Does Salt Help If You Have POTS? Understanding Sodium's Role

December 4, 2025 •

4 min read

People with Postural Orthostatic Tachycardia Syndrome (POTS) are known to have lower blood volume, a key factor contributing to their symptoms. For this reason, many patients are advised to increase their salt and fluid intake to help alleviate their condition.

Quick Summary

Increasing salt intake is a common, expert-backed strategy for managing POTS symptoms like dizziness and fatigue. It helps the body retain fluids, which boosts blood volume and supports circulation when standing up.

Key Points

Increase blood volume: Salt helps the body retain more fluid, which expands blood volume and can mitigate symptoms caused by low blood volume.
Improve orthostatic tolerance: Higher blood volume supports better circulation when standing, reducing the severity of dizziness, lightheadedness, and fainting spells.
Work with a doctor: A high-salt diet should be tailored to individual needs and implemented under a healthcare provider's supervision, especially for those with coexisting conditions.
Drink plenty of fluids: Increased salt must be accompanied by higher fluid intake, typically 2-3 liters per day, for maximum effectiveness.
Consider supplement options: For some, salty snacks are not enough, and salt tablets or electrolyte drinks may be necessary to reach target sodium intake levels.
Monitor side effects: Be aware of potential side effects like bloating or blood pressure changes and report them to your doctor.

The Connection Between Salt and POTS

For individuals with Postural Orthostatic Tachycardia Syndrome (POTS), the body's autonomic nervous system fails to regulate blood flow properly, especially upon standing. This can cause blood to pool in the lower extremities, leading to reduced blood flow back to the heart and brain. In response, the heart rate increases significantly to compensate, triggering hallmark POTS symptoms such as dizziness, lightheadedness, and palpitations. A key issue underlying this response is often a lower-than-normal blood volume, also known as hypovolemia.

How Sodium Increases Blood Volume

Sodium plays a critical role in fluid balance within the body. When salt (sodium chloride) is consumed, it helps the body retain more water. This retention of fluids directly increases total blood volume, giving the heart more blood to circulate. With a higher circulating blood volume, the orthostatic challenge of standing is better tolerated, and the body does not need to rely as heavily on a rapid heart rate to compensate. Research, including a study published in the Journal of the American College of Cardiology, has shown that a high-sodium diet can increase plasma volume and decrease standing heart rate in POTS patients compared to a low-sodium diet.

Recommended Salt and Fluid Intake

Expert consensus and guidelines for POTS patients often recommend a significantly higher daily salt intake than for the general population, provided there are no contraindications like kidney disease or hypertension. Recommendations typically range from 3,000 to 10,000 mg of sodium per day, or up to 10-12 grams of salt. It is crucial to remember that salt (sodium chloride) is not the same as sodium. As a reference, one teaspoon of salt contains approximately 2,300 mg of sodium. Patients should also pair this increased salt intake with adequate fluid consumption, often suggested to be 2-3 liters of water or other hydrating fluids per day. Increasing fluid and salt together is essential for maximizing the benefit.

Methods for Increasing Sodium

Patients can increase their sodium intake through various methods:

Dietary Sources: Incorporating naturally salty foods into your meals can be a simple approach. Examples include pickles, olives, broth, salted nuts, soy sauce, and high-sodium cheeses.
Salt Tablets: For those who cannot get enough sodium through diet, salt tablets or capsules like Vitassium or Thermotabs can be prescribed by a doctor. These offer a concentrated, easy way to manage intake, though some patients may experience gastrointestinal upset.
Electrolyte Drinks: Many patients benefit from drinking electrolyte-rich beverages or oral rehydration solutions (ORS) throughout the day. These drinks provide sodium and other important electrolytes like potassium, which is also crucial for fluid balance.
Cooking Adjustments: Generously seasoning food at home is another practical way to boost sodium levels.

Potential Risks and Considerations

While high-salt diets are beneficial for many POTS patients, they are not suitable for everyone. It is imperative to consult with a healthcare provider before making significant dietary changes.

Who Should Be Cautious?

