If you live with Postural Orthostatic Tachycardia Syndrome (POTS), you’ve probably heard a lot about the importance of hydration, salt and electrolytes.
For most people, hydration is relatively straightforward. But for someone with POTS, maintaining adequate fluid levels and blood volume can play a much more important role in how the body responds to standing, heat, exercise and everyday activities.
In fact, increasing fluid and salt intake is commonly recommended as part of the non-pharmacological management of POTS. Healthdirect Australia lists drinking plenty of water and increasing salt intake among the measures that may help relieve POTS symptoms, while the Australian POTS Foundation includes salt and fluid intake among its recommended lifestyle modifications.
So, why are electrolytes for POTS so often discussed? And what makes sodium particularly important?
Let’s take a closer look.
WHAT IS POTS?
Postural Orthostatic Tachycardia Syndrome, or POTS, is a disorder of
the autonomic nervous system – the system responsible for regulating many of
the body’s automatic functions, including heart rate and blood pressure.
One of the defining characteristics of POTS is an excessive increase in heart rate after moving into an upright position.
According to Healthdirect Australia, POTS can cause symptoms including dizziness, a fast heartbeat and feeling unwell when standing. Other symptoms can include difficulty exercising, sleep disturbances and gastrointestinal problems.
People with POTS may also experience:
- Lightheadedness or dizziness
- Rapid or pounding heartbeat
- Fatigue
- Brain fog or difficulty concentrating
- Weakness or shakiness
- Headaches
- Nausea
- Exercise intolerance
- Fainting or feeling as though they may faint
The experience of POTS can differ considerably from one person to
another, and symptoms may fluctuate from day to day.
One important piece of the POTS puzzle is how effectively the body maintains
circulation when you’re upright.
WHAT HAPPENS WHEN SOMEONE WITH POTS STANDS UP?
When you stand, gravity naturally causes some of your blood to move towards your legs and lower body.
Normally, your autonomic nervous system responds by adjusting heart
rate and blood vessel constriction to help maintain adequate circulation.
In POTS, this response doesn’t function normally. Blood may pool in the lower body and the heart rate can increase significantly as the body attempts to maintain adequate circulation.
Johns Hopkins Medicine explains that people with POTS can have difficulty balancing blood vessel constriction and heart rate responses when upright, and that treatment needs to be tailored to the individual.
This helps explain why hydration and maintaining adequate circulating blood volume can be important considerations for people with POTS.
WHY ARE ELECTROLYTES IMPORTANT FOR POTS?
Electrolytes are minerals that carry an electrical charge when dissolved in fluid. They include sodium, potassium, magnesium, chloride and calcium.
Your body relies on electrolytes for a wide range of normal physiological processes, including fluid balance, nerve signalling and muscle function.
When discussing POTS and electrolytes, however, one electrolyte receives particular attention:
Sodium.
Sodium plays an important role in regulating fluid balance and helps the body retain water. Increasing sodium together with fluid can increase circulating blood volume, which is one reason increased salt and fluid intake is commonly recommended as part of POTS management.
The Australian POTS Foundation notes that increased salt intake can help expand plasma volume in people with POTS and specifically identifies electrolyte drinks as one potential way of incorporating additional salt.
WHY SODIUM IS IMPORTANT FOR POTS?
You might normally associate health advice about salt with being told to consume less of it.
POTS can be different.
For some people with POTS, a healthcare professional may recommend increasing sodium alongside fluids as part of their individual management plan.
Why?
Sodium helps the body retain water.
Increasing sodium and fluid intake can help expand circulating blood volume. This may assist the cardiovascular system in maintaining circulation when a person moves into an upright position.
A peer-reviewed review on the diagnosis and management of POTS published in the Canadian Medical Association Journal includes increased water and salt consumption among the suggested initial non-pharmacological approaches to POTS management.
Importantly, this doesn’t mean that everyone with POTS should simply start consuming large amounts of salt.
Individual requirements vary and increased sodium may not be appropriate for everyone. Your doctor or another appropriately qualified healthcare professional should help determine the appropriate amount for you.
HOW MUCH WATER AND SALT IS RECOMMENDED FOR POTS?
