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Salt Loading And Extra Fluids?


Alaska
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Salt loading and extra fluids  

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Hi Alaska,

same here, all I know is that the extra salt I'm taking in is really starting to affect my stomach despite taking nexium, tums, eating the "right" kinds of foods etc.

I have days when I don't overload on salt and my BP is normal (for me at least - over 100/60) and so is my heart rate (then again I'm taking a bunch of meds to help keep these under control), while at different times, I can literally lick salt 24/7 (I'm exaggerating a bit, but you get the point) and I can't seem to raise my BP over 90. So far it's been more of a trial and error process. I don't go below 3 liters of liquid a day, but I am still playing around with the salt intake. (I take florinef, so I should be both drinking lots of water and eating plenty of salty stuff in order for it to work properly).

Thanks for starting this poll. I'd be interested to see what others have experienced. I've read a lot of posts from people who have improved significantly by doing just this.

Alex

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I gave up on salt loading and drinking extra fluids. I know not everyone is alike, but for me it messed up my electrolytes more and made me gain weight due to the extra fluid retention. Blah!! Now I just drink when I'm thirsty and salt my food to my taste.

Interesting thing I wanted to add. I did a 23andme genetic test and I have every single marker that suggests salt intake will not increase my BP. I already knew that beforehand though... :) It was just nice to see my genes reflected that phenotype.

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I don't salt load either - was told not to because of high bp's with HyperPOTS. Can't do florinef either - raises bp and gave me a Horrible headache.

Dana, you might try more fluid - that has helped my hr to stay down better. Just don't imbalance your electrolytes - add a little himalyian salt (about 1/4 tea to a gallon of water) - slight amount and it puts the minerals in your water. Or you can buy liquid minerals and/or trace minerals.

Issie

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Ashelton, how do you tolerate all that salt? Do you have any GI issues whatsoever? Does your BP show an increasing trend?

Alex

No, not really. I have more GI issues when I eat gluten or dairy, but once I cut that out I don't have any GI issues from the salt at all. I have no idea how I can handle so much. The tabs make me nauseous so I started putting a couple of 1 gram tabs in my water bottles several times a day and haven't had a problem. It makes my life so much easier versus doing all the chicken broth and tomato juice. yuck I need to keep better track of my heartrate and bp, but I can definitely tell a huge difference when I am salt loading really well. From what I can gather over the last few years, I am extremely hypovolemic. So much so that I believe it's the whole problem for me. Now why my body won't hold onto fluid or balance it on it's own I have no idea. All I know is I feel normal when I'm pregnant and almost normal when I soak in the ocean for days on end and gain 5 lbs of fluid.

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Hey Issie,

I've tried more fluids a few years ago and it doesn't do anything but make me pee too much. lol I was even on DDAVP for a while, which forces your body to hold onto fluids.

We are all very different. Some have amazing results with saline IV, but my first TTT was done while on saline and DDAVP and my HR still hit 180. hahah!! I don't deprive myself of water. I just drink normal amounts.

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Ashelton, does the water taste different with the salt tab added? Also, does the tablet dissolve right away or kindof linger at the bottom of the bottle for quite awhile? I suppose I can try it, it just sounds gross. :blink:

I also do not have GI trouble tolerating them. Once in a while, I will notice a small amount of acid reflux if taking them on an empty stomach. But, the interesting thing is that a few months ago, when I was experimenting with reducing my salt to see if it would make any difference, I had constant acid reflux and a very upset tummy. When I upped the salt again, it was gone...

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Hey Issie,

I've tried more fluids a few years ago and it doesn't do anything but make me pee too much. lol I was even on DDAVP for a while, which forces your body to hold onto fluids.

We are all very different. Some have amazing results with saline IV, but my first TTT was done while on saline and DDAVP and my HR still hit 180. hahah!! I don't deprive myself of water. I just drink normal amounts.

Well, Dana --- all out of ideas :) Wish we could all find some solutions to these issues.

Issie

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Ashelton, does the water taste different with the salt tab added? Also, does the tablet dissolve right away or kindof linger at the bottom of the bottle for quite awhile? I suppose I can try it, it just sounds gross. :blink:

I also do not have GI trouble tolerating them. Once in a while, I will notice a small amount of acid reflux if taking them on an empty stomach. But, the interesting thing is that a few months ago, when I was experimenting with reducing my salt to see if it would make any difference, I had constant acid reflux and a very upset tummy. When I upped the salt again, it was gone...

