How do you rehydrate with POTS? Your High-Salt Hydration Guide

January 5, 2026 •

4 min read

Research suggests many individuals with Postural Orthostatic Tachycardia Syndrome (POTS) experience hypovolemia, or low blood volume, making proper rehydration a critical component of symptom management. This guide explains exactly how do you rehydrate with POTS, focusing on increased fluid and electrolyte intake to expand blood volume and reduce orthostatic symptoms like dizziness and fatigue.

Quick Summary

Effectively rehydrating with POTS requires a high intake of fluids and sodium to address low blood volume, stabilize heart rate, and manage symptoms. Consistent sipping of electrolyte-rich drinks and salty foods is key.

Key Points

Increase Fluid and Sodium Intake: Many POTS patients have low blood volume (hypovolemia) and require more fluid and salt than average to effectively manage symptoms.
Sip Frequently, Don't Gulp: Consistently sipping electrolyte-rich fluids throughout the day is more effective and easier to tolerate than consuming large amounts at once.
Electrolytes are Crucial: Plain water is often not enough. Electrolyte drinks, oral rehydration salts, and salty broths help your body retain fluids and maintain proper fluid balance.
Avoid Dehydrating Factors: Limit or avoid alcohol, excessive caffeine, and high-sugar beverages, as these can exacerbate POTS symptoms or lead to fluid loss.
Consider Supplements and IV Therapy: For some, salt tablets or medical-grade IV saline may be necessary to meet sodium targets or treat severe dehydration, always under a doctor's supervision.
Eat Hydrating Foods: Incorporate salty foods like pickles, olives, and soups into your diet to contribute to your daily fluid and sodium goals.

Why Hydration is Different for People with POTS

For individuals with Postural Orthostatic Tachycardia Syndrome (POTS), rehydration is not just about drinking plain water. Many POTS patients experience hypovolemia (low blood volume) and issues with retaining fluids due to autonomic nervous system dysfunction. This means that the standard hydration advice is insufficient. The cornerstone of effective POTS hydration is to pair high fluid intake with a significantly higher daily sodium intake, which helps the body retain water and expand blood volume. By increasing your overall blood volume, you can help mitigate some of the most common and debilitating POTS symptoms, such as dizziness, lightheadedness, and tachycardia upon standing.

Daily Fluid and Sodium Goals

Working with your healthcare provider is essential to determine your specific fluid and sodium targets, as they vary based on individual needs and POTS subtype. General recommendations are often higher than for the average population.

Fluid Targets

Most POTS patients are advised to consume approximately 2–3 liters (about 68–101 ounces or 8.5–12.5 cups) of fluid per day. This should be spread out evenly throughout the day, with a focus on sipping regularly rather than chugging large amounts at once, which can be hard on the digestive system.

Sodium Targets

Daily sodium recommendations for POTS patients are often much higher than for the general population. Many doctors recommend an intake of 3,000–10,000 mg of sodium daily. It is crucial to consult your doctor before dramatically increasing your sodium intake, especially if you have high blood pressure or certain comorbidities.

Optimal Rehydration Sources

To meet these increased needs, you can incorporate a variety of fluids and foods into your routine. Not all beverages are created equal when it comes to rehydrating with POTS.

Recommended Fluids

Electrolyte Drink Mixes: Many commercial electrolyte powders or drops, like LMNT or Buoy, are formulated with high sodium levels suitable for POTS patients. Opt for lower-sugar varieties to avoid blood sugar spikes.
Oral Rehydration Salts (ORS): Medical-grade ORS solutions, such as NormaLyte, are specifically designed for effective fluid and electrolyte absorption.
Broth: Bone broth and vegetable broth are excellent sources of sodium and hydration.
Coconut Water: A natural source of electrolytes, particularly potassium.
Milk: Can contribute to fluid and electrolyte intake.

Hydrating Foods

High-Sodium Snacks: Incorporate salty snacks throughout the day, such as pickles, olives, salted nuts, and canned beans.
Salty Meals: Enhance your meals by adding extra salt, or choose naturally salty foods like cured meats and some cheeses.
Soups: Store-bought or homemade soups offer both fluid and salt.

