Yes, salt is one of the most widely recommended treatments for postural orthostatic tachycardia syndrome (POTS). Increasing sodium intake expands blood volume, which directly addresses one of the core problems driving POTS symptoms. A study published in the Journal of the American College of Cardiology found that a high-sodium diet nearly eliminated the roughly 11% blood volume deficit seen in POTS patients on a low-sodium diet, reducing it to less than 1%. The improvement is real, though it doesn’t completely normalize heart rate upon standing.
Why Salt Helps POTS
Many people with POTS have lower-than-normal blood volume. When you stand up, gravity pulls blood into your legs, and your body compensates by increasing heart rate and constricting blood vessels to keep blood pressure stable. With less blood to work with, that compensation has to work harder, which is why standing triggers the signature racing heart rate, dizziness, and lightheadedness of POTS.
Sodium pulls water into your bloodstream. When you eat more salt, your body retains more fluid, expanding your total blood volume. This gives your cardiovascular system more to work with when you stand, so the spike in heart rate doesn’t have to be as dramatic. In clinical testing, patients on a high-sodium diet showed lower standing heart rates, lower stress hormone levels while upright, and improved blood volume compared to those on a low-sodium diet. The standing heart rate still ran higher than in healthy controls (median of 117 beats per minute versus 85), but the gap narrowed meaningfully.
How Much Salt Is Recommended
The amounts recommended for POTS are far above what’s considered normal for the general population. The American Heart Association caps sodium at 2,300 mg per day for most adults. POTS guidelines go in the opposite direction. A Heart Rhythm Society expert consensus statement recommends 10,000 to 12,000 mg of salt per day for POTS patients, which translates to roughly 4,000 to 4,800 mg of sodium. The Canadian Cardiovascular Society recommends about 10,000 mg of salt daily (4,000 mg sodium).
To put that in perspective, one teaspoon of table salt contains about 2,300 mg of sodium. So POTS recommendations call for roughly double the general population’s upper limit. This is a therapeutic dose meant to address a specific physiological deficit, not a general health recommendation.
Fluid intake matters just as much. Current guidelines pair that sodium with 2 to 3 liters of water per day. Salt without adequate fluids won’t expand blood volume effectively, because your body needs the water to retain.
Ways to Get Enough Sodium
Salting your food more liberally is a starting point, but most people with POTS find it difficult to reach therapeutic levels through diet alone. Salt tablets and electrolyte drinks fill the gap.
- Salt tablets: Products like Thermotabs, SaltStick Vitassium, and Klaralyte provide concentrated sodium in capsule form. Johns Hopkins Medicine suggests starting with one tablet daily and gradually working up to two tablets three times a day. Some people tolerate even higher doses, but stepping up slowly helps you find the right amount without overwhelming your stomach.
- Electrolyte drinks and mixes: Options like Liquid IV, Normalyte, LMNT, Nuun, and Gatorlyte provide sodium in a more palatable form. These also help with fluid intake since you’re drinking them dissolved in water. Standard sports drinks like Gatorade contain sodium but in lower concentrations than products specifically designed for high-sodium needs.
- Salty foods: Pickles, olives, broth, pretzels, and salted nuts all contribute. These work well as snacks throughout the day but typically can’t carry the full load on their own.
Timing and Practical Tips
When you consume salt and fluids throughout the day can affect how well you feel. Drinking fluids before getting out of bed in the morning helps raise blood volume before you’re upright, which is when symptoms tend to be worst. Keeping a glass of water or an electrolyte drink on your nightstand is a simple habit that pays off.
If you feel faint during the day, drinking two glasses of cool water quickly can temporarily raise blood pressure and lower heart rate. Eating smaller, more frequent meals (five or six per day rather than three large ones) also helps, because large meals can divert blood to your digestive system and worsen symptoms. If nausea is an issue, drinking fluids between meals rather than right before eating tends to be easier on the stomach.
Tolerability and Limitations
Not everyone tolerates high sodium equally well. Some people experience bloating, nausea, or stomach discomfort when increasing salt intake, especially if they ramp up too quickly. The gradual approach recommended for salt tablets, starting low and increasing over days or weeks, helps minimize these issues.
It’s also worth understanding what salt can and can’t do. In the study that nearly corrected blood volume deficits, patients’ standing heart rates still remained elevated compared to healthy controls. Salt improved but did not normalize the orthostatic response. Most POTS specialists treat high sodium as a foundational strategy that works alongside other approaches like compression garments, exercise programs, and sometimes medication, rather than as a standalone cure.
People with kidney disease, heart failure, or high blood pressure that isn’t related to POTS may not be good candidates for high-sodium diets. The recommendation to increase salt applies specifically to the blood volume deficit commonly seen in POTS, not to all forms of dizziness or rapid heart rate.