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

Salt Intake and Managing Blood Volume

There has been some really interesting posts on the new Facebook Group about sodium intake.  When I first started the Levine protocol I gradually built up to 10,000mg per day with the help of my nutritionist.  Working with my local physician I had my blood tested weekly to ensure my potassium levels were ok.

After about a month such high levels of salt I no longer needed such a high dose and gradually reduced the salt to a point that "felt" right.  I found that too much could trigger what felt like heart palpitations and other unpleasant feelings.

Since the purpose of the high sodium is to help with blood volume, it makes sense to combine the effort with the "bed wedge", carefully avoiding diuretics like caffeine and alcohol (I must admit the occasional glass of wine will sneak by my lips) and ensuring plenty of fluids.

The blood volume challenge is, for me, one of the less onerous lifestyle changes to make in helping managing POTS symptoms. Love that salt! ;-)


  1. I have sooo many questions for you! I just came across this site! I'm so thankful. There is so much useful information. How do you manage to work and deal with POTS? Are you able to Fly? They recommended I did not fly. I take salt pills...but no medication. Do you get aniexty? Did you get POTS after a baby, or having the flu? I would like to hear from you. here is my email Thanks so much!!

  2. I too have POTS. I haven't been diagnosed because docs don't seem to know what POTS is, but I'm absolutely positive it's POTS. Acts like POTS, responds like POTS, it's POTS. I have been diagnosed with Neurocardiogenic Syncope, which goes hand in hand with POTS.

    I too get PVC's for sure and I believe PACs as well. Makes me feel quite sick when it happens for extended periods of time. Keeping a watch on my potassium and magnesium seem to keep this fairly well under control.

    Trying to be "healthy," I cut back on salt. I had been a salt fiend, often craving it, but I wanted to be good to my body, so I cut it down to near zero, among other diet changes. BAD IDEA for someone with POTS, which I didn't know I had at the time.

    I got -extreme- anxiety and panic attacks for months on end before I realized I had POTS. I'd go to sleep at night absolutely -knowing- that I'd die during the night. I'd wake up, and simply not believe I'd last the day. I can't explain living like this, with the panic hormones constantly being released in the brain. It was the most brutal thing I have ever experienced. The panic is caused by hypoxia to the brain due to lack of blood flow. POTS is -commonly- misdiagnosed as General Anxiety Disorder, which I was diagnosed with.

    Solution for me was salt increase (no thanks to doc, thank you Wikipedia). The panic and anxiety was -gone- within hours of high doses of salt and lots of water. A mind fog that destroyed my engineering career before I learned what was wrong was also improved drastically within hours of the salt and water. Still not to the point of recovering my career, but drastic improvement.

    I have reduced my alcohol intake quite a bit just on principle, however I've hardly noticed an effect at all when I do drink, surprisingly. I do however avoid alcohol like the plague on days I'm particularly bad, but mostly because I just don't want it when I'm feeling like that. Use caution though, alcohol will dehydrate you or interact with medications, bad news for POTS.

    I was recently put on a beta blocker for my heart palpitations. I didn't notice that it had an effect, so the doc took me off of it. Once I was off of it, -then- I noticed how much worse I actually am without it. Not only the palpitations are back, but everything. Mind fog, headaches, concentration, everything. Beta blockers, here I come.

    Notes on caffeine. While it has an obvious positive effect on most of the POTS symptoms like mind fog and headaches, it causes my heart palpitations to increase drastically. While on the beta blocker, I could drink caffeine for the positive effects, without heart issues.

    One thing I have had a problem adding to my treatment is recumbant exercise. Rowing machine, recumbant bicycle. I have issues with exercise because of palpitations and blacking out. Even while on beta blockers. Exercise is crucial for treating POTS, and I just can't do it because of what it does to my heart. Since I can't convince the docs I have POTS, I can't get advice on what to do about this. I was literally told "Wow, I don't know what to tell you. See ya..." Gee, thanks.

    I have also heard a few success stories about a possible CURE for POTS! Apparently it -could- be due at least in part by nerves pinched in the neck where the skull attaches to the spine. Chiropractic adjustments to get things back straight have apparently been successful in CURING POTS. I can't make this claim because I have not tried this, but I do have neck and spine issues, so it's on my to-do once I can figure out how to pay for it.

    So I hope this information on my experiences helps someone coming across this page!

    1. Anonymous with October 14, 2012 post, please reply to this as I would like to get in touch with you to discuss this post as I have the exact symptoms and after years of searching the net, yours is the closest I have found to my own situation. Please let me know if you are out there. Thanks!