Do people with Ehlers Danlos need more salt? Understanding the link with POTS

October 24, 2025 •

4 min read

Up to 80% of individuals with hypermobile Ehlers-Danlos Syndrome (hEDS) also experience Postural Orthostatic Tachycardia Syndrome (POTS), a form of autonomic dysfunction. This common comorbidity often prompts the question: Do people with Ehlers Danlos need more salt? For many, increasing salt and fluid intake is a crucial, doctor-supervised strategy.

Quick Summary

Many individuals with Ehlers Danlos syndrome, particularly those with comorbid Postural Orthostatic Tachycardia Syndrome, may require a higher salt and fluid intake. This strategy aims to increase low blood volume and counteract blood pooling, helping to manage symptoms such as dizziness and fatigue.

Key Points

EDS often co-occurs with POTS: A high percentage of individuals with hypermobile EDS also have Postural Orthostatic Tachycardia Syndrome (POTS), which can cause symptoms like dizziness and a fast heart rate upon standing.
POTS is linked to low blood volume: The autonomic dysfunction in POTS, combined with lax connective tissue in EDS, often results in low blood volume and blood pooling in the legs.
Salt helps increase blood volume: Increased salt intake promotes water retention, which in turn boosts blood volume and helps raise low blood pressure.
Medical supervision is essential: Increasing salt is not suitable for everyone, particularly those with high blood pressure, and should only be undertaken with guidance from a healthcare provider.
Hydration and electrolytes are key: Adequate fluid intake is just as important as increased sodium. Electrolyte supplements or even homemade solutions can help maintain proper fluid balance.
Methods include diet and supplements: Sodium intake can be increased through specific food choices (like broths or canned beans), electrolyte supplements, or adding salt to drinking water.

The Autonomic Dysfunction Connection in EDS

Ehlers-Danlos Syndromes (EDS) are a group of inherited connective tissue disorders that can affect multiple systems in the body. For those with the hypermobile type (hEDS), a common comorbidity is autonomic dysfunction, a malfunction of the nervous system that controls involuntary bodily functions. The most frequently cited form of this is Postural Orthostatic Tachycardia Syndrome (POTS).

POTS is characterized by an abnormal increase in heart rate that occurs when moving from a lying or sitting to a standing position, which can cause symptoms like lightheadedness, palpitations, dizziness, and fatigue. The underlying mechanism for this in many EDS patients is often attributed to issues with blood volume and vessel elasticity. The compromised connective tissue in EDS can lead to laxer blood vessels, which impairs their ability to constrict effectively. As a result, blood can pool in the lower body upon standing, leading to a decrease in blood volume circulating to the heart and brain, a condition known as hypovolemia.

The Crucial Role of Sodium and Hydration

This is where salt and proper hydration become critical. Sodium plays a key role in regulating fluid balance in the body. When salt intake is increased, it causes the body to retain more water, thereby expanding the overall blood volume. For individuals with EDS-related POTS and hypovolemia, this can directly counteract the effects of blood pooling and low blood pressure. By increasing circulating blood volume, more blood can be pumped to the brain, alleviating symptoms like dizziness and brain fog upon standing.

Benefits of increased salt intake

Increases Blood Volume: Helps address the low blood volume (hypovolemia) common in POTS.
Raises Blood Pressure: Aids in counteracting orthostatic hypotension, or the rapid drop in blood pressure upon standing.
Reduces Venous Pooling: Promotes vasoconstriction to lessen blood pooling in the legs.
Alleviates Symptoms: Can reduce instances of lightheadedness, dizziness, and fatigue.

Important Considerations and Contraindications

While beneficial for many, increasing salt intake is not a universal recommendation for all EDS patients. It is vital to consult with a healthcare provider before making any significant dietary changes. For individuals with normal or high blood pressure, increasing salt could be harmful. A doctor can help determine the appropriate intake based on your specific symptoms and other health conditions.

