While used for a variety of things, one main use of the tile table test (TTT) is to rule in/out issues with the body’s autonomic nervous system. That’s because one important automatic function that all bodies should do is respond to gravity, and make sure that a person has blood flow to the brain regardless of if they are laying down, sitting, or standing. Whether it’s orthostatic hypotension, postural orthostatic tachycardia syndrome (POTS), autonomic failure, or other conditions, the TTT can offer valuable insight into the nuance of any disruptions, and informs what treatment might be best. 

What is the test itself?

I have had the TTT through my local neurology office, and also during my Mayo Clinic autonomic evaluation. Both were similar, and I’m only speaking from experience (not as a professional, nor to speak to industry standard). 

I thought the tilt table is a neat setup, kind of like a motorized recliner, except it’s a bed/table that goes from horizontal, to upright at an angle, without the patient moving. While I tend to be a little nervous during any sort of medical testing, this is one that I have found to provide a lot of insight while being non-invasive and fairly approachable. After laying on the bed, I was outfitted with a blood pressure cuff around my arm, a beat-to-beat blood pressure monitor on my finger, a pulse oximeter on another finger, and ekg sticky patches on my chest. Lots of cables and cords – lots of data! 

After being set up, the tests commenced with the table being gently raised at the head, and lowered at the feet. Because I was dealing with untreated POTS, this simple maneuver caused symptoms (like fainting and blood pooling), high heart rate (from 77bpm to 128bpm), and arrhythmias (irregular heartbeats) that ultimately confirmed my diagnosis. One test was 10 minutes, and the other was 30 minutes, and both were “positive.” They were also accompanied by additional autonomic tests, such as the valsalva maneuver and QSART which gave us an even better picture of what might be going on. 

It was a great idea to have my mom drive me to my appointments, because I did faint with one of them, and was pretty symptomatic the rest of the day for both. While it’s never fun to have worse symptoms, I was grateful to have the opportunity to run tests that could ultimately get me on the path to recovery. 

Note of encouragement:

If you’re anticipating an upcoming tilt table test and feeling nervous, I want to clap and say “You’ve GOT this!” While I’m sorry that you are going through health issues that have brought you to this point, I’m proud of you, and that you’re seeking help and engaging in the journey towards stability and wellness. I know it’s not easy, and not every test provides clarity, but I pray that you would be encouraged, strengthened, and be at peace as you navigate the coming days. 

Have you had a tilt table test? How did your experience differ? Feel free to comment below!