Postural Orthostatic Tachycardia Syndrome, or POTS, is a condition that affects the body’s autonomic nervous system — the system responsible for controlling automatic body functions such as heart rate, blood pressure, and blood flow. When people with POTS stand up, their heart rate increases sharply, and they may feel dizzy, light-headed, or even faint.
For many patients, small daily choices—like how much water or salt they consume—can make a big difference. One of the most discussed lifestyle changes for POTS management is increasing dietary sodium (salt) intake. But why does salt matter so much? Let’s explore the science behind it, how it helps, and what patients should know before making changes.
1. Understanding How Salt Affects the Body
Sodium is an essential mineral that helps the body maintain fluid balance, nerve signaling, and muscle function. It plays a vital role in regulating blood volume and blood pressure.
When you eat salt, your body retains more water to balance the sodium levels in your bloodstream. For most healthy individuals, too much salt can lead to high blood pressure.
However, in POTS patients, the problem is often the opposite — low blood volume and poor circulation when standing.
This means that for people with POTS, extra salt can actually help by expanding blood volume and improving blood flow to the brain when they stand up.
2. Why Blood Volume Matters in POTS
In POTS, one of the main issues is that blood tends to pool in the lower part of the body (legs and abdomen) instead of circulating efficiently back to the heart and brain. This can cause symptoms like:
- Dizziness or fainting when standing
- Rapid heart rate (tachycardia)
- Fatigue or weakness
- “Brain fog” or trouble concentrating
- Nausea and shortness of breath
A higher sodium intake, combined with adequate fluids, helps the body retain more water, increasing the amount of blood in circulation. This, in turn, can reduce heart rate fluctuations and improve how patients feel throughout the day.
3. What Research Says About Sodium and POTS
Several studies have explored how salt and fluid intake affect POTS symptoms:
- Johns Hopkins University and other research centers have found that increasing sodium to 3–10 grams per day can help expand plasma volume and stabilize blood pressure in patients with orthostatic intolerance.
- A 2018 study in the Journal of the American College of Cardiology showed that a high-sodium diet improved blood volume and reduced heart rate increase upon standing in POTS patients.
- Clinical guidelines often recommend both high sodium and high fluid intake as first-line, non-pharmacological strategies for symptom management.
These studies suggest that dietary changes can complement medical therapy, helping many patients feel better without increasing medication doses.
4. How Much Sodium Is Considered “High”?
For healthy adults, the recommended daily sodium limit is usually around 2,300 mg per day (roughly one teaspoon of salt).
For people with POTS, doctors may recommend 3,000 to 10,000 mg of sodium per day depending on the patient’s age, body weight, and other medical conditions , as directed by your healthcare provider or under medical supervision.
This does not mean adding spoonfuls of table salt blindly; rather, sodium can come from specific sources such as:
- Electrolyte drinks designed for POTS or athletes
- Salt tablets prescribed by a physician
- Broths or soups made with added salt
- Canned vegetables or tomato juice with sodium content
- Pickles or olives in moderation
It’s important to spread the intake throughout the day instead of consuming a large amount at once. Drinking water consistently alongside salt helps your body maintain a balanced fluid level.
5. Practical Tips for Increasing Sodium Safely
If your healthcare provider recommends higher sodium intake, here are some safe and simple ways to implement it:
- Start Gradually – Increase your sodium by small amounts over a week or two. This helps your body adjust without causing bloating or discomfort.
- Pair With Hydration – For every gram of sodium, drink roughly 250–500 mL (one to two cups) of water.
- Choose Smart Sources – Use electrolyte packets or drinks instead of processed junk food. Avoid adding sodium through chips or instant noodles, which contain unhealthy additives.
- Track Your Intake – Read nutrition labels. Many healthy foods like cottage cheese or soups already contain sodium.
- Monitor Your Symptoms – Keep a journal to note how your heart rate, dizziness, or energy levels respond to sodium adjustments.
Always discuss any changes with your healthcare provider before making dietary adjustments.
6. When High Sodium Might Not Be Suitable
Although salt can be helpful for many POTS patients, it’s not safe for everyone.
You should avoid increasing sodium intake—or do so only under supervision—if you have:
- High blood pressure (hypertension)
- Kidney disease or reduced kidney function
- Heart failure
- Liver disease
- Severe swelling (edema)
In these cases, too much salt can put extra strain on your heart and kidneys. Your doctor might recommend other ways to manage POTS symptoms, such as compression garments, exercise therapy, or specific medications.
7. Balancing Sodium with Other Lifestyle Changes
Increasing salt is just one part of managing POTS effectively. Other supportive measures include:
Adequate Hydration
Aim for 2 to 3 liters of water per day, or as your doctor recommends. Combine with electrolyte drinks for better absorption.
Physical Conditioning
Light exercises like recumbent cycling, swimming, or yoga can improve circulation and reduce deconditioning.
Compression Garments
Waist-high compression stockings help prevent blood from pooling in the legs.
Balanced Diet
Ensure you get enough potassium, magnesium, and B-vitamins, which support nerve and muscle function. Include fruits, vegetables, lean protein, and whole grains.
Rest and Stress Management
Fatigue and stress can worsen symptoms. Good sleep hygiene and relaxation techniques like breathing exercises may help improve daily function.
8. The Role of Personalized Care
Every POTS patient is unique. Some may respond dramatically to high-salt diets, while others see little change or experience side effects like bloating or headaches.
That’s why personalized medical supervision is crucial. Doctors who specialize in Dysautonomia often combine dietary recommendations with medications such as fludrocortisone, midodrine, or beta-blockers—depending on each patient’s needs.
Working with a healthcare professional who understands POTS ensures that sodium recommendations are safe, effective, and customized.
9. Common Myths About Salt and POTS
Myth 1: “More salt is always better.”
Reality: There is an upper limit. Excessive sodium can still raise blood pressure or strain kidneys, especially if not balanced with fluids.
Myth 2: “You can replace salt with sports drinks.”
Reality: Most commercial sports drinks contain too little sodium for therapeutic use. Specialized electrolyte mixes designed for POTS patients are more effective.
Myth 3: “Salt alone can cure POTS.”
Reality: Salt helps manage symptoms but does not address underlying causes. Treatment should include medical evaluation, lifestyle adjustments, and sometimes medication.
Final Thoughts
For many living with POTS, the journey toward stability can feel overwhelming. The body’s reactions may seem unpredictable, and even simple tasks like standing or walking can be exhausting. Yet, with the right guidance and lifestyle changes, improvement is possible.
Adjusting dietary sodium intake is one of the simplest yet most powerful ways to support your body’s circulation. When paired with medical supervision, it can lead to fewer dizzy spells, steadier heart rates, and a noticeable boost in daily energy.
If you or someone you love is living with POTS, talk to your healthcare provider about how sodium and fluid management could fit into your care plan.
You deserve to feel understood, supported, and empowered in your journey toward better health.
