POTS, Salt and Electrolytes: How to Tell If Yours Are Doing Anything

You bought the electrolyte powder everyone in the POTS groups recommended. You're drinking it. And you still feel like you're standing on the deck of a boat by 11am. Before you assume it isn't working for you, it's worth checking what's actually in the sachet — because a lot of drinks marketed for hydration contain far less sodium than a POTS body is usually looking for, and a lot more sugar.

💧 Why water alone often isn't enough

In POTS, blood tends to pool in the lower body when you stand, leaving less circulating volume available for your brain and heart. Increasing fluid intake is one of the standard first-line strategies precisely because it increases that circulating volume. But water on its own passes through relatively quickly. Sodium is what helps the body hold onto that fluid in the bloodstream rather than losing it — which is why salt and fluids are almost always discussed together in POTS management, and rarely one without the other.

This is also why some people find they drink three litres a day and feel no better. The volume is going in; it just isn't staying where it's needed.

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🏷️ How to actually read the label

This is where most of the confusion happens, because the front of the packet almost never tells you what you need to know. Turn it over and look for these three things:

• Sodium per serving, in milligrams. This is the number that matters most, and it varies enormously between products — some sports drinks aimed at general fitness contain only a small fraction of what a dedicated rehydration or POTS-oriented product contains. If the label lists sodium as a percentage of daily value only, that percentage is calculated against a general-population target that assumes you're trying to limit sodium, which is the opposite of most POTS guidance.

• Sugar per serving. A small amount of glucose genuinely helps sodium absorption in the gut, which is the principle behind oral rehydration solutions. Large amounts are mostly there for taste — and if you also have MCAS in the picture, added flavourings and colours are worth scanning too.

• What else is in there. Caffeine appears in some hydration products marketed for energy, which is a separate variable you may or may not want — our guide to POTS and caffeine covers why that one is genuinely contested.

🧂 Powder, tablets, or just salt?

Commercial electrolyte powders

Convenient, consistent, and easy to take with you. The main downsides are cost over time and the fact that formulations vary wildly — two products on the same shelf can differ by a factor of ten in sodium content.

Salt tablets or capsules

Often discussed in POTS communities as a way to increase sodium without drinking flavoured liquid all day. These need a doctor conversation first: dosage matters, and they aren't appropriate for everyone, particularly if you have kidney concerns or high blood pressure alongside POTS.

Salt on food, plus plain water

The least glamorous option and, for some people, entirely sufficient. Broth, salted snacks, and generously seasoned meals spread sodium across the day rather than delivering it in one hit — which some people tolerate better.

There's no universally correct answer here. What matters more than the format is whether your total daily intake actually changed, and whether your symptoms changed with it.

⚠️ Why the "how much" question needs your doctor

You'll see specific gram targets quoted constantly in POTS spaces. We're deliberately not repeating a number here, and that's not evasiveness — it's that recommended sodium intake for POTS is individualised and depends on your blood pressure, kidney function, other conditions, and medications. Someone with hyperadrenergic POTS and elevated blood pressure may be given very different guidance from someone with low blood pressure and significant pooling.

Ask your cardiologist or specialist directly: "What daily sodium and fluid target is appropriate for me specifically?" Then you have a real number to work with instead of a forum average.

❓ Frequently asked questions

📚 Sources & further reading

The information in this article is drawn from the following sources. We encourage you to explore them.

• Dysautonomia International — Lifestyle Adaptations for POTS

• Standing Up to POTS — Patient Resources and Research Updates

✍️ Written with care by Emma at SpoonieToolkitStudio.