Postural Orthostatic Tachycardia Syndrome (POTS) can significantly impact daily life, causing a rapid increase in heart rate upon standing, leading to dizziness, lightheadedness, and even fainting. While POTS can affect anyone, it is more prevalent among females aged 15-50. Dietary modifications, particularly a high sodium diet, along with increased fluid intake, have emerged as potential strategies to alleviate POTS symptoms. This article explores the role of a high sodium diet in managing POTS, providing practical tips and insights to help individuals navigate this dietary approach effectively.
Understanding POTS and Its Symptoms
POTS is characterized by an excessive increase in heart rate (typically 30 beats per minute or more) within 10 minutes of standing up from a lying or sitting position. This occurs because less blood returns to the heart upon changing positions. Common symptoms include:
- Dizziness
- Lightheadedness
- Fainting
- Fatigue
- Nausea
- Brain fog
- Palpitations
The Role of Diet in Managing POTS
Dietary changes can play a crucial role in managing POTS symptoms. Eating more salt and drinking more fluids may help with POTS symptoms. A gluten-free or low FODMAP diet might also help with certain symptoms.
Increasing Fluid Intake
Reduced blood volume is a common issue for individuals with POTS. Experts recommend drinking 2-3 liters (68-101 ounces) of fluids daily to combat this. Staying adequately hydrated is essential for maintaining blood volume and supporting overall cardiovascular function. Here are some practical tips for increasing fluid intake:
- Start the day with hydration: Drink a glass of water as soon as you wake up.
- Use a water-tracking app: Monitor your daily fluid intake to ensure you meet your goals.
- Drink before meals: Have a glass of water before each meal to increase your fluid consumption.
- Replace other drinks with water: Opt for water instead of sugary beverages or caffeine.
- Keep water accessible: Carry a reusable water bottle and keep it within reach throughout the day.
- Hourly hydration: Aim to drink one glass of water per hour while at work or during other activities.
If you feel faint, drinking 2 cups (480 milliliters) of cold liquid may help boost your blood pressure and lower your heart rate. However, it's essential to consult with a doctor, especially if you have heart or kidney disease, before significantly increasing your fluid intake.
Read also: High-Fiber Diet for Better Health
Embracing a High Sodium Diet
Several studies suggest that increasing salt intake can help alleviate POTS symptoms. A recent study involving 27 participants found that those with POTS who followed a high sodium diet experienced fewer symptoms. Salt helps the body retain water, increasing blood volume and potentially reducing the severity of POTS symptoms.
Recommendations for daily salt intake for people with POTS vary from 6-20 grams. Since salt is about 40% sodium, this equals about 2.4-8 grams of sodium. Given that this is significantly higher than the American Heart Association's recommendations, it's crucial to consult with a doctor before making significant changes to your sodium intake, especially if you have pre-existing heart or kidney conditions.
Practical Ways to Increase Sodium Intake
Incorporating more sodium into your diet doesn't have to be complicated. Here are some salty snack ideas:
- Pickles
- Olives
- Salted nuts and seeds
- Popcorn
- Cheese
- Anchovies
- Smoked fish
- Miso
- Sauces such as cheese or gravy
The Importance of Potassium
The body manages its electrolyte levels through a balance of ratios, and one important ratio is between sodium and potassium. Increasing sodium and water intake may help manage your symptoms, but sufficient potassium intake is also necessary. The body always wants to maintain a balance of sodium and potassium; therefore, if potassium levels are too low, sodium absorption through the digestive system may be inhibited.
Meal Timing and Composition
Large, carbohydrate-rich meals can exacerbate POTS symptoms by diverting blood to the digestive tract. To mitigate this, consider the following:
Read also: Delicious High-Fiber Smoothie Recipes
- Smaller, More Frequent Meals: Experts recommend eating five to six small meals a day to maintain steady energy levels and reduce nausea, a common POTS symptom. Eating smaller meals can help you keep your energy level steady. It can also help if you experience nausea, a common POTS symptom.
- Balanced Macronutrient Intake: Base your meals around vegetable or animal protein and smaller amounts of whole-grain carbohydrates like brown rice, sweet potato, or seeded bread such as rye. Reducing simple carbohydrates and replacing them with protein and fiber can help.
- Limit Refined Carbohydrates: Avoid refined carbohydrates like white bread and pasta, as they can worsen POTS symptoms.
Addressing Gastrointestinal Issues
Many individuals with POTS experience gastrointestinal (GI) problems such as nausea, vomiting, bloating, diarrhea, and constipation. Common gastrointestinal (GI) problems include:
- nausea
- vomiting
- bloating
- diarrhea
- constipation
Some experts recommend a gluten-free or low FODMAP diet to manage these symptoms. You could try eliminating certain foods from your diet to see which ones trigger POTS symptoms.
Foods to Avoid
In addition to refined carbohydrates, you may want to avoid alcohol and fizzy beverages, as they can worsen POTS symptoms.
Salt vs. Sodium
Although the words “salt” and “sodium” are often used interchangeably, they do not mean the same thing. We most commonly associate the term “salt” with “table salt” or “sodium chloride”. However, they are not the same! For example, 1 gram of salt (1,000 milligrams) contains 400 mg of sodium.
