Another Salt Observation

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Hello all!

When I was first diagnosed (over a year ago now, wow!) my doctor told me to drink a lot and eat more salt. I already drank a TON because of being excessively thirsty, but at the time I was hardly eating any salt (because I feared it would make me more thirsty). I don't tend to eat processed foods so my salt intake was quite low.

At the time of diagnosis, my sodium levels would sometimes come back high and sometimes come back normal. My potassium always came back normal. My BP has never dropped upon standing, and sometimes increases when I stand up. My resting BP tends to be on the high-ish end of normal (at the time it was consistently around 120-125/60-70). So I was REALLY worried about increasing my salt-intake, since I thought it might make my BP higher and/or my sodium levels higher.

Finally about six months ago I started trying the increased salt thing because I hadn't really tried it yet, and it's made me feel a lot better! My BP hasn't gone up (in fact it's a little bit lower now, in the 115/55 range) and I don't feel nearly as thirsty as I did before I started eating more salt. My tachycardias aren't as bad, either. I noticed a difference almost right away, and now I make sure to add salt daily.

If I didn't have low BP and if my potassium wasn't off, why is the increased salt making me feel better? Does anyone know?

[potsgirl]

Sorry I can't give you a reason for the salt making you feel better, except to say that people with POTS are usually told to increase their salt use dramatically. It sounds like perhaps you were really low on sodium, and now you're eating enough to make your body run more smoothly? It's kind of an anomaly that both POTS people with higher BPs and those who have very low BPs that drop significantly when standing both benefit from increased salt use. It's an excellent question...

[janiedelite]

I have POTS with a hyperadrenergic response, so my BP goes up with orthostatic stress. Mayo advised me to increase salt, fluids, compression, etc. The doc said that if I address my pooling and low blood volume that my hyperadrenergic response should subside also. He was right! For me, prior to implementing a high salt intake, my standing BP was easily 140's/100's, and lying was 120/60's. Now my standing BP is on average 130's/80's, lying is 110/60's. If I have any type of stress, like even having a casual conversation, it will go higher. Compression helps too. When my BP was above 140/95, I'd feel my pulse in my head, have pounding chest pain, and it was a horrible feeling. I still get it occasionally, but laying down will usually reduce these symptoms within an hour or so.

I did 2 urine sodium tests at Mayo. The first came back at 75 (which the doc said was quite low). He told me to increase my fluid intake to 3L/day, and the next week my sodium was in the 130's. That was without even increasing my sodium.

[ramakentesh]

In most patients the orthostatic high blood pressure in the hyperadrenergic response some POTS patients gets can really be said to be a false positive - its high but since the actual amount of blood travelling to the brain is significantly reduced (maybe between 60-44%) the increase blood pressure correlates with reduced flow.

In other words while it appears to be hypertensive, its actually a coping mechanism for low blood flow (and thus pressure) to the brain.

Therefore increased salt is not an issue in MOST (if not possibly all) patients.