General vs. EDS/POTS Patient Salt Intake


Feature	General Population	Individuals with EDS/POTS (with doctor approval)
Standard Recommendation	General health guidelines often suggest limiting sodium intake	Medical guidance may recommend higher sodium intake for symptom management
Goal of Intake	Minimize risk of high blood pressure and heart disease	Increase blood volume to manage POTS symptoms
Who Should Practice	Healthy individuals without specific medical needs for higher sodium	Patients with EDS and confirmed POTS, especially those with low blood pressure
Key Caveat	Guidelines are for healthy individuals; may vary based on health status	Must be individualized and medically supervised; contraindicated for those with high blood pressure

Practical Methods for Incorporating More Salt and Fluids

Working with your medical team, you can explore various ways to increase your daily sodium intake and improve hydration. This isn't just about salty snacks; a balanced and considered approach is best.

Oral Rehydration Solutions (ORS): Electrolyte powders, tablets (like Vitassium Salt Stick), and sports drinks are effective ways to get a boost of sodium and other key electrolytes.
Salt Tablets: These provide a concentrated dose of sodium and can be taken throughout the day, as advised by a doctor.
Adding Salt to Water: Simply adding salt to your drinking water multiple times a day is a straightforward method.
Salty Foods: Incorporate more naturally salty or high-sodium foods into your diet, such as broths, canned beans, pickled vegetables, and roasted nuts.
Hydration with Glucose: Combining fluids with a small amount of glucose (sugar) can improve intestinal absorption of water and sodium.

It is also essential to ensure you are drinking sufficient fluids, with general recommendations for POTS patients often involving a significant daily intake. Proper hydration and sodium intake go hand-in-hand to effectively manage symptoms associated with dysautonomia.

Conclusion

For many individuals with Ehlers-Danlos Syndrome, particularly those experiencing the symptoms of comorbid POTS, a medically supervised increase in salt and fluid intake is a cornerstone of symptom management. The goal is to raise low blood volume, mitigate the effects of blood pooling, and stabilize blood pressure, thereby reducing distressing symptoms like dizziness and fatigue. However, this therapeutic approach is highly individualized and must be discussed with a healthcare provider to ensure it is appropriate and safe, especially for those with low blood pressure. Combining increased salt and fluids with other lifestyle modifications like compression wear and specialized exercise can form a comprehensive strategy for improving daily functioning and quality of life.

For more detailed information on living with Ehlers-Danlos syndrome, consider visiting The Ehlers-Danlos Society: https://www.ehlers-danlos.com/.

Frequently Asked Questions

Many people with EDS have a comorbid condition called Postural Orthostatic Tachycardia Syndrome (POTS), which causes low blood volume. Increased salt intake helps the body retain more water, thus increasing blood volume and raising blood pressure to manage symptoms like dizziness.

No, increasing salt is not safe for all EDS patients. It is crucial to have a consultation with a healthcare provider, as it is contraindicated for individuals with high blood pressure, heart disease, or kidney problems.

By increasing blood volume, a higher salt intake helps counteract blood pooling in the lower extremities when standing. This ensures more blood flows to the brain, which can reduce symptoms such as lightheadedness, fatigue, and fainting.

While general population guidelines suggest limiting sodium intake, many doctors may recommend a higher intake for EDS/POTS patients to help manage symptoms. The precise amount must be personalized and medically supervised.

You can increase salt intake through a variety of methods, including consuming salty foods like broths and pickles, adding salt to drinking water, or using electrolyte powders and salt tablets, all under a doctor's supervision.

Yes, hydration is crucial. Salt and fluid intake go hand-in-hand. For salt to effectively increase blood volume, a sufficient fluid intake is often recommended for those with POTS.

Self-medicating with higher salt intake without a doctor's guidance can be dangerous, especially if you have normal or high blood pressure, or underlying heart or kidney conditions. Always consult a healthcare professional first.