Safe Dosing, Options, and Simple Swaps
Why Salt and Fluids Matter So Much in POTS
For people with POTS, symptoms aren’t caused by dehydration alone — they’re driven by low effective blood volume and impaired autonomic regulation. Salt helps your body retain fluid, which increases circulating volume and improves blood flow to the brain. Fluids without enough sodium often don’t help and can sometimes make symptoms worse.
This is why salt and hydration are considered first-line treatments for POTS, not optional lifestyle tips.
How Much Sodium Is Commonly Recommended?
Many POTS management guidelines recommend 8–12 grams of additional sodium per day (not milligrams). That number surprises a lot of people because it goes against general public health messaging — but POTS physiology is different.
This should always be individualized, especially if you have:
- High blood pressure
- Kidney disease
- Heart disease
- A history of electrolyte imbalance
Generally, when I am working with POTS patients, I have them start at 1-2g of sodium in the form of sodium chloride 1g tablets which are super cheap on amazon per day and increasing slowly from there as tolerated. Once you determine the needed dose of sodium then you can try out the different brands that are flavored and add those in as you wish. Even though the research that has been done on POTS recommends doses up to 8-12g per day I rarely need to get that high to see symptom improvement.
SUPER IMPORTANT
Knowing the dose of electrolytes is complicated and requires some background in chemistry. I’ll try to make this as simple as possible. If you buy an electrolyte supplement and you look at the label on the back and it says there is 1000mg of “Sodium Chloride” that means that there is actually less than 500mg of Sodium per serving because half (~500mg) is Sodium and half (~500mg) is Chloride. Another supplement may say that there is 1000mg of just Sodium so you would assume this means that there is actually ~2000mg of Sodium Chloride so half of that would be the 1000mg they are saying is present.
Each supplement will list things differently and many are not clear on which type they have because supplements are not regulated by the FDA which makes things even more confusing.
When you are starting out with electrolyte dosing you really need to pay a lot of attention to the dose, or at the very least continue using a consistent product so you can titrate up the dose in a consistent way.
This took me years to understand even though I have degrees in biochemistry, medical science and have been prescribing medications for about 10 years as a PA. This is why working with a knowledgeable provider can be very helpful.
Why Water Alone Isn’t Enough
Drinking large volumes of plain water can actually dilute sodium levels and worsen symptoms like dizziness or fatigue. Sodium helps fluids stay where they’re needed — inside the blood vessels.
Remember that fluids work best when paired with salt.
Electrolyte Options: What Actually Helps
Not all electrolyte products are created equal. Many popular options contain very low sodium and are essentially flavored water.
Helpful options tend to include:
- Higher sodium content (500–1,000+ mg per serving)
- Minimal sugar (unless you tolerate it well)
- Simple ingredient lists
This doesn’t mean you need expensive supplements — it means you need enough sodium.
Simple Salt Swaps That Add Up
You don’t have to get all your sodium from drinks.
Easy daily additions include:
- Salting meals more intentionally
- Broth or bouillon
- Pickles or olives
- Salted nuts
- Pretzels or crackers
- Adding salt to smoothies or soups
Small changes throughout the day are often better tolerated than large doses at once.
Timing Matters
Spacing salt and fluids throughout the day tends to work better than front-loading everything in the morning. Many people notice benefits from:
- Increasing salt earlier in the day
- Pairing fluids with meals
- Using salt before known triggers (heat, standing, activity)
Signs You May Need Adjustment
Too little sodium may show up as:
- Worsening dizziness
- Fatigue
- Brain fog
- Frequent urination
Too much may cause:
- Swelling
- Headaches
- GI upset
- Elevated blood pressure
Your body’s feedback matters.
Safety First
Salt loading should be intentional, monitored, and personalized. What works for one person may not work for another. If symptoms change suddenly or you feel worse, reassessment is important.
The Takeaway
Salt and hydration aren’t cures — but they are powerful tools when used correctly. When dosing is adequate and consistent, many people notice meaningful symptom improvement and better daily function.
Share Your Experience
What hydration or salt strategies have helped you the most? What didn’t work? Your trial-and-error journey may help someone else shorten theirs.
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The Hypermobile Solutions Team
References
Home. The Ehlers Danlos Society. https://www.ehlers-danlos.com/
What is HSD?. The Ehlers Danlos Society. https://www.ehlers-danlos.com/what-is-hsd/
What is eds?. The Ehlers Danlos Society. https://www.ehlers-danlos.com/what-is-eds/
Jovin, D., Atwal, P., Herman, K., Block, N., Maxwell, A. J., Mitakides, J., Maitland, A. M., Saperstein, D., Hamilton, M., Schofield, J., Koby, M., Klinge, P., McElroy, A., Bluestein, L., Chopra, P., Tishler, J., Pocinki, A. G., Varga, J., Dempsey, T., … Lane, K. (2020). Disjointed: Navigating the diagnosis and management of Hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorders. Hidden Stripes Publications, Inc.
Smith, C., & Wicks, D. (2017). Understanding Hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorder: (previously known as Ehlers-Danlos Syndrome Hypermobility Type & Joint Hypermobility Syndrome, respectively). Redcliff-House Publications.
Cox, C. (2022). Holding it all together when you’re Hypermobile. Journey2Joy
Afrin, L. B. (2016). Never bet against Occam: Mast cell activation disease and the modern epidemics of chronic illness and medical complexity. Sisters Media, LLC.
Freeman, K., Goldstein, D. S., & Thompson, C. R. (2025). The dysautonomia project: Understanding autonomic nervous system disorders (2nd ed.). Bardolf.
Disclaimer
This blog is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no provider/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user’s own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.