Wendy, I put them in a 16 oz bottle and it tastes slightly salty. I am so used to it that I barely even taste the salt. Every once in a while I'll ask my husband to taste it and he cringes because it's so salty to him. It actually tastes similar to your tears. The tabs (not thermotabs just sodium chloride) take about 10-15 minutes to dissolve completely in a bottle. I usually shake it often if I want it faster. Otherwise super simple and so much easer for me. I also like to know exactly how much I'm getting where as before with the liquids I had no clue and it was always inconsistent.

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Thanks, Ashelton. Since I only have Thermotabs, I tried one in my water just for kicks. Nasty...it didn't dissolve smoothly at all and tasted awful. I don't know if I can get tablets with just sodium chloride around here or even what the difference would be. I'll have to look into that. I also tried 6 shakes of table salt in a different glass of water and it did dissolve fine, but was too gross for me to drink. It reminded me of the colonoscopy prep solution I had to force down a couple of times, that is probably why my mind won't let me tolerate it. I'll stick to swallowing the tablets for now. I remember that someone on this forum made little salt shots and got it that way, that might not be as bad as sipping it. That is great that you got used to it and it works for you, though. Whatever works!

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Before I started florinef - high salt usually made me feel worse. Now Im the opposite. I did read a few articles where some of the volume regulation abnormalities in POTS cannot be rectified simply by loading with salt or water other than perhaps in the very short term.

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I was advised not to salt load - but do drink lots of water. If i drink too much i sometimes feel worse and waterlogged.

Like issie bp too high to think it is a good idea.

Felt a bit better recently and even on the florinef bp has come down so as the body recovers ...

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I take in about 5g of salt a day now and I think I feel a bit better by doing so. I drink two liters of water and about 16 ounces of gatorade a day.

I just tested low in aldosterone and renin and the endocrinologist wants to start florinef but first he wants me to go on low sodium diet for a few days and then test. I think that salt can artificially lower the aldosterone and he wants to see if I am deficient without it. I am a bit nervous that I will feel awful but will give it a go.

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1. I always wonder why people assume that postural hypertension in the setting of POTS equals dangerous malignant hypertension that requires avoidance of salt.

Nearly all the dangers of hypertension are from sustained increases where there is often hyperdynamic circulation and INCREASED blood volume and perfusion of the brain. In POTS there is sometimes short-term postural fluctuations in peripheral blood pressure but there is nearly always cerebral hypoperfusion and LOW blood volume.

Since most patients have low blood volume, postural hypertension in some could be a compensatory mechanism in the face of reduced absolute blood volume and reduced cerebral hypoperfusion.

I have to assume that a patient that is refusing salt or is receiving advice to avoid salt must not suffer from symptoms of hypoperfusion. Otherwise it makes very little sense if you sit down and read the literature.

2. In many with POTS there may be biochemical reasons why their blood volume is low, and where salt and fluid loading may have little effect on that low volume set point without the intervention of medications. Evidence supports this.

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Thanks, Ashelton. Since I only have Thermotabs, I tried one in my water just for kicks. Nasty...it didn't dissolve smoothly at all and tasted awful. I don't know if I can get tablets with just sodium chloride around here or even what the difference would be. I'll have to look into that. I also tried 6 shakes of table salt in a different glass of water and it did dissolve fine, but was too gross for me to drink. It reminded me of the colonoscopy prep solution I had to force down a couple of times, that is probably why my mind won't let me tolerate it. I'll stick to swallowing the tablets for now. I remember that someone on this forum made little salt shots and got it that way, that might not be as bad as sipping it. That is great that you got used to it and it works for you, though. Whatever works!

The difference between sodium chloride tabs and thermotabs is that thermotabs are buffered. Meaning they have a coating on the outside that keeps them from dissolving to quickly. They are definitely better for straight up swallowing as the whole purpose of them being buffered is to lower the nausea that often comes with salt tabs. When I try to used regular salt in my water I always end up with way too much and it does taste nasty. I don't know about you, but when I put 2 of the Na tabs in my water I can barely taste the salt. I've been salt loading for years so maybe I'm just used to it. My body also really needs it so maybe thats why it doesn't bother me as well. Who knows?!!