Fluids to Limit or Avoid

Plain Water Alone: Can dilute blood sodium levels and lead to hyponatremia if consumed in excessive quantities without sufficient salt.
Excessive Caffeine: Can increase heart rate and worsen symptoms for some.
Alcohol: Is dehydrating and can exacerbate symptoms.
High-Sugar Sports Drinks: Many contain excessive sugar, which can trigger symptoms.
Ice-Cold Water: Can cause vasoconstriction and potentially trigger symptoms.

Practical Daily Hydration Tactics

Consistency is key. Implementing these strategies can help maintain your hydration status throughout the day.

Start Your Day Right: Drink a large glass of an electrolyte-rich fluid before getting out of bed. This helps boost blood volume before you stand up.
Sip, Don't Chug: Carry a reusable water bottle and sip consistently throughout the day to avoid overwhelming your system.
Set Reminders: Use phone alarms or hydration apps to remind you to drink regularly, especially if you have difficulty remembering.
Pre-hydrate for Activity: If engaging in exercise (especially reclined activities like rowing or swimming, often recommended for POTS) or spending time in heat, proactively increase your fluid and salt intake.
Consider Salt Supplements: For those who struggle to meet their sodium needs through diet and beverages, salt tablets or capsules can be a useful tool, always used under medical guidance.

Comparison of Hydration Methods for POTS


Method	Sodium Content	Sugar Content	Absorption Speed	Cost	Customization	Best For
Commercial Electrolyte Mix	High (500-1000mg/serving)	Varies (low to high)	Fast	Medium-High	Good (can choose low-sugar options)	Everyday hydration, post-exercise
DIY Electrolyte Drink	Customizable	Customizable	Fast	Low	High (avoiding triggers)	Everyday hydration, budget-friendly
Salt Tablets	Very High	None	Variable	Low-Medium	Low	Quick sodium boost, supplementing diet
Salty Foods	Varies	Low	Slow	Low-Medium	Medium	Consistent intake throughout the day
Plain Water	None	None	Fast	Low	Not applicable	Should be paired with salt/electrolytes

Intravenous (IV) Fluids for Acute Dehydration

In severe cases of dehydration or during illness with fluid loss (e.g., vomiting, diarrhea), oral rehydration may not be sufficient. When symptoms are severe and unresponsive to oral methods, IV saline administered under medical supervision can rapidly increase blood volume and provide quick symptom relief. This is often used for patients who are unable to drink enough or retain fluids orally. Your doctor will determine if and when IV fluid therapy is necessary for your condition.

Conclusion

Rehydrating with POTS is a strategic process that involves significantly increasing both fluid and sodium intake to combat the condition's low blood volume and autonomic dysfunction. By focusing on constant sipping of electrolyte-rich fluids, consuming salty foods, and considering supplements or IV therapy when necessary, you can better manage your symptoms. Always work closely with your healthcare provider to develop a personalized hydration plan that accounts for your specific needs and tolerance. A consistent and thoughtful approach to hydration is a cornerstone of effective POTS management.

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Frequently Asked Questions

POTS patients are often recommended to drink between 2 and 3 liters (approximately 8.5 to 12.5 cups) of fluid per day, though individual needs can vary. It's best to discuss your specific target with a healthcare provider.

For most POTS patients, plain water is not sufficient. It should be paired with increased salt intake, typically through electrolyte drinks, tablets, or salty foods. Too much plain water can dilute sodium levels, potentially worsening symptoms.

Salt (sodium) helps the body retain water, which is critical for increasing overall blood volume. Many POTS patients have low blood volume (hypovolemia), and the extra sodium helps manage symptoms like dizziness, fatigue, and fainting.

Good options include commercial electrolyte mixes (like LMNT, Buoy, or NormaLyte), oral rehydration salts, bone broth, and homemade concoctions with salt and juice. Look for products with higher sodium and lower sugar content.

Yes, IV saline may be used in severe cases of dehydration or before medical procedures that require fasting. It can rapidly increase blood volume and alleviate severe symptoms when oral intake is ineffective.

It is generally recommended to limit or avoid alcohol, which is dehydrating. Some people find that excessive caffeine or high-sugar drinks can also worsen their symptoms. Pay attention to how your body responds to different beverages.

You can add extra salt to your food, snack on naturally salty foods like pickles and salted nuts, and drink salty broths or electrolyte beverages throughout the day. Salt tablets can also be used under a doctor's supervision.

Hypovolemia is low blood volume. It is a common feature in many POTS patients and is a primary cause of symptoms like dizziness and fatigue. Increased fluid and sodium intake directly addresses this issue.