Postural Orthostatic Tachycardia Syndrome (POTS) is a condition affecting the autonomic nervous system, which controls involuntary bodily functions. Individuals with POTS often experience symptoms like lightheadedness, dizziness, and a rapid increase in heart rate upon standing. A common strategy for managing these symptoms involves increasing dietary salt intake.
Understanding POTS
In POTS, the autonomic nervous system, responsible for regulating functions like heart rate, blood pressure, and blood vessel constriction, does not function correctly. Normally, when a person stands, the body adjusts blood flow to ensure adequate circulation to the brain. In individuals with POTS, this adjustment is impaired.
When standing, gravity pulls blood into the lower extremities, leading to blood pooling. This pooling reduces the amount of blood returning to the heart and to the brain. Many people with POTS also experience hypovolemia, an abnormally low blood volume. This combination contributes to POTS symptoms, as the heart works harder, beating faster to compensate.
How Salt Helps People with POTS
Salt (sodium chloride) helps the body retain water. When sodium is consumed, it signals the kidneys to hold onto more fluid rather than excreting it. This mechanism is beneficial for people with POTS, as increased fluid retention increases overall blood volume.
A higher blood volume counteracts blood pooling upon standing, allowing more blood to return to the heart and flow to the brain. This expanded blood volume helps stabilize blood pressure and can reduce symptoms such as dizziness, lightheadedness, and fatigue. Studies indicate that a higher sodium diet can increase plasma volume and reduce the excessive heart rate response seen upon standing in POTS patients. This improved fluid balance supports the cardiovascular system, making it easier for the body to manage changes in posture.
Important Considerations for Salt Intake
Increasing salt intake for POTS is a medical strategy and requires healthcare professional guidance. The amount of salt needed varies among individuals, with recommendations ranging from 3,000 milligrams up to 10,000 milligrams of sodium per day, far exceeding typical dietary guidelines for healthy individuals. Salt and sodium are not the same; 1 gram of salt contains about 400 milligrams of sodium, so patients should clarify with their doctor whether recommendations refer to salt or sodium.
Alongside increased salt intake, consuming adequate fluids is also important, typically 2 to 3 liters per day, for proper hydration and blood volume expansion. Salt can be incorporated by adding extra table salt to food, consuming salty snacks like broth or pickles, or using salt tablets or electrolyte drinks. Oral rehydration solutions (ORS) are often recommended as they provide a balanced combination of electrolytes and glucose for efficient absorption. While salt tablets offer a convenient way to increase sodium, they must be taken with sufficient water to be effective and avoid stomach upset.