For people suffering from Orthostatic Intolerance, Postural Orthostatic Tachycardia, Mast Cell Activtation or EDS. Follow me as I document my struggle towards better health.

Increasing the Salt in Your Diet - PART I

Ways to increase your salt intake...without resorting 
to salt pills or junk food.

Increasing the amount of salt in your diet in addition to exercise are a more natural way to help increase blood volume.  People with Orthostatic Intolerance or Postural Orthostatic Tachycardia know very well the drawbacks of not having enough blood volume: it can dramatically increase the severity of symptoms.

In the past, doctors have suggested to patients with POTS or OI to take Thermotabs or other over the counter salt tablets.  When I was diagnosed with POTS over 12 years ago that is exactly what the doctors suggested to me.  However, it has since been established that ingesting salt via tablet can have the reverse effect on blood volume and dehydrate the body.  According to Dr. B. Levine's Research Team in Texas:
"The use of salt tablets isn't recommended as they provide a very large amount of salt to the stomach all at once and actually cause water to move from your circulation into your stomach and gastrointestinal system thus dehydrating you."
Many people would prefer to use salt to increase their blood volume over drugs like Florinef because of the potential short and long-term side-effects of taking fludrocortisone.

Putting Some Funk into your Lotsa Salt Diet
I have learned in the 10 days or so that I have been on my lotsa salt diet that in order to survive a diet containing >8,000mg of salt daily I need to embrace the salt crystal and learn how to use it creatively in my cooking.

I went to my local gourmet foods store to look for options and to get inspired.  In case you didn't know, there are many different types of salt available to purchase for a variety of cooking applications.  Some of the new and groovy salt I have found include:

  • Grey Celtic Sea Salt is totally unprocessed and hand harvested. It is dried by the sun and the wind, retaining the ocean s moisture and locking in a vast array of vital trace elements. Celtic Sea Salt is a coarse, moist salt that gets a light grey hue from the pure clay sole it is harvested from in France. I use this in vegetable stews, mushroom soup and for grilling fish.
  • Himalayan Salt is a multi-coloured salt due to the different types of minerals it contains. Check out this video on its (nudge) magical health properties.   I stir this salt into low-fat cottage cheese for a tasty lotsa salt snack.
  • Hawaiian Black Salt is just  apparently due to the lava particles.  I haven't actually found a use for this one yet.
  • Anglesey Salt, harvested on the west coast of Wales, has a light, smokey flavour.  Terrific on fish, pork or even sliced tomatoes with fresh basil leaves and a shake of old balsamic vinegar.
Gourmet salts such as the ones above are more easily absorbed into your food while cooking so add them towards the end.  I normally add my vast amounts of salt just before serving so I don't have to inflict my saltiness on other diners.  In PART II of Increasing Salt in Your Diet I am going to talk about what foods are particularly tolerant to the addition of lotsa salt as some foods instantly are overwhelmed by the extra saltiness where others have flavours that can still compete.   ...PART II


  1. Your link didn't work - what are the long-term effects of Florinef?

  2. Geeze, the link worked for me...I will try to send it to you direct if I can.

  3. Here is an excerpt from the Merck Manual but you can google yourself re side effects and fludrocortisone or corticosteroids. Taking or not taking a particular drug to help treat POTS and OI is a deeply personal choice.

    My personal choice is to avoid taking medications as much as I can because my opinion is that the meds may increase the symptoms in an already poorly understood condition. If I can achieve the same or better results in impoving symptoms through a different treatment protocol that does not include meds then my choice is to take the non-meds route.

    Additionally - re short term effects, my dermatologist told me that while on Florinef and for a period of time afterwards, any facial treatments (such as a peel etc) would not be possible as the drug inhibits the body's production of collagen. (yipes! At my age I need all the collagen I can get ;-)

    Concerns related to adverse effects:

    • Adrenal suppression: May cause hypercorticism or suppression of hypothalamic-pituitary-adrenal (HPA) axis, particularly in younger children or in patients receiving high doses for prolonged periods. HPA axis suppression may lead to adrenal crisis. Withdrawal and discontinuation of a corticosteroid should be done slowly and carefully. Fludrocortisone is primarily a mineralocorticoid agonist, but may also inhibit the HPA axis.

    • Immunosuppression: May increase risk of infection and/or limit response to vaccinations; close observation is required in patients with latent tuberculosis and/or TB reactivity. Restrict use in active TB (only in conjunction with antituberculosis treatment).

    Disease-related concerns:

    • Cardiovascular disease: Use with caution in patients with HF; use may be associated with fluid retention, edema, weight gain and hypertension.

    • Electrolyte disturbances: Use with caution in patients with sodium retention and potassium loss. Monitor electrolytes periodically; sodium restriction and/or potassium supplementation may be required.

    • Hepatic impairment: Use with caution in patients with hepatic impairment, including cirrhosis; long-term use has been associated with fluid retention.

    • Myocardial infarction (MI): Use with caution following acute MI; corticosteroids have been associated with myocardial rupture.

    • Osteoporosis: Use with caution in patients with osteoporosis; high doses and/or long-term use of corticosteroids have been associated with increased bone loss and osteoporotic fractures.

    • Renal impairment: Use with caution in patients with renal impairment; fluid retention may occur.

    Special populations:

    • Elderly: Because of the risk of adverse effects, systemic corticosteroids should be used cautiously in the elderly in the smallest possible effective dose for the shortest duration.

    • Pediatrics: Safety and efficacy have not been established in children.

    Other warnings/precautions:

    • Discontinuation of therapy: Withdraw therapy with gradual tapering of dose.

    Adverse Reactions
    Frequency not defined.

    Cardiovascular: CHF, edema, hypertension

    Central nervous system: Dizziness, headache, seizures

    Dermatologic: Acne, bruising, rash

    Endocrine & metabolic: HPA suppression, hyperglycemia, hypokalemic alkalosis, suppression of growth

    Gastrointestinal: Peptic ulcer

    Neuromuscular & skeletal: Muscle weakness

    Ocular: Cataracts

    Miscellaneous: Anaphylaxis (generalized), diaphoresis

  4. Ok, I'm confused, I thought tomatoes, basil, vinegar, etc were *not* allowed on the pseudo-allergen diet.. or are you referring to later on when you start reintroducing these foods? I thought the diet was for as long as one wanted to be POTS-free, or at least POTS-reduced!