Sodium and POTS: What you need to know
09.14.2026 |
Written by Sophie Wright, Accredited Exercise Physiologist and founder of CardioCare Clinic |
If you’ve been diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS), a medical condition that affects the autonomic nervous system (the system that controls automatic bodily functions like heart rate and blood pressure), there’s a good chance you’ve been told to “eat more salt” or “drink more fluids.”
For many people, that can sound surprising. We’re often taught that reducing salt is an important part of a healthy diet, so why would increasing sodium be recommended for POTS?
The answer comes down to how POTS can affect blood volume and the body’s ability to regulate blood flow when moving into an upright position.
We’ve put together this guide to answer some of the most common questions around sodium, salt and hydration in POTS.
Important: This article is general educational information and is not individual medical or dietetic advice. Sodium and fluid requirements vary between individuals, and increasing sodium intake is not appropriate for everyone. Speak with your GP, cardiologist, dietitian or other treating health professional before making significant changes to your sodium or fluid intake.
Why is increasing sodium recommended for some people with POTS?
When you stand, gravity causes some blood to move towards the lower part of your body. Normally, your blood vessels constrict and your muscles help push blood back towards your heart.
In POTS, these responses may not work as effectively. Some people with POTS also have lower circulating blood volume. This can mean that less blood returns to the heart when standing, and the body compensates by increasing heart rate.
This can contribute to symptoms such as dizziness, light-headedness, fatigue, brain fog, palpitations and exercise intolerance.
Sodium plays an important role in maintaining fluid balance. Increasing sodium intake can help the body retain fluid, which may increase circulating blood volume and support blood flow when upright.
Research has shown that increasing dietary sodium can increase blood volume and reduce standing heart rate in people with POTS.
How much sodium should I have each day?
The Australian POTS Foundation recommends around 10 g of salt per day (equivalent to 4,000 mg of sodium or about 2 heaped teaspoons) for people with POTS where appropriate and where there are no contraindications. Two Islands Hydrate⁴ Hydration Powder can help support you in meeting your daily target, with each sachet containing 1,000 mg of Sodium.
This is a general guide rather than a prescription for everyone.
Your individual sodium requirements may be different depending on factors such as your blood pressure, kidney and cardiovascular health, medications and individual POTS presentation.
Is sodium the same as salt?
No - although the terms are often used interchangeably, sodium and salt are not the same thing.
Table salt is sodium chloride, which contains both sodium and chloride. Sodium makes up approximately 40% of the weight of table salt.
This means the amount of sodium you consume is less than the total weight of salt.
Australian food labels generally list sodium, while healthcare professionals may sometimes give recommendations in terms of salt, so understanding the difference can be helpful.
How much salt equals 1 gram of sodium?
As a general conversion:
1 gram of sodium ≈ 2.5 grams of table salt
And in the other direction:
1 gram of table salt ≈ 400 mg of sodium
So, for example, 4,000 mg of sodium is approximately equivalent to 10 g of table salt (2 heaped teaspoons).
These are approximate conversions and can vary slightly depending on the type of salt.
How much water should I drink when increasing sodium?
Sodium and fluid work together.
The Australian POTS Foundation recommends around 2–3 litres of fluid per day for people with POTS, where appropriate.
Rather than drinking a large volume of water all at once, many people find it easier to spread their fluid intake throughout the day.
Your fluid requirements may increase depending on factors such as:
- Hot weather
- Sweating
- Exercise
- Illness
- Vomiting or diarrhoea
- Prolonged periods of standing
Individual fluid requirements should be discussed with your healthcare professional, particularly if you have another condition that affects fluid balance.
What are the easiest ways to increase sodium?
There are many ways to increase sodium intake, and you don't necessarily need to rely on supplements.
Some practical options include:
- Adding salt to meals
- Salted nuts or crackers
- Pretzels
- Olives and pickles
- Soups and broths
- Salted spreads or sauces
- Electrolyte drinks (Hydrate⁴ Hydration Powder)
- Salt tablets or capsules, if recommended by your healthcare professional
For many people, spreading sodium intake throughout the day is easier and more comfortable than consuming a large amount at once.
Increasing sodium also doesn't mean your diet needs to consist of highly processed foods. Salt can be added to nutritious meals and snacks as part of an overall balanced diet.
Do I need electrolyte supplements, or can I get enough sodium from food?
It depends on the individual.
Some people can comfortably meet their sodium requirements through food and added salt. Others may find this difficult, particularly if they experience nausea, reduced appetite, dietary restrictions or simply find it difficult to consistently consume enough sodium through meals.
For these people, an electrolyte drink like Two Islands Hydrate⁴ Hydration Powder can be a convenient way to combine fluid and sodium.
The important thing is to look at how much sodium the product contains. Not all electrolyte products contain the same amount of sodium.
Electrolyte supplements aren't essential for everyone with POTS, and they don't need to replace sodium obtained through food.
The best approach is the one that is safe, practical and sustainable for you.
Can you have too much sodium?
Yes.
Although increasing sodium can be an important part of POTS management for some people, more is not necessarily better.
High sodium intake can contribute to increased blood pressure and may be inappropriate for people with certain cardiovascular or kidney conditions.
This is particularly important if you already have high blood pressure, kidney disease, heart disease or take medications that affect fluid or electrolyte balance.
Sodium should therefore be considered as part of an individualised POTS management strategy rather than simply a dietary recommendation to follow without limits.
If you're considering significantly increasing your sodium intake, speak with your treating healthcare professional first.
Should everyone with POTS increase their sodium intake?
Not necessarily.
POTS is a complex condition, and people can have different contributing factors, symptoms and responses to treatment.
While increased sodium and fluid intake can be helpful for many people, it isn't appropriate to assume that everyone with POTS should follow exactly the same strategy.
For example, someone with POTS alongside hypertension or another condition where increased sodium is not recommended may require a different approach.
This is why sodium recommendations should be individualised and discussed with a healthcare professional who understands your medical history and POTS presentation.
The goal isn't to consume as much sodium as possible. The goal is to find an appropriate sodium and fluid strategy that supports your symptoms and overall health.
Want to learn more?
The Australian POTS Foundation (APF) is an Australian not-for-profit organisation dedicated to increasing awareness, education, research and support for people living with POTS.
Their website provides further information about POTS, including treatment approaches, living with POTS and resources for people who have recently been diagnosed.
Learn more about POTS:
potsfoundation.org.au
APF also offers membership for people who would like to access additional resources, community support and member benefits.
Learn more about APF membership:
potsfoundation.org.au/become-a-member
*About Sophie
Sophie Wright is an Accredited Exercise Physiologist and founder of CardioCare Clinic, a specialised exercise physiology clinic supporting people across cardiovascular health and chronic conditions, including POTS and dysautonomia.
Through CardioCare Clinic, Sophie provides individualised exercise physiology, small-group programs and telehealth support, helping people build confidence with movement and exercise across prevention, recovery and long-term health.
