How to increase salt intake: a practical guide

Most people with POTS or suspected autonomic dysfunction are told at some point to increase their salt intake. The recommended target is typically 10–12g of sodium chloride per day, roughly double what most people eat. Getting there is harder than it sounds, and nobody tells you how to actually do it.

This post is about the practical mechanics: what to use, how to measure it, when to take it, and how to build it into a daily routine without living on processed food or feeling constantly nauseous.

Why salt matters (briefly)

The evidence is covered in detail in Salt, water, compression, and electrolytes: what the evidence says.

The short version: in orthostatic conditions, extra sodium and fluid help expand blood plasma volume, which reduces the degree of pooling when you stand. This doesn’t cure the underlying dysfunction, but it can meaningfully reduce symptoms for many people. The effect is dose-dependent: a small amount of extra salt helps a little; hitting the full target helps more.

The target and why it matters

10–12g of salt per day is the figure cited in most POTS guidance, including from specialist centres. This refers to sodium chloride (table salt), not sodium alone. For reference:

1 teaspoon of table salt = approximately 6g
1g of sodium = approximately 2.5g of salt
Average UK adult intake = approximately 8g/day

So the target is roughly 2–4g above average. That’s a meaningful amount, and getting there without conscious effort is unlikely.

What to use

There is no meaningful evidence that one form of salt is better than another for this purpose. The practical options:

Table salt is the most straightforward. It’s cheap, widely available, and easy to measure. The drawback is that adding enough to food to hit the target requires either very salty food or supplementing between meals.

Salt tablets (sodium chloride capsules) are a clean, measurable way to top up intake without affecting the flavour of everything you eat. They’re sold as electrolyte or sodium supplements, typically in 500mg or 1g sodium equivalent doses. They can cause nausea if taken without food or water.

Electrolyte sachets and drinks (such as Dioralyte, SOS Hydration, LMNT) contain sodium alongside other electrolytes. These can be useful for people who find drinking plain water difficult or who want to spread sodium intake throughout the day. They vary significantly in sodium content; check the label.

Soy sauce, miso, and similar condiments are very high in sodium and can contribute meaningfully to intake. 1 tablespoon of soy sauce contains around 1g of sodium (2.5g salt equivalent). Useful for people who cook a lot of Asian-style food; less useful as a standalone strategy.

How to measure what you’re eating

Most people significantly underestimate their sodium intake. The only reliable way to know where you are is to track it, at least for a couple of weeks.

A food tracking app (Cronometer is good because it shows micronutrients including sodium) will give you a baseline. Log everything for a week and see how far below the target you are. Most people eating an unprocessed diet will be at 5–7g of salt per day. Most people eating a lot of processed food will already be at or above 8g.

Once you know your baseline, the gap to fill becomes clear. If you’re at 7g and need 10g, you need to add roughly half a teaspoon of salt equivalently per day, either through food or supplementation.

Timing

Salt works better when paired with fluid. The mechanism is that the sodium helps retain the water, expanding plasma volume. Taking a large amount of salt without adequate hydration doesn’t work as well and can cause headaches.

The most useful times to take extra salt are:

On waking, before getting up, combined with 500ml of water. This is when orthostatic symptoms are often worst. Pre-loading with salt and fluid before standing can reduce the initial morning spike in heart rate.

Before activity that involves prolonged standing or walking. Taken 20–30 minutes before, with water, it can blunt the orthostatic response.

With meals, particularly if meals contain fluid. This is the most natural way to increase intake and easiest to sustain long-term.

Avoid large amounts of salt in the evening if you have sleep problems; the water retention can sometimes increase night-time urination.

Practical strategies for reaching the target

Add salt to everything you cook. This is the single most effective change. Pasta water, soups, stews, vegetables, eggs: all of these can carry significantly more salt than most people add without tasting unpleasantly salty. Taste is not a reliable guide to sodium content.

Use stock or broth. A mug of homemade or good-quality stock contains 500mg–1g of sodium. It’s easy to drink, hydrating, and filling without adding many calories.

Salt water shots. Half a teaspoon of salt dissolved in a small glass of water, taken with a larger glass of water. Not pleasant but fast and measurable. Some people find this easier first thing in the morning before the taste aversion kicks in.

Salt tablets with meals. If cooking at home allows you to hit 7–8g, one or two 1g salt tablets at mealtimes can bridge the gap without affecting food.

Electrolyte drinks. One high-sodium electrolyte sachet per day (check it contains at least 500–1000mg sodium, not just a small amount) can contribute meaningfully.

What doesn’t work well

Relying on processed food to hit the target. Processed food is high in sodium, but it’s also high in things that are genuinely bad for cardiovascular health long-term. It also makes intake harder to control and monitor.

Adding salt only to taste. Most people’s salt taste preference adjusts rapidly in both directions. If you’ve been on a low-sodium diet, you’ll find normal salt levels taste extreme. If you’ve been on a high-sodium diet, the same food tastes bland. Your sense of saltiness is not a reliable guide to how much you’re eating.

Expecting to notice an immediate effect from increasing intake. For some people the improvement is noticeable within a day or two; for others it takes a couple of weeks of consistent higher intake to see a difference. Plasma volume expansion is a slow process.

Tolerability

The most common issue is nausea, particularly from salt tablets or concentrated salt drinks on an empty stomach. Taking salt with food almost entirely solves this.

Some people notice their ankles swell slightly when sodium intake is high. If this is significant, mention it to your doctor; it can occasionally indicate a need to reassess fluid management. Mild ankle oedema in isolation is common and not dangerous.

People with kidney disease, heart failure, or hypertension should not increase salt intake without medical supervision. For most people with POTS or dysautonomia, the concern runs in the opposite direction: they need more, not less, sodium.

What I do

I track sodium in Cronometer about once every month or two to check I’m still on target. My daily routine:

Add generous salt to all cooking
One 500ml glass of water with a quarter teaspoon of salt first thing in the morning
One electrolyte sachet (LMNT, the unflavoured version) dissolved in a water bottle during the morning
Salt tablets (500mg x2) if I know I have a demanding afternoon

On a typical day this gets me to around 10–11g without significant effort once the habit is established. The morning salt water is the hardest part to maintain because it’s unpleasant; the electrolyte sachet approach is more sustainable for most people.

The key is consistency over days and weeks, not heroic doses on bad days.