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Nutrition Recommendations for POTS
It is important to distinguish between salt and sodium: 5 grams of salt provides approximately 2000 mg of sodium, 10 grams of salt provides approximately 4000 mg of sodium, and 12 grams of salt provides approximately 4800 mg of sodium. As another reference point, one teaspoon of table salt contains approximately 2400 mg of sodium. For comparison, the general population is advised to limit sodium intake to approximately 2300 mg per day. However, average sodium intake is estimated at approximately 2760 mg per day in Canada and more than 3300 mg per day in the United States. Much of this sodium comes from processed foods, prepared meals, and restaurant foods.
Before recommending how much additional salt to consume, it is important to assess a person’s usual dietary sodium intake. For example, someone who regularly eats prepared meals may already consume substantial amounts of sodium, while someone who primarily cooks with fresh ingredients may consume considerably less. Sodium targets should therefore account for total dietary sodium intake, rather than just added salt. Although a target of approximately 4,000 mg of sodium (equivalent to 10 g of salt) is commonly used in POTS management, this is not a universal upper limit.
In practice, table salt is a simple, effective, and much more affordable option than commercial electrolyte supplements. It can be added directly to foods or used to prepare a homemade electrolyte drink (see these recipes). Commercial electrolyte drinks and salt capsules may still be convenient for individuals who have trouble tolerating the taste of salt or have difficulty meeting their sodium needs through food alone.
Adjusting Meals to Reduce Postprandial Symptoms
Some individuals with POTS experience worsening tachycardia, dizziness, or fatigue after meals. This response may be partly explained by increased blood flow to the digestive system, which can exacerbate orthostatic intolerance.
In a small clinical study involving 12 women with POTS and 13 healthy controls, an oral glucose load of 75 grams led to an increase in standing heart rate and a reduction in stroke volume among participants with POTS. These changes were associated with increased levels of glucose-dependent insulinotropic polypeptide (GIP), a gut hormone that may promote vasodilation in the splanchnic circulation. These findings suggest a potential physiological mechanism but should be interpreted cautiously, as the study used a pure glucose load rather than a mixed meal. Other clinical studies involving patients with POTS have also observed increased orthostatic tachycardia after meals, although they have not established the optimal meal composition for managing these symptoms.
In practice, individuals who experience worsening symptoms after eating may benefit from smaller, more frequent meals and avoiding large amounts of carbohydrates in a single sitting. The goal is not to recommend a low-carbohydrate diet, but rather to distribute carbohydrate intake more evenly throughout the day.
Conclusion
Nutrition interventions are an important component of POTS management. Optimizing fluid and salt intake, along with adjusting meal size and composition, may help improve orthostatic tolerance and reduce symptoms. An individualized approach remains essential to account for each patient’s symptoms, dietary habits, and comorbidities. To this end, personalized guidance from a dietitian is recommended.
Sources
Raj et al. (2020). Canadian Cardiovascular Society Position Statement on Postural Orthostatic Tachycardia Syndrome (POTS) and Related Disorders of Chronic Orthostatic Intolerance. Canadian Journal of Cardiology; 36(3):357–372.
Raj, Fedorowski et Sheldon. (2022). Diagnosis and management of postural orthostatic tachycardia syndrome. CMAJ, 194(10), E378–E385.
Harris (2022). COVID-19 Increases the Prevalence of Postural Orthostatic Tachycardia Syndrome: What Nutrition and Dietetics Practitioners Need to Know. Journal of the Academy of Nutrition and Dietetics;122(9):1600-1605.
Wei et al (2025) Pathophysiological mechanisms of Postural Orthostatic Tachycardia Syndrome analyzed by means of hemodynamics. PLoS One;20(7):e0327236.
Garland et al (2021) Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia Syndrome. J Am Coll Cardiol;77(17):2174-2184.
Chung et Raj (2026). Postural Orthostatic Tachycardia Syndrome (POTS): A Review. JAMA;336(13):1149-1164.
Breier et al (2022) Worsening Postural Tachycardia Syndrome Is Associated With Increased Glucose-Dependent Insulinotropic Polypeptide Secretion. Hypertension;79(5):e89-e99
Tani et al (2000) Splanchnic-mesenteric capacitance bed in the postural tachycardia syndrome (POTS). Auton Neurosci;86(1-2):107-113.
Habek et al (2019) Effect of food intake on hemodynamic parameters during the tilt-table test in patients with postural orthostatic tachycardia syndrome. J Clin Neurol;15(2):205-210.
Author
Kathryn holds a Bachelor Degree in Nutrition as well as a Bachelor and a Master Degree in Kinesiology, all from Laval University. She is a Registered Dietitian and active member of the Ordre professionnel des Diététistes Nutritionnistes du Québec (ODNQ) and of the American Academy of Nutrition and Dietetics. She holds the Monash University's certification for the FODMAP diet and IBS, and has considerable clinical experience in that area. She is also an accomplished athlete, having ran track and cross-country at a national level. Kathryn specializes in sports nutrition, weight loss, diabetes, as well as heart and gastrointestinal health.
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