There isn’t one amount that’s appropriate for every person with POTS, which is why individual medical advice is important.
As a general reference, Healthdirect Australia currently recommends that people with POTS drink around 2–3 litres of water each day and describes a target of 10–12 grams of salt per day as one strategy that may help manage symptoms.
The Australian POTS Foundation
discusses a consensus recommendation of around 10 grams of salt per day,
equivalent to approximately 4,000 mg of sodium.
It’s important to understand that salt and sodium aren’t the same measurement. Sodium makes up only part of table salt, so 10 grams of salt does not mean 10 grams of sodium.
These figures are general clinical guidance – not a recommendation for you personally.
Your appropriate fluid and sodium intake can depend on your individual circumstances, other medical conditions, medications and the type and severity of your POTS.
IS WATER ENOUGH FOR POTS HYDRATION?
Water is essential for hydration, but hydration isn’t simply about drinking as much water as possible.
Sodium helps regulate fluid balance within the body and helps retain the fluid you consume.
This is where an electrolyte drink for POTS can provide a convenient option for someone who has been advised to increase both their fluid and sodium intake.
Rather than consuming water alone, an electrolyte drink allows water and electrolytes to be consumed together.
If your healthcare professional has given you a daily sodium target, knowing how much sodium is in each serving can also make it easier to understand how an electrolyte drink contributes to your overall intake.
WHAT ARE THE POTENTIAL BENEFITS OF ELECTROLYTES FOR POTS?
When increased sodium and fluid intake form part of an individual’s POTS management plan, electrolyte drinks can provide a practical way of supporting that strategy.
1. Supporting circulating blood volume
Some people with POTS experience low circulating blood volume.
Because sodium helps the body retain water, increasing sodium alongside fluids can help support blood and plasma volume.
The aim is to support the body’s ability to maintain circulation when upright – one of the reasons salt and fluid intake are frequently discussed in clinical POTS management.
2. Making consistent hydration easier
For someone who needs to pay particular attention to hydration, having a structured
routine can make it easier to maintain consistent fluid intake throughout the day.
An electrolyte drink provides a convenient way of consuming fluid and electrolytes together.
3. Providing a measurable source of sodium
If your healthcare professional has recommended increasing your sodium intake, getting additional sodium entirely through food isn’t always convenient.
An electrolyte drink containing a meaningful and clearly labelled amount of sodium provides another option.
The important word here is meaningful.
Electrolyte products can vary enormously in the amount of sodium they contain. If sodium is the reason you’re using an electrolyte product, always check the nutrition information rather than assuming every electrolyte drink provides a similar amount.
4. Supporting hydration during hot Australian weather
Heat can be particularly challenging for people with POTS.
Both Healthdirect Australia and Johns Hopkins Medicine identify hot environments as something that can aggravate POTS symptoms.
Heat causes blood vessels to widen and sweating results in the loss of both fluid
and electrolytes.
For Australians living with POTS, having an appropriate hydration plan can
therefore become particularly important during summer, hot weather or periods
of increased sweating.
5. Supporting hydration around physical activity
Physical activity can increase fluid and electrolyte losses through sweat.
Exercise tolerance varies considerably among people with POTS, and exercise or
rehabilitation plans should be appropriate for the individual.
If you’ve been advised to increase fluids and sodium, it’s worth discussing with your healthcare professional how hydration should fit around your exercise or rehabilitation programme.
WHAT SHOULD YOU LOOK FOR IN AN ELECTROLYTE DRINK FOR POTS?
Not all electrolyte products are the same.
If you’re looking at electrolytes because you’ve been advised to increase your sodium and fluid intake, don’t rely solely on the word “electrolytes” on the front of the packet.
Turn it over and read the nutrition information.
Check the sodium content
Start by looking at how much sodium you’re actually getting per serving.
There can be a considerable difference between electrolyte products.
If your healthcare professional has given you a sodium target, knowing the sodium
content per serving allows you to understand how the product contributes towards your overall daily intake.
Look at the complete electrolyte profile
Sodium isn’t the only electrolyte your body uses.
Depending on the formulation, an electrolyte product may also contain potassium, magnesium, chloride and other minerals.
Look at the complete nutritional profile rather than judging a product solely by one ingredient.