Supplementing Sodium Intake
Sodium intake can be increased to 3g to 10g daily using ordinary table salt (1 tsp. is approximately 2.3g sodium), salt capsules such as Vitassium, or electrolyte solutions. The exact amount of sodium and hydration increase can change from patient to patient and can vary between symptom severity. Some Vitassium consumers take as few as two capsules per day, which translates to 500mg of extra sodium. Others take more than eight per day, which equates to more than 2,000mg of extra sodium.
Read also: Explore the pros and cons of a high metabolism diet
Not all salt is created equal. If you’ve been told to increase your sodium, you may have noticed that high amounts of salt (i.e. In contrast, Vitassium capsules are specifically made for people with POTS and sensitive stomachs. Vitassium capsules are buffered, non-GMO, vegan, gluten free, preservative free, allergen free, soy free, and starch free.
Electrolyte Supplement Brands
Here is a side-by-side comparison of some of the popular electrolyte supplement brands available. None of these is endorsed or recommended by either Jeannie Di Bon or Lorna Ryan. Remember, it is always best to speak with your provider about how much sodium is needed for your particular symptoms.
When looking at supplements, you may want to compare the amount of electrolytes per serving, the cost, taste, and any ingredients that may not suit you.
- Vitassium Capsules (US/UK/Europe/Can/Mex/Aus/NZ)\Per serving: 500 mg sodium and 100mg potassium (2 capsules)\Cost per serving: USD $0.48 (100 capsules for $23.99) or $0.40 (200 capsules for $39.99)\Price per 500mg: USD $0.48\Ingredients: Sodium chloride, potassium citrate, hypromellose (vegetable capsule), vegetarian stearic acid
- Vitassium Fast Chews (US/UK/Europe/Can/Mex/Aus/NZ)\Per serving: 125mg Sodium, 25mg Potassium\Price per 500mg: USD $1.12\Cost per serving: USD: 60 tablets per bottle, $16.99 per bottle $0.28 (USD) per chew\Ingredients: Sodium citrate, potassium citrate, dextrates, dextrose, citric acid, stearic acid, natural fruit punch (orange, lemon, grapefruit) & raspberry flavors, crospovidone, silica, magnesium stearate, Reb A (stevia extract).
- LMNT Powder (US/UK/Canada/Aus)\Per serving: 1000 mg Sodium, 200mg Potassium\Cost per serving: USD $1.50 (one-time purchase) or $1.30 (subscribe and save)\Price per 500mg: USD $0.75\Ingredients: Salt (Sodium Chloride), Citric Acid, Magnesium Malate, Potassium Chloride, Natural flavors, Stevia leaf extract (with variations for flavors)
- Liquid IV Powder (US, Australia, Canada, China, Mexico, Italy, and the UK)\Per serving: 510mg Sodium, around 380mg Potassium (varies by flavor)\Cost per serving: USD $1.56 (one-time purchase) or $1.09 (subscribe and save)\Price per 500mg: USD $1.53\Ingredients: Cane Sugar, Dextrose, Citric Acid, Salt, Potassium Citrate, Sodium Citrate, Natural Flavors, Dipotassium Phosphate, Silicon Dioxide, Stevia Leaf Extract, Vitamin C, Vitamin B3, Vitamin B5 ,Vitamin B6, Vitamin B12
- Buoy Drops (US, but ships internationally)\Per serving: 50mg Sodium, 15mg Potassium\Cost per serving: USD $0.33 (one time) or $0.28 (subscribe and save)\Price per 500mg: USD $3.30\Ingredients: Sea minerals (Sodium, Chloride, Potassium, Magnesium, 87 ionic trace minerals (proprietary blend) and B vitamin complex and antioxidants
- Redmond ReLyte Hydration Powder\Per serving: 810 mg Sodium, 400mg Potassium\Cost per serving: USD $0.75 (one time) or $0.64 (subscribe and save)\Price per 500mg: USD $0.46\Ingredients: Redmond Real Salt, essential electrolytes (sodium, potassium, chloride, calcium, magnesium), coconut water powder, non-GMO citric acid, and natural flavors, with stevia leaf extract.
- Bulk Unflavoured Electrolyte Powder (UK and Europe)\Per serving: 517 mg sodium\Cost per serving: £0.10/serving to £0.06/serving\Price per 500mg: £0.10\Ingredients: Sodium Chloride, Potassium Sulphate, Dicalcium Phosphate, Magnesium Oxide.
- Sodii Powder (Australia)\Per serving: 1000mg sodium, 210 mg potassium\Cost per serving: AUD $2.23\Price per 500mg: AUD $1.12\Ingredients: Varies by flavor
Cautions and Considerations
Research is limited and does not give any insight into the long-term effects of a high salt diet. However, it is well documented that people with cardiovascular and kidney diseases should not be on a high sodium diet, and that high sodium diets may cause issues with high blood pressure, the cardiovascular system, kidneys, and stomach.
Other Factors Aggravating POTS
Besides diet, several other factors can aggravate POTS symptoms:
- Getting overheated
- Eating refined carbohydrates like white bread
- Being dehydrated or not drinking enough
- Exercise
- Getting your period
- Resting too much
- Pregnancy
- Trauma
- Viral illness
- Major surgery