Skip to main content
Core view on Advanced sections are hidden so you can scan the shortest version of this page first.

Clinician handoff

Anxiety

Designed for a 60-second scan in primary care. Use this to explain why this theory fits, what would weaken it, and which tests are most worth discussing.

Why this still fits

I've been experiencing brain fog with racing heart and anxiety symptoms for [DURATION]. My GAD-7 score is [X]. Before accepting an anxiety diagnosis, I'd like to rule out POTS and thyroid issues.

What would weaken it

  • -Does your racing heart depend on your body POSITION (worse standing, better lying down)?
  • -Have you had unexplained weight changes and do you feel unusually hot or cold?
  • -Do you consume more than 2 cups of coffee daily, and does reducing caffeine help?
  • -When symptoms flare, do they reliably occur 1-3 hours after meals and improve when meal composition changes?

Key points to communicate

  • Most POTS patients are initially misdiagnosed with anxiety
  • My symptoms [are/are not] position-dependent - this is key
  • Hyperthyroidism causes identical symptoms to anxiety
  • Please separate metabolic, sleep, autonomic, and medication overlap before narrowing to one cause.

Tests and measurements to discuss

Need the fuller context? Use the test explainers for the measurement itself, or jump back to the tests section on the Anxiety page to see how the tests fit the whole pattern.

Orthostatic vitals / Tilt table test

What this helps clarify: Combined HR and BP measurements with position

Range context

Stable BP/HR

How to use the result

Save the result with date and symptoms from the same week.

Thyroid panel (TSH, Free T4, Free T3)

What this helps clarify: Active thyroid hormone that directly affects brain function

Range context

3.0–4.0 pg/mL

How to use the result

Save the result with date and symptoms from the same week.

Rule Out Medical Causes

Peer-reviewed references

  1. https://www.nice.org.uk/guidance/cg113
  2. https://doi.org/10.1176/appi.ajp.2009.09081168
  3. https://doi.org/10.3390/nu9050429
  4. NICE CG113; Heart Rhythm Society POTS Consensus 2015