Check the sugar content
Electrolyte drinks also differ considerably in their sugar content.
Traditional sports drinks can contain significant amounts of sugar, while other electrolyte formulations contain little or no sugar.
The right choice depends on your individual needs, preferences and the advice you’ve received from your healthcare professional.
CREATING A POTS HYDRATION ROUTINE
Knowing that hydration is important is one thing. Staying consistent with it is another.
If increased fluid and sodium intake have been recommended as part of your POTS management plan, consider making hydration a deliberate part of your daily routine rather than something you only think about when you become thirsty.
Some practical things to discuss with your healthcare professional include:
- Your personal daily fluid target
- Your recommended daily sodium or salt intake
- How to spread fluid and sodium intake throughout the day
- Whether electrolyte drinks are appropriate for you
- How your hydration needs may change during hot weather
- Hydration around exercise or increased physical activity
- How medications or other health conditions may affect your fluid or sodium requirements
Most importantly, know your numbers.
Once you know the amount of fluid and sodium recommended for you, you can read nutrition labels and make informed decisions about how different foods and electrolyte products fit within your daily routine.
WHERE CAN SALTT FIT INTO A POTS HYDRATION ROUTINE?
For people with POTS who have been advised by their healthcare professional to increase their sodium and fluid intake, SALTT Electrolytes can provide a convenient way to incorporate electrolytes into a daily hydration routine.
SALTT was formulated with an emphasis on sodium rather than simply including a token amount and calling it an electrolyte drink.
SALTT is also sugar-free, making it an option for people who want electrolytes without the added sugar found in many traditional sports drinks.
For someone managing POTS, however, the important question isn’t simply:
“Does this drink contain electrolytes?”
A more useful question is:
“How does the amount of sodium and other electrolytes in this product fit into the daily targets recommended for me?”
That’s why we encourage you to check the nutritional information for the SALTT product you’re using and discuss your sodium and fluid requirements with your healthcare professional.
SALTT isn’t intended to treat POTS. Instead, for someone who has already been advised to increase their sodium and fluid intake, it can provide a convenient and measurable way of incorporating electrolytes into their hydration routine.
POTS AND SODIUM AND ELECTROLYTES: THE TAKEAWAY
For someone living with POTS, hydration can mean much more than simply remembering to drink enough water.
Maintaining adequate circulating blood volume can be an important part of POTS management, which is why increased fluid and sodium intake is commonly recommended for many people with the condition.
Electrolytes – and sodium in particular – can provide a practical way of supporting a structured hydration strategy when increased sodium has been recommended by a healthcare professional.
The key is to make hydration intentional, consistent and individualised.
Know your recommended fluid and sodium targets. Read nutrition labels. Understand what your electrolyte drink actually provides. And work with your healthcare professional to develop a hydration strategy that’s appropriate for you.
Explore the SALTT Electrolytes range to find out more about our sugar-free electrolyte drink mixes and their nutritional information.
SOURCES AND FURTHER READING
For further information about POTS, its diagnosis and management, we recommend referring to recognised health organisations and medical literature:
Healthdirect Australia – Postural Orthostatic Tachycardia Syndrome (POTS)
Australian POTS Foundation – Treating POTS
Johns Hopkins Medicine – Postural Orthostatic Tachycardia Syndrome (POTS)
CMAJ – Diagnosis and Management of Postural Orthostatic Tachycardia Syndrome
NIH Expert Consensus – POTS: State of the Science and Clinical Care
IMPORTANT INFORMATION
The information provided in this article is for general educational and informational purposes only. It is not intended to constitute medical advice or to diagnose, treat, cure or prevent POTS or any other medical condition.
POTS is a complex condition and individual fluid, sodium and electrolyte requirements can vary considerably. Increasing sodium or fluid intake may not be appropriate for everyone, particularly people with certain cardiovascular, kidney or other medical conditions, or those taking particular medications.
SALTT Electrolytes are not intended to diagnose, treat, cure or prevent POTS.
Always seek advice from your doctor or another appropriately qualified healthcare professional before significantly changing your sodium, electrolyte or fluid intake, taking supplements, or making changes to the management of POTS or any other medical condition.
