How Much Sodium Do You Actually Need With POTS?
Why sodium matters for blood volume in POTS, the ranges clinicians commonly discuss, and how to raise intake without guesswork.
If you have postural orthostatic tachycardia syndrome (POTS), you have probably been told to “get more salt and water.” It is one of the most common non-drug recommendations for the condition — but the advice is often vague. How much salt? On top of what? And why does it help at all?
Why sodium matters in POTS
Many people with POTS have lower-than-ideal blood volume. When you stand up, gravity pulls blood toward your legs and abdomen. A healthy autonomic system tightens blood vessels and nudges heart rate up slightly to compensate. In POTS, that compensation is exaggerated — the heart races to keep blood moving to the brain.
Sodium helps your body hold on to fluid. More retained fluid can mean more circulating blood volume, which gives your cardiovascular system more to work with when you stand. That is the logic behind the “salt and fluids” approach.
The ranges clinicians commonly discuss
Published guidance and specialist clinics frequently mention sodium targets in the range of 3 to 10 grams per day, often paired with 2 to 3 liters of fluid. That is a wide range, and the right number for you depends on your blood pressure, kidney function, other conditions, and how you respond.
This is exactly the kind of change to make with your own clinician — not from a blog. Sodium loading is not safe for everyone, particularly people with high blood pressure, heart failure, or kidney disease.
Turning grams into something you can picture
Sodium math is confusing because food labels list sodium in milligrams while salt is sodium chloride. A useful anchor:
| Amount | Sodium |
|---|---|
| 1 teaspoon table salt | ~2,300 mg |
| 1 gram of sodium | ~2.5 g of salt |
| Typical electrolyte serving | 500–1,000 mg |
So a target of “5 grams of sodium” is roughly two-plus teaspoons of salt spread across the whole day, from all sources combined — food, broth, and any electrolyte drinks.
Practical ways to raise intake
- Spread it out. Several smaller doses across the day tend to sit better than one large hit.
- Pair sodium with fluid. Salt without enough water does not expand volume the way you want.
- Use foods you already like — broth, pickles, olives, salted nuts — so it is sustainable.
- Track for a week. Most people dramatically over- or under-estimate where they are starting.
The bottom line
Sodium is a lever, not a cure. Used deliberately and under medical supervision, raising sodium and fluids is one of the most accessible tools for managing orthostatic symptoms — but the right dose is personal, and worth dialing in with your care team.