What is the best diet for POTS syndrome?

October 22, 2025 •

4 min read

Over 80% of Postural Orthostatic Tachycardia Syndrome (POTS) patients experience reduced blood volume, making dietary management a critical part of treatment. Understanding what is the best diet for POTS syndrome involves focusing on specific strategies like increasing fluid and salt intake to manage blood volume and minimize symptoms like dizziness and fatigue.

Quick Summary

Optimizing a diet for POTS involves increasing fluid and salt intake, eating smaller, frequent meals, and choosing nutrient-dense foods. Identifying and avoiding individual triggers is also key to managing symptoms effectively and improving quality of life.

Key Points

Increase fluid intake: Aim for a substantial daily fluid intake, including water and electrolyte-rich drinks, to boost blood volume.
Increase salt intake: Consume a higher amount of sodium, but only under a doctor's supervision due to individual health needs.
Eat small, frequent meals: Opt for 5-6 smaller meals to prevent symptoms caused by blood pooling in the abdomen after eating large portions.
Choose complex carbohydrates: Focus on whole grains and high-fiber foods to maintain stable blood sugar levels and avoid energy crashes.
Avoid alcohol and limit refined sugar: Both can worsen POTS symptoms through dehydration, blood pressure fluctuations, and blood sugar spikes.
Identify individual triggers: Pay attention to food sensitivities, such as gluten, and consider an elimination diet under medical guidance if necessary.

The Cornerstone of a POTS Diet: Fluids and Electrolytes

For many living with Postural Orthostatic Tachycardia Syndrome (POTS), a primary issue is reduced blood volume. This leads to blood pooling in the lower extremities upon standing, causing symptoms such as a rapid heart rate, lightheadedness, and fatigue. The most fundamental dietary strategy is to increase both fluid and salt intake to boost overall blood volume.

Why Proper Hydration and Salt are Vital

Adequate fluid consumption helps increase the total amount of blood circulating in the body. However, for POTS patients, simply drinking water isn't always enough. High salt intake is necessary to help the body retain that extra fluid within the bloodstream, effectively increasing blood volume and stabilizing blood pressure upon standing. The appropriate amount of salt can vary significantly from person to person and must be determined with medical supervision.

Practical Tips for Increasing Fluid and Salt

Target Fluid Intake: Aim for a significant daily fluid intake, typically between 2-3 liters (68-101 ounces), depending on your individual needs and medical advice.
Hydrating Beverages: While water is essential, consider other options like electrolyte drinks, bone broths, and vegetable soups.
Boost Salt Intake: Incorporate naturally salty foods into your diet. This can include pickles, olives, salted nuts, soy sauce, and cheeses. Salt tablets may also be prescribed by a doctor if dietary changes aren't sufficient.
Drink Upon Waking: Many individuals find it helpful to drink a glass or two of fluid first thing in the morning, before getting out of bed, to help prepare the body for the day.

Eating Habits and Macronutrient Balance

Beyond just fluids and salt, how you eat can significantly impact your symptoms. Large meals can trigger or worsen POTS symptoms by diverting blood flow to the digestive tract, a condition known as postprandial hypotension.

The Strategy of Small, Frequent Meals

Instead of two or three large meals, it is recommended to eat smaller, more frequent meals throughout the day. This approach helps prevent large blood sugar fluctuations and minimizes the impact of digestion on blood flow, resulting in more stable energy levels.

The Right Carbohydrates, Proteins, and Fats

Choosing the right macronutrients can also make a difference. Focusing on lean protein, complex carbohydrates, and healthy fats is key. Complex carbohydrates, such as whole grains, release energy slowly and prevent the blood sugar spikes and crashes associated with refined sugars.

Foods to prioritize:

Complex Carbs: Oats, brown rice, quinoa, whole-wheat bread, and sweet potatoes.
Lean Protein: Chicken, fish (like salmon), turkey, eggs, and legumes.
Healthy Fats: Avocados, nuts, seeds, and olive oil.
Probiotics and Fiber: Yogurt, kefir, sauerkraut, and high-fiber foods like beans, lentils, and fruits can aid digestive health, which is often a related issue for POTS patients.

