medical advice, nor can it provide you with a diagnosis.
When you move from lying down to standing, gravity pulls blood down toward your legs. While lying down, your blood is spread more evenly through the body.
Standing from a seated position does the same thing but on a smaller scale, as gravity is already working on your body being vertical. However, if you have been sitting for a long time, then your body will have adapted to this position, and standing causes a temporary shift in blood pressure.
Your nervous system’s job is to detect this shift in posture, and respond quickly so your brain stays well-perfused.
This response is coordinated by:
Baroreceptors (pressure sensors)
The autonomic nervous system
Vagal withdrawal followed by sympathetic support
This process is called the orthostatic response.
A Typical, Healthy Heart Rate Pattern
1. Immediate Rise (First 10–15 seconds)
Heart rate increases by ~10–20 beats per minute
This is normal and expected
It reflects temporary vagal withdrawal to maintain blood pressure
The vagus nerve typically decreases blood pressure so we want it to withdraw it’s function temporarily to enable an increase in blood pressure, to push the blood up to the head
Note - no rise in heart rate, or a larger spike in heart rate, is informative something isn’t quite right
2. Early Stabilisation (30–60 seconds)
Heart rate should stop climbing
It may remain slightly elevated compared to lying down
Breathing should feel natural
No dizziness, pressure, or visual disturbance
This is where vagal–sympathetic coordination matters. The sympathetics boost your heart rate and blood pressure to get the blood where it needs to be. The vagus kicks back in so that the higher heart rate and blood pressure is not maintained, and tries to pull it back to a natural baseline.
3. Return Toward Baseline (1–3 minutes)
Heart rate should begin trending back toward baseline
Often settles within 5–10 bpm of resting
You should feel “normal” standing - not effortful
It doesn’t have to return to exact lying heart rate. Standing is still more demanding. So we aren’t looking for the same baseline heart rate as if you were lying down.
You might even like to start by measuring your resting heart rate lying down, sitting, and standing (when you know it’s stable), as a guidepost.
What variations can mean
Larger spike (20–30+ bpm)
Possible contributors:
Dehydration
Deconditioning
Reduced vagal tone
High stress load
Overactive sympathetics - fight/flight system
Recent illness
Important nuance:
A large spike that settles quickly is very different from one that doesn’t.
Continued rise beyond 60 seconds
This can suggest:
Poor autonomic coordination - ie your vagus nerve is not kicking in as it’s supposed to
Baroreceptor underperformance
Increased sympathetic drive to maintain blood pressure - your fight/flight systems are ON and kicking on
This pattern is often seen in people who:
Crash after activity
Feel worse the longer they’re upright
Struggle with pacing programs
Very slow return to baseline (3–5+ minutes)
This suggests:
Reduced recovery capacity - your vagus nerve CAN kick in but it’s slow, possibly low tone, or burnt out
High nervous system cost for upright posture - this could be due to hypermobility, low muscle tone, vestibular dysfunction, cerebellum dysfunction.. the reasons are many and go beyond this blog post
Exercise may feel disproportionately draining
This is about capacity, not pathology. You have probably been checked and told everything is FINE. Or maybe not.. maybe you’ve got chronic fatigue syndrome, or fibromyaglia, long covid or POTS.
Minimal or no heart rate change
To be fair, this is very rare and near-on impossible. You’d have to have an overactive vagal or parasympathetic response, OR a completely burnt out sympathetic system that cannot cope with any additional stressors.
This can reflect:
Rigid autonomic response
Reduced adaptability
Sometimes (but rarely) seen in highly stressed or chronically dysregulated systems
Usually it would mean the heart rate baseline is already too high for the system.
Symptoms that matter more than the number
Heart rate data should always be paired with sensation. You might find you get symptoms at different heart rates to others. And that’s because we are all so different.
I have tracked my own heart rate and notice there are two distinct times I personally get a ‘whoosh’ in my head. I make note of these - because one of them I know I can push through and be ok, and the other I know I’m at my limit. So you can use your heart rate to link to symptoms, and play around with it. Don’t be afraid to challenge it every now and then as well!
Pay attention to:
Lightheadedness
Pressure in the head
Shortness of breath
Anxiety or internal buzzing
Needing to brace or hold breath
If you have these symptoms, or any others that I’ve missed, make note of the patterns with your heart rate.
I’d also recommend if you DON’T have these symptoms, but you are struggling to recover after exercise, that you test your heart rate with standing. Perhaps it’s an early sign your vagus nerve isn’t working as well as it could be..
Why this matters for exercise readiness
Standing is already a stress test. Many nervous systems struggle to cope with this alone. Imagine adding exercise on top of that - especially weights, or anything involving straining or bending/straightening the trunk.
If your system struggles to transition upright, stabilise heart rate, and recover? Then adding exercise intensity often compounds stress instead of building resilience. You might find you’re pushing yourself far too hard for what your nervous system can cope with.
Exceeding nervous system capacity might feel like struggling to recover afterwards. Maybe thinking “why am I so unfit, I push so hard but never progress”.
The key is progressing in a way that supports your nervous system, rather than your muscular system. You will start to grow your capacity to handle gravity, changes in body position, and THEN and only then, do you start focusing on building muscle strength.
Working within your nervous system capacity (or only just pushing the limit of capacity), rather than boom and bust cycles, are really going to help you get through this season and back to what you love doing.
Important Clarifications
These ranges describe common patterns, not strict rules
Medications, hydration, illness, menstrual cycle, and sleep all influence results
This information does not diagnose POTS or dysautonomia
It simply helps you understand how much work your nervous system is already doing.
The Return to Movement Protocol
In the Return to Movement Protocol, we use this response to determine how and when to layer movement - not whether you’re ‘allowed’ to exercise.”
