Many patients with “idiopathic POTS” are misdiagnosed, and suffer with ineffective treatments because of this misdiagnosis. Some patients are told they have “presumed mitochondrial disorders” (muscle biopsies and genetic tests are negative, but patients present with most of the symptoms of mitochondrial disorders). Others are told they have lupus or Sjogren’s syndrome, despite an inability to locate evidence of an autoimmune condition beyond symptomology. Many are diagnosed with Mast Cell Activation Syndrome yet POTS persists after treatment. A closer look at these patients can reveal the hidden underlying cause of symptoms and proper treatment can then reverse these presentations.