Foods to limit or avoid:

Alcohol: Known to be dehydrating and a vasodilator, it can significantly worsen POTS symptoms.
Refined Carbohydrates: White bread, white pasta, sugary snacks, and candy can cause rapid blood sugar changes.
High-Fat Meals: Meals that are excessively greasy or high in unhealthy fats can slow digestion, potentially worsening symptoms.
Caffeine: The effect of caffeine varies among individuals. While some may find it beneficial, others find it increases tachycardia. It is recommended to use caution and monitor your own reaction.

Identifying and Avoiding Trigger Foods

Some people with POTS may have specific food sensitivities that worsen their symptoms. A strong link has been suggested between POTS and conditions like Celiac disease and gluten intolerance. Additionally, many POTS patients also experience symptoms of Irritable Bowel Syndrome (IBS), which can be managed with specific dietary changes.

For those with gastrointestinal symptoms, a trial elimination diet, such as a gluten-free or low-FODMAP diet, might be helpful to identify individual triggers. It is important to do this under the supervision of a healthcare provider or a registered dietitian to ensure proper nutrition is maintained.

POTS Diet vs. Standard Dietary Advice


Dietary Principle	POTS Diet Approach	General Dietary Advice	Reasoning for POTS
Salt Intake	Increased salt intake is often advised, under medical supervision.	Low salt intake is typically recommended for cardiovascular health.	Increased salt helps retain fluid, boosting blood volume to counteract low blood pressure.
Fluid Intake	Higher fluid intake (2-3 liters/day), including electrolytes, is encouraged.	2-3 liters/day is a general guideline, but not all fluids are emphasized equally.	Increased fluid directly increases blood volume, aiding circulation.
Meal Size	Small, frequent meals (5-6/day) are recommended to prevent post-meal symptoms.	3 main meals a day are standard.	Large meals divert blood to the gut, which can worsen symptoms of blood pooling and postprandial hypotension.
Macronutrients	Balance complex carbs, lean protein, and healthy fats, with attention to potential carb sensitivity.	Balanced intake, but often with less emphasis on specific carb types or meal frequency.	Stabilizing blood sugar prevents energy crashes, and complex carbs offer sustained energy without rapid spikes.

Conclusion: A Personalized Approach is Key

Ultimately, there is no one-size-fits-all best diet for POTS syndrome. Managing symptoms effectively through diet requires a personalized approach that addresses the core issues of reduced blood volume and triggers specific to your body. By focusing on consistent hydration, increased salt intake, smaller and more frequent meals, and identifying individual food sensitivities, you can significantly improve your daily quality of life. Always consult with a healthcare professional or a dietitian specializing in POTS before making any significant changes to your diet to ensure your nutritional needs are met safely.

For further reading and resources on managing POTS, consider exploring the Dysautonomia International website.

Frequently Asked Questions

A higher salt intake is recommended for many POTS patients because it helps the body retain more fluid. This increases blood volume, which counteracts the blood pooling in the legs and helps stabilize blood pressure upon standing.

The effect of caffeine on POTS symptoms is highly individual. Some people report that caffeine can temporarily improve alertness and blood pressure, while others experience worse symptoms, like increased heart palpitations or anxiety. It is recommended to proceed with caution and monitor your body's reaction.

It is generally better for POTS patients to eat smaller, more frequent meals throughout the day. This prevents a large amount of blood from being diverted to the digestive system, which can trigger dizziness and lightheadedness after a large meal.

In addition to a high-salt diet, some patients may be advised to take salt tablets or electrolyte supplements to help manage symptoms. Magnesium and potassium can also be important electrolytes to monitor. Any supplementation should be discussed with a doctor to ensure safety and appropriateness.

Postprandial hypotension is a drop in blood pressure that occurs after eating. In POTS, this is often triggered by large meals. Eating smaller, more frequent meals that are lower in high-glycemic carbohydrates can help minimize this effect by reducing the blood diversion to the digestive system.

If you suspect a food intolerance, especially if you experience gastrointestinal issues, you should consult a doctor or dietitian. They may recommend a trial elimination diet, such as going gluten-free for a month, to see if it improves your symptoms. A coeliac test may also be necessary first.

Don't rely on thirst alone as a sign of dehydration. Carry a reusable water bottle, set reminders on your phone, and incorporate hydrating foods like fruits, vegetables, and soups. Flavoring water with fresh fruit or adding electrolyte powders can also make it more appealing to drink throughout the day.