Individuals with pre-existing conditions that can be worsened by high sodium should approach this treatment with care. This includes patients with:

Hypertension (High Blood Pressure): A high-salt diet is a known risk factor for elevated blood pressure in the general population. While some POTS patients have low blood pressure, others, particularly those with hyperadrenergic POTS, may experience high blood pressure, especially when lying down.
Heart or Kidney Disease: These conditions can be negatively impacted by excessive fluid and salt retention. Medical supervision is essential.
Gastrointestinal Issues: Some patients with sensitive stomachs or comorbidities like gastroparesis may find that large doses of salt or salt tablets cause bloating, cramping, or nausea.

Low Salt vs. High Salt for POTS Patients


Outcome	Low Salt Diet (Normal population standard)	High Salt Diet (POTS management)
Blood Volume	Reduced	Increased
Heart Rate	Higher, especially standing	Lower, steadier
Symptoms	More dizziness, fatigue, and orthostatic intolerance	Fewer episodes reported by many patients
Norepinephrine	Elevated	Reduced

Conclusion

For many people with POTS, increasing salt intake is a safe and effective dietary strategy to manage symptoms by boosting blood volume and improving orthostatic tolerance. This approach is widely recommended by experts and backed by research. However, it is a management technique that must be personalized and implemented under the guidance of a qualified healthcare provider. Factors such as a patient's specific POTS subtype, overall health, and reaction to sodium must be considered. By combining increased salt with adequate fluids and other lifestyle adjustments, many patients can achieve a better quality of life. For further resources, consider exploring the materials provided by the non-profit organization Dysautonomia International. Dysautonomia International

Finding the right balance is key

Navigating dietary needs with a complex condition like POTS requires careful attention to individual responses. While salt is a potent tool, it's not a one-size-fits-all solution. Monitoring your symptoms and working closely with your doctor ensures you find the right balance that supports your health without causing unwanted side effects.

Consistency is crucial

The benefits of increased salt intake for POTS management often depend on consistency. Making increased sodium and fluid consumption a regular part of your daily routine, rather than an occasional fix, can lead to more stable symptom control over time. Consider strategies for integrating salty foods and drinks consistently throughout the day.

Other lifestyle factors matter

Salt is just one part of a comprehensive POTS management plan. Combining a high-salt diet with other lifestyle adaptations—such as wearing compression garments, avoiding prolonged standing, and staying hydrated—can provide synergistic benefits and more effective symptom relief. A holistic approach is often the most successful.

Frequently Asked Questions

Expert guidelines often suggest a daily sodium intake of 3,000 to 10,000 mg for adults with POTS, significantly more than for the general population. The exact amount varies by individual and should be determined with a doctor.

Salt helps the body retain water, which increases blood volume. This higher blood volume improves blood circulation and reduces the body's need to drastically increase heart rate to compensate when a person stands up, thereby lessening symptoms like dizziness and fatigue.

Yes. Table salt is sodium chloride, while sodium is the specific electrolyte that aids fluid retention. While often used interchangeably, it is the sodium content that matters for fluid balance. One gram of salt is roughly 400 mg of sodium.

Potential risks include increased blood pressure, especially for those with a pre-existing tendency toward hypertension or the hyperadrenergic POTS subtype. It can also cause gastrointestinal upset or bloating in some individuals.

Salt tablets are an effective way to boost sodium intake but should be used under medical supervision. They can sometimes cause stomach issues, so it's important to find what works for you, including possibly incorporating more salty foods.

You can add more salt to your food, use salty snacks like pickles or broth, and incorporate electrolyte drinks. Some find it helpful to front-load their intake in the morning to combat overnight dehydration.

Not necessarily. While increased sodium is a cornerstone of management for many, it depends on the individual and their specific POTS subtype. For example, a high-salt diet might not be suitable for those with hypertension. Always consult your doctor.

Salt intake must be paired with sufficient fluids for it to be effective. A common recommendation is to drink 2-3 liters of fluids daily, including water and electrolyte-rich drinks. Maintaining this balance is key to increasing blood volume.