PoTS diet: what to eat, how much salt and fluid to aim for
There is no single PoTS diet, but UK guidance points to a clear pattern. Drink 2-3 litres of fluid a day, add salt as your doctor advises, and eat small, regular meals built around protein. Cut back on large, high-carbohydrate meals if they make you feel worse. Below, we explain each step and when to check with your doctor first.
TL;DR
- PoTS UK advises adults to aim for 2-3 litres of fluid and 6-10g of additional salt daily.
- Small meals and snacks through the day may help, because digestion diverts blood to the gut.
- Some people feel worse after high-carbohydrate meals, so protein-based meals with wholegrain or low-GI carbohydrates may suit better.
- If you have heart disease, kidney disease or high blood pressure, ask your doctor before increasing salt or fluid.
- A personalised plan helps you fit all this around your own symptoms and routine.
Table of Contents
- Why food affects PoTS symptoms
- Fluids: how much and when
- Salt intake with PoTS
- Meal size and timing
- Carbohydrates and possible triggers
- Electrolyte drinks
- Does PoTS cause weight gain?
- Our perspective
- Get a plan built around you
- FAQ
- Sources
Why food affects PoTS symptoms
Postural tachycardia syndrome (PoTS) is a condition where standing up causes a fast heart rate and symptoms such as dizziness and fatigue. Diet cannot cure it, but it is one of the first lines of self-management. PoTS UK’s information booklet lists fluids, salt, compression tights and exercise as the usual measures, with medication considered when lifestyle changes are not enough.
The aim of most dietary advice is to support blood volume and avoid sudden drops in blood pressure.
Fluids: how much and when
The commonly recommended target is 2-3 litres of fluid a day. Practical ways to get there:
- Keep a bottle with you and sip steadily rather than drinking large amounts at once.
- Drink a glass of water before you get out of bed. PoTS UK suggests this can help with morning symptoms by boosting blood volume.
- Spread drinks across the day and set reminders if you forget.
Salt intake with PoTS
PoTS UK advises adults to have 6-10g of additional salt a day. Research on high dietary sodium in PoTS is part of why this is a standard recommendation, but it is not right for everyone.
Check with your doctor first if you have heart disease, kidney disease or high blood pressure. The same PoTS UK page says these groups should ask their doctor how much salt and fluid they should have. Dr Ellie Cannon also stresses that increasing salt should not be done without explicit medical advice.
Easy ways to add salt to food include seasoning meals, salty snacks such as olives or salted nuts, and soups, broths and gravies. If you cannot manage enough through food, your doctor may prescribe salt tablets.
Meal size and timing
Eating diverts blood to the gut, which may lead to a small drop in blood pressure. For that reason, many people with PoTS do better with:
- Smaller meals and snacks spread through the day, rather than two or three big plates.
- Protein foods such as meat, fish, eggs, Quorn or soya at each meal.
- Smaller portions of wholegrain or low-GI carbohydrates.
- Sitting or resting briefly after eating if symptoms flare.
Carbohydrates and possible triggers
Starchy foods such as bread, pasta, rice and potatoes are staples, and you do not need to remove them. The evidence is that some people feel worse after a high-carbohydrate meal, not everyone. A simple food and symptom diary shows whether this is true for you.
Record what you ate, the portion size, the time, and how you felt over the following two hours. Patterns usually appear within two weeks, and you can bring the diary to your GP or dietitian.
Electrolyte drinks
Electrolyte drinks are a popular way to add fluid and sodium. A Guardian report on functional drinks notes that people who drink enough water and eat a normal diet do not need them, so they are a convenience rather than a requirement for most. If you use them for PoTS, read the label for sodium per serving and for added sugar, and count them within your daily fluid and salt totals rather than on top. Ask your doctor if you have high blood pressure or kidney problems.
Does PoTS cause weight gain?
People often ask this, and the honest answer is that it varies. Changes in activity, medication and a higher-salt diet can all affect weight and bloating for some individuals, as in one patient’s account. If your weight is changing and you are worried, speak to your GP, and ask for a plan that does not compromise your fluid and salt needs.
Our perspective
PoTS advice often arrives as a list of rules: this much salt, that much water, eat little and often. The list is a good start, but it rarely fits a real life. Fatigue, digestive symptoms, hormones, work and family all shape what you can actually do.
This is why we work in programmes rather than single appointments. We look closely at your lifestyle, your symptoms and your eating pattern, then build recommendations you can keep up without added stress. Where it is useful, we can also interpret functional laboratory tests. Our practitioners hold an MSc in Nutrition and are BANT and CNHC registered.
Salt and fluid targets should always sit alongside your medical care, and we encourage you to involve your doctor.
Irina
Get a plan built around you
If you want help turning general PoTS guidance into daily habits, our nutrition consultations are designed for exactly that. An initial consultation of one and a half hours with written personalised recommendations costs £150, and a follow-up within 8 weeks is £120. Our 12 weeks of dedicated support costs £250. See the consultation prices or our nutrition support services.
FAQ
What diet is best for PoTS?
There is no single best diet. Guidance generally recommends enough fluid, extra salt if your doctor agrees, and small regular meals with protein. Adjust it according to how your own symptoms respond.
What foods should you avoid with PoTS?
No foods are banned. Some people notice symptoms after large, high-carbohydrate meals, so smaller portions and more protein may help. A food diary helps you identify your own triggers.
How much salt should you have with PoTS?
PoTS UK advises 6-10g of additional salt daily for adults. If you have heart disease, kidney disease or high blood pressure, ask your doctor for your own figure first.
Do you need electrolyte drinks for PoTS?
Not necessarily. Water and salty foods can meet the same needs, but electrolyte drinks are a convenient option. Check sodium and sugar on the label.