Get Salty: Nutrition for POTS

If you or someone you know has been diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS), you're likely familiar with the daily challenges it can bring—rapid heart rate, dizziness, fatigue, and more. While POTS is a complex autonomic nervous system disorder that often requires a multi-faceted treatment plan, nutrition plays a powerful and supportive role in managing symptoms and improving quality of life.

In this post, we’ll break down what POTS is, how it affects the body, and the key nutritional strategies that may help reduce symptoms.

person salting food

What is POTS?

POTS is a form of dysautonomia, a disorder of the autonomic nervous system. People with POTS may experience the following:

• rapid heart rate when moving from lying down to standing with a change of 30 beats per minute(bpm) or more for adults or 40 bpm or higher for children or heart rate of 120 bpm or higher within 10 minutes of standing with normal blood pressure

• Dizziness or fainting

• Fatigue

• Nausea

• Brain fog

• Heart palpitations

• Exercise intolerance

  
  

Some potential causes of POTS include viral illness, autoimmune conditions, Ehlers-Danlos, alcohol use disorder, multiple sclerosis, diabetes and vitamin deficiencies. Treatment usually includes nutrition, medications and lifestyle changes.

6 Nutritional Strategies for Managing POTS

The autonomic nervous system is heavily influenced by fluid balance, electrolyte levels, and blood volume.  Nutrition has a big impact on all three of these!  

1. Increase Salt Intake 

Most people with POTS are advised to increase their sodium intake significantly—often 2 to 4 times the general recommendation. Salt helps the body retain water and increases blood volume, which may improve circulation and reduce symptoms like dizziness and fatigue.

• Many people with POTS respond to 3,000–10,000 mg sodium/day - increasing sodium intake to these levels should be done with the guidance of a dietitian and doctor supervision to monitor heart rate and blood pressure response to the diet changes.

• Ways to increase sodium:

  • Add more salt to food: 1 teaspoon table salt = about 2000 mg sodium, 1 tablespoon soy sauce = about 900 mg sodium, 1 tablespoon fish sauce = 1400 mg sodium

  • Add electrolytes to water - common choices include Liquid IV, LMNT and Lytes which is stevia-free for those that don’t like the taste of stevia, Skratch Labs makes an option that also includes carbohydrates which may provide additional benefit for stabilizing blood volume and electrolytes.

    
    

2. Stay Hydrated

Adequate water intake is essential to expand blood volume. Dehydration can worsen POTS symptoms dramatically.

person staying hydrated

• Aim for 2–3 liters of fluids/day (or more if exercising or during hot weather)

• Drinking large amounts of plain water can cause a shift in electrolytes and increase POTS symptoms so drinking water with a salty meal or adding electrolytes can be helpful

Oral rehydration solution recipes that can be used in place of electrolyte powders and tablets:

• ½ cup cranberry or grape juice, 3 ½ cups water, ½ teaspoon salt

• 1 cup apple juice, 3 cups water, ½ teaspoon salt

• 1 ½ cups coconut water, 2 cups water, ¼ cup lemon juice, ¼ cup pomegranate juice, ¼ teaspoon salt

• 2 cups regular chicken broth (not low sodium), 2 cups water, 2 tablespoons sugar

  
  

3. Balance Blood Sugar

POTS symptoms can worsen with blood sugar spikes and crashes, so it’s important to eat balanced meals that stabilize glucose levels.

• Include protein, fat, and fiber in every meal and snack.

• Choose complex carbs such as whole grains, beans, lentils and starchy veggies like peas, corn and sweet potato.

  
  

4. Experiment with Meal Size and Meal Timing

Large meals can divert blood flow to the digestive tract and make POTS symptoms worse. Eating smaller meals more frequently may help.

• Eating 4-6 times/day may feel best, experiment with the timing between meals to see what feels best, some feel better eating every 2-3 hours and some feel ok with every 3-4.

enjoying a meal

5. Rule Out Food Sensitivities and Allergies

High histamine loads can impact POTS.  Generally low histamine diets are not recommended as they are very restrictive and can lead to malnutrition over time, however it may be helpful to explore if there are any food allergies or sensitivities or bacterial overgrowth in the gut that is adding to overall histamine load and addressing those to reduce overall histamine load. This work is ideally done with both an allergist and dietitian on your team.

6. Rule Out Vitamin and Mineral Deficiencies

The following labs can help rule out vitamin deficiencies that can impact blood volume and nervous system regulation: B12, iron, iron saturation, ferritin, folate, B1, B6, homocysteine, vitamin D, alpha + gamma E, copper, magnesium.

Final Thoughts

Managing POTS is highly individual, and what works for one person may not work for another. However, targeted nutritional strategies can go a long way in helping stabilize symptoms, improve energy levels, and enhance overall quality of life. Work closely with your healthcare team—ideally including a registered dietitian familiar with dysautonomia—to create a plan that’s safe, effective, and tailored to your needs.

Resources:

• Standing Up to POTS: https://www.standinguptopots.org/

• Dysautonomia International: https://www.dysautonomiainternational.org

This blog is for educational and informational purposes only and solely as a self-help tool for your own use. I am not providing medical, psychological, or nutrition therapy advice. You should not use this information to diagnose or treat any health problems or illnesses without consulting your own medical practitioner. Always seek the advice of your own medical practitioner and/or mental health provider about your specific health situation.