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Ashelton...just a thought, have you ever had your renin/aldosterone/angiotensin levels checked? Those hormones are a big part of bp regulation and blood volume. If any of those levels are way off (especially low aldosterone) that may explain why your blood volume won't increase.

http://www.cvphysiol...ssure/BP015.htm

No I haven't. No one has ever even mentioned it to me. I have really crappy doctors though. My Vanderbilt doctor is a joke. I guess I've just always assumed that if something is wrong with the RAAS that no one would know what to do about it anyway. That seems to be what always happens. I remember mentioning to Dr. Cherdak that I wanted my kidneys checked because I have had issues with them since I was young and she basically blew me off and said it wasn't her area and I would just need to find a kidney specialist.

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Ashelton...just a thought, have you ever had your renin/aldosterone/angiotensin levels checked? Those hormones are a big part of bp regulation and blood volume. If any of those levels are way off (especially low aldosterone) that may explain why your blood volume won't increase.

http://www.cvphysiol...ssure/BP015.htm

No I haven't. No one has ever even mentioned it to me. I have really crappy doctors though. My Vanderbilt doctor is a joke. I guess I've just always assumed that if something is wrong with the RAAS that no one would know what to do about it anyway. That seems to be what always happens. I remember mentioning to Dr. Cherdak that I wanted my kidneys checked because I have had issues with them since I was young and she basically blew me off and said it wasn't her area and I would just need to find a kidney specialist.

I have low renin and aldosterone - the nephrologist said that the treatment would be betas (which I can't take because of MCAS and have tried about 5 of and didn't do well with any of them) and also diruretics and stopping salt. He said with POTS - they can't do the traditional treatments because we have to keep our fluid volumes up and can't afford the heavy duty diuretics and told me not to do salt. I had 3 doctors tell me not to do salt - not just one. Also, he told me that when my bp hits 200/100 to come back and then he would try to get more agressive, but it would probably make the POTS symptoms way worse. So, at this time - basically not a whole lot to do for it. It is true that aldosterone regulates fluid volume and if that is low - the fluid volume will be impacted. It seems that all these doctors are in agreement with each other. I keep thinking that there has to be a way to increase both renin and aldosterone without creating other issues - but, according to the docs - with POTS - it will make us worse - not better. (Also, salt lowers the function of aldosterone - if it's already low - you will lower it further. That's one reason why people have to use florinef - it's synthetic aldosterone and you are artifically putting back in what you are depleting with high salt usuage. I did try florineff - by the way - I don't remember what it did to my bp - but, it gave me horrible headaches and I couldn't stand the headaches. Whether or not going on florinef will create permanent dysfunction of the adrenals and aldosterone function - remains to be seen. Some people have a hard time coming off the florinef because their adrenals won't pick back up the function on it's own. It could be a lifelong drug at that point.)

I do know a girl (she's on this forum and I PM her) that did not treat her out of control blood pressure and high NE levels for years and the doctors are not giving her long to live - because of the damage that this has done to her heart and blood vessels and having two heart attacks. The high bp's don't just affect your fluid volumes - it does DAMAGE to things within your body. This is not something to take lightly and allow these high pressures to continue. There might be some side effects of lowering the pressures and you might have to figure out what is worse. But, I know from talking to this girl ---It is serious to allow these high blood pressures to stay high and not do something about it. I have fluctuating bp's and they will swing in both directions - but mine are mostly high. (I wish she would post what has happened to her - it might make people take their high bp's and high NE levels more seriously.)

Issie

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Thanks for that Issie. I agree about not salt loading if br is high. It is sometimes a fine line between keeping bp and hr in balance and i agree i do not want to damage my heart or vascular system.

The whole medical department here quotes a study that disputed the use of extra salt and so i have been advised against any increase and I feel happy with that.

I wish i was not on Florinef but the adrenaline surges were probably very damaging as bp during these episodes was unreadable and very high even when calm enough to take a reading.

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Emma, can you post a link to that study. I have also read a study showing studies with rats and when they took florinef and salt loaded - it killed them very fast. Those who they did not salt load with the florinef - remained alive. I wonder if it's the same study?

Issie

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