• Taylor Leahy - Dietitian

Sodium for POTS: 5 Tips and Tricks to Add More Salt Without Adding Table Salt.

Updated: Aug 23, 2020


For a ‘typical healthy’ individual or for someone with kidney or heart failure diagnosis, sodium is an electrolyte that doctors recommend we limit as much as possible. You’ve probably heard it many times, from either your doctor, family member, or even dietitian – limit your sodium! Sodium is an electrolyte that, when combined with increased fluid intake, increases blood pressure, which for some individuals is a side effect we want to avoid.

For POTS sufferers, it’s the opposite! POTS is a condition that affects blood circulation, mainly affecting the body’s ability to regulate blood pressure when the body changes positions from laying or sitting to standing. Without this crucial system working properly, individuals can experience lightheadedness, fainting, rapid heart rate, sweating, and nausea, just to name a few.

According to the Cleveland Clinic, a diet high in sodium and fluid can help mitigate POTS symptoms by increasing blood volume and preventing hypotension. Sodium plays a large role in how much fluid accumulates in the blood, so by increasing sodium intake, blood volume will naturally increase and blood pressure will rise.

There are many healthy ways to add sodium to your diet. Let’s take a look at a few options:

Choose foods that are naturally high in sodium: Some foods are naturally higher in sodium than others. Reading the nutrition label can be helpful in determining the sodium content of the foods you eat. For individuals with POTS, the Cleveland Clinic recommends 3,000-10,000 mg of sodium per day.

· Avoid consuming processed foods with high saturated fat levels such as: fried foods, pizza, cold cuts and cured meats.

· Dairy, although high in sodium, may cause digestive issues for those with lactose intolerance. Be cautious when adding dairy into your eating pattern, and opt for low-fat options when possible if gastroparesis is an issue.

· Including things like: spinach, eggs, smoked salmon, peanut butter, salted nuts, and vegetable soups are healthier ways to increase sodium intake.


Other good sources of sodium can include:

  1. Breads and rolls (3-80mg/slice)

  2. Canned soup and chili (varies widely: 480-900mg/cup)

  3. Chicken, whole pieces (70mg/3 oz)

  4. Hard cheese (~170mg/oz)

  5. Cottage cheese (700mg/1 cup)

  6. Milk (~100mg/1 cup)

  7. Sandwiches (600-1200mg/sandwich)

  8. Salad dressings and vegetable oils (0-240mg/1 tbsp)

  9. Canned fish (300-470mg/3 oz)

  10. Eggs, omelets (100-150mg/egg)

  11. Ready to eat cereals, instant oatmeal (165-270mg/packet)

*The sodium of each food item can always be increased when paired with other foods and by adding salt.


Add salty food toppings when able: Adding salty food toppings to things like salads, sandwiches, and pasta can help boost sodium content when needed.

· For salads, top with: crushed salted nuts, olives, feta or mozzarella cheese, anchovies, canned beans or corn, celery, diced chicken, ham or turkey.

· For sandwiches, top with: spinach, swiss chard, pickles, mayonnaise, mustard, olives, sliced deli turkey or ham, cheddar cheese (if tolerated). Choose white bread for sandwiches if available – white bread has less fiber and may be easier to digest for those with gastroparesis.

· For pastas, top with: kalamata or black olives, capers, cheese (if tolerated), ground turkey, shrimp, and fresh spinach.

Add fermented products: Fermented products like kimchi, sauerkraut, kombucha and tempeh are naturally high in sodium and also have unexpected health benefits. Fermented products contain prebiotics which are the food for probiotics, the “good bacteria”, which helps increase the digestibility of fermented products, and may help relieve gastrointestinal issues such as diarrhea.


· Yogurt, cheese and milk are also good examples of fermented foods although these may be less tolerated in individuals with POTS – so add them to your eating plan with caution.

· Kombucha is a fermented drink that is a good source of sodium and fluid – both crucial aspects of a POTS eating plan.

Limit alcohol and caffeine: Alcohol and caffeine are both diuretics which cause an increase in urination. The more you urinate, the less sodium and water is present in the body.

· Also avoid tea, energy drinks and any drinks that promise a “boost” in energy, as any drinks promising you an increase in energy will most likely contain caffeine.

Consider sports drinks or oral rehydration solutions (ORS): If you’re still not getting enough sodium through diet alone, consider adding sports drinks or ORS to your eating plan. Sports drinks contain electrolytes including sodium, so they may be a good avenue to consider if you’re struggling to consume enough sodium and fluid in a day. ORS are over the counter solutions that are diluted in water – they generally contain sodium and sugar in water to increase hydration.

Sources:

1. Overview of Sodium’s Role in the Body—Hormonal and Metabolic Disorders. (n.d.). Merck Manuals Consumer Version. Retrieved August 8, 2020, from https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/electrolyte-balance/overview-of-sodium-s-role-in-the-body

2. Postural Orthostatic Tachycardia Syndrome (POTS) Management and Treatment. (n.d.). Cleveland Clinic. Retrieved August 2, 2020, from https://my.clevelandclinic.org/health/diseases/16560-postural-orthostatic-tachycardia-syndrome-pots/management-and-treatment

3. Top 25 Foods that Add the Most Sodium to Your Diet. (n.d.). American Heart Association. Retrieved August 10, 2020, from https://sodiumbreakup.heart.org/top_25_foods_that_add_the_most_sodium_to_your_diet

4. Calories in White Bread | CalorieKing. (n.d.). Retrieved August 9, 2020, from https://www.calorieking.com/us/en/foods/f/calories-in-breads-white-bread/MYdVDzj5TemqsaeIZiyMNw

5. Fermented Foods—Are They the Next Big Nutrition Trend? (n.d.). Today's Dietitian. Retrieved August 10, 2020, from https://www.todaysdietitian.com/newarchives/070112p32.shtml

6. Hyponatremia—Symptoms and causes. (n.d.). Mayo Clinic. Retrieved August 10, 2020, from https://www.mayoclinic.org/diseases-conditions/hyponatremia/symptoms-causes/syc-20373711

7. Nutrition Facts: Gatorade. (n.d.). Eat This Much. Retrieved August 10, 2020, from https://www.eatthismuch.com/food/nutrition/gatorade,3212/


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