Salt Loading

[AmberK]

Hi, Can anyone give me advice about salt loading please? I've been told to do it by my consultant, but he didn't say how much extra salt I need, or what kind of things I should be eating. Also, does anyone know how best to make electrolyte drinks?- the advice from google seems very mixed. I've had POTS for a long time, but only just been diagnosed, so any other advice in what I should be doing would also be appreciated, thanks

[Batik]

Personally I simply put salt in my water bottle. I use low-sodium salt, so I get a mixture of sodium and potassium. I think I should probably go back to the mix that was half low-sodium salt, and half ordinary salt, as that's probably a better balance of sodium to potassium. Anyway, 1/2 tsp to a 800ml/27oz water bottle. Try something like that and see how you get on. Commercial electrolyte drinks are expensive, full of sugar or artificial sweetener, and generally have very little potassium in them, but they do work well for many people.

As for salt loading, have you tried just adding more salt to your food? Do you crave salt?

[AmberK]

Thanks for your reply Batik

That's really helpful advice with the making your own electrolyte drink, I will definitely try it this week, thanks. I've often craved salt but assumed I should keep it to a minimum. I'm overweight so asked the nurse that did my TTT about it, and she said as I don't have high blood pressure, I should be salt loading. It's apparently no extra risk being overweight, it's all about the blood pressure. I've been adding salt to my food since wednesday, so will see how it goes

[Mydoggielovesme2]

The advice from Dr Goodman from Mayo: Nuun tabs, or pedialite, 2.5--3L of water per day, with half being one of these. Also to salt food liberally. Have you had your sodium levels ck, with a blood test? It can give you a good indication of where you are, and where you need to be. When he cked mine I was at 80, should be 170. I was so surprised, I too crave salt, so much so that I would even put some in the palm of my hand and just eat it. (Sea salt) that's why it might be goo to get cked.

[AmberK]

Thanks for the advice, Shona. I am seeing the consultant again at the end of next month so will ask then if I can have my blood checked for salt levels. I've not heard of Nuun tabs or pedialite, so will check them out too.

This forum is invaluable! It's so weird suddenly learning about the illness that has had my life upside down for the past two decades! Very very exciting that there may be things that can help though.

[Guest Alex]

From what I know it's the 24 h urine sodium test that is relevant for POTS, not the blood one. I was told that for POTS the 'goal' should be 170+ mmol/L.

My dr recommended 10 g salt a day (never used that much) and up to 1 gallon of water (that I did). I used to drink 1-2 cups of V8 with as much salt added to it as my stomach was able to tolerate.

Best,

Alex

[looneymom]

My son uses thermotabs (buffered salt tablets). I had to monitor his blood pressure in the beginning to figure out how much he needed. He is not big on salting his food, but is getting better. He can use the regular sodium chloride tablets after he has ate a meal. He does drink a liter of Gatoraide every day plus 1-2 liters of water everyday. Using the tablets only, he gets about 7-10 grams of salt a day. Because his current medications are being changed, I am have to monitor his blood pressure hourly.

[AussieOI]

My doctor recommended taking about 2g of salt in the form of tablets at dinner time. Apparently some people can get an upset stomach with salt tablets so it can be good to take them with food. I have not had that problem but take them with food all the same. There seems to be a huge difference of opinion with what is the right amount to take daily - I have seen anything from 2g - 10g

[Mydoggielovesme2]

Thanks Alex, you are soooo right, it is urine not blood test. (I'm not blonde, so guess blame it on brain fog.... ;-)

[Guest Alex]

Shona,

don't even worry. We're only human

Alex

[seattle chris]

The Cleveland Clinic recommends a 5g sodium diet for autonomic disorder patients. On the other hand, there is a widely distributed paper by several Mayo doctors that recommends 10-20g per day. I tried the high end of the spectrum and was taking 9 1g sodium chloride tablets daily in addition to salt loading my food. My urine test showed that my output was more than 2x the max, so I cut back to 5x daily. Based on recent bouts with high blood pressure and preliminary blood volume test results that indicated my blood volume was 25% higher than normal, I am cutting back even more (I will post my recent testing results in another thread). Recommended intake is probably a trial and error process as results can vary considerably from person to person.

As far as hydration, I second the Nuun recommendation. They don't have sugar and are portable. I bought some online from Super Supplements and they had a variety of flavors on clearance if you are looking to save a few dollars. In addition, I start the day with a Propel drink mixed with a sodium tab.

[songcanary]

The day I added 1 teaspoon of salt to 2 liters of water I was washing walls within two hours. Keeping in mind I was non functional for the previous three years. It was a godsend and I still use that amount faithfully every day. I got my advice from the Cleveland Clinic.

[Batik]

This is what I use to make my electrolyte drink, sometimes mixed with ordinary sea salt: Tesco Reduced Sodium Salt. 89p for 350g. I only recently realised that it provides twice as much potassium as sodium, despite having equal weights of the chloride salts, but it seems to suit me. I might go back to mixing it 50:50 with plain salt to change the ratio, but then I add plain salt to my food in abundance, so it probably evens out that way.

I'd suggest that you start by simply salting water and seeing how a) you like the taste it makes you feel. Start with adding a pinch to a glassful and keep going. If you go for a water bottle, try something like 1/4tsp to 800ml or so and work up from there. I think a water bottle is easier, as you can give it a shake to mix and you tend to drink more that way. Mixing salt into a glass with a fork is a little odd. Some people like a splash of lemon in their salty water to improve the taste. If you can handle the taste of salty water, it's a much cheaper way to get your salt, and potassium too if you choose.

The electrolyte tablets have much less potassium, probably not really a useful amount, and sometimes very small amounts of other minerals. If you try coconut water, that gives you plenty of potassium but almost no sodium, and costs a lot. I get the Vita Coco coconut water with pineapple (the plain tastes odd to me, and the other brands all have sugar or cost even more) from Tesco as an occasional treat. It was quite soothing when I had a cold with a sore throat the other week.

[AmberK]

Thanks everyone, that's really helpful advice. I bought 6 bottles of 1.5l water, and have added a teaspoon of salt to one of them. It's not as bad a taste as I thought, but I think I will put less in the next one and build it up if need be. I've ordered two jugs so that I can use tap water for the rest of the time, and alternate them in the fridge.

Does anyone know why people with POTS should salt-load? I had a hair mineral analysis test done 11 years ago. I've just looked, and my sodium levels came back high on that I know it was 11 years ago, but I was just as symptomatic then.

[westernmass]

Can someone help me understand this? I don't see why salt is recommended, unless you have evidence of being hypovolemic or having very low BP. If bp is relatively normal (low normal) and there is no evidence of hypovolemia, why salt load? Doesn't that just potentially end up harming kidneys?

[Batik]

Hair mineral analysis is, erm, not regarded as reliable by the medical profession.

I find it easiest to buy a metal water bottle and keep refilling that, by the way. Much better for the environment, tap water is better quality than bottled (OK, there are some areas where the tap water is vile, I'll grant you that), and you can put it in the dishwasher.

[Guest Alex]

I believe that the 'theory' as to what salt does for POTS pts is that high dietary sodium level may expand plasma volume in POTS.

Recently there were some posts about the salt loading being quite controversial, and one in particular that has caught my attention about the mechanism of action of salt in one's body.

According to some Boston researchers, salt increases one's BP via adrenalin.

http://www.scientificamerican.com/podcast/episode.cfm?id=salt-boosts-bp-but-via-adrenalin-12-01-11

http://www.ncbi.nlm.nih.gov/pubmed/22227820

Alex

Edited May 15, 2013 by corina