Electrolytes for POTS Available in South Africa

Postural Orthostatic Tachycardia Syndrome
Written By Julie Anne van Veenendaal

If you have been diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS), you have probably been told that you need to increase your fluid and salt intake. But by how much? And why does this work?

(Please note that you may need to check in with your provider about this, these are general recommendations and shared here for educational purposes).

The Physiology

The goal of increasing fluids and salt is to increase overall blood volume in the body. This is why it is important to increase both fluids and salt. Expanding blood volume changes the cardiovascular dynamics improving overall circulation which helps to reduce symptoms.

When you stand up gravity naturally pulls about 500 to 800 mL of blood down into the abdomen and lower limbs. In a healthy body, the autonomic nervous system quickly compensates by constricting blood vessels to push that blood back up and maintain steady blood flow to the brain. In POTS, this system falters (for various reasons). Because of this blood pooling, which you might notice with your feet changing colour, less blood returns to the heart (reduced venous return). With less fluid filling its chambers, the amount of blood the heart can push out with each individual beat (stroke volume) drops significantly. Our brains require a steady, uninterrupted supply of oxygen. When it detects that stroke volume has plummeted upon standing, it triggers a massive surge of adrenaline and sympathetic nervous system activity which increases heart rate to try and get more blood to the brain (tachycardia).

Increasing blood volume aids venous return because there is more blood in the system. This means that stroke volume remains stable and those adrenaline surges and sympathetic nervous system activity is no longer required. Increasing blood volume means that the heart rate no longer needs to work twice as hard to maintain blood pressure.

General Recommendations

Generic recommendations for POTS is to increase fluid intake to 2-3 liters per day (about 12 glasses of water) and increase salt intake to 8-12 grams which is about 2 teaspoons (or 3,000-4,600 mg of sodium). There are various ways to do this, but electrolyte drinks are a particularly effective.

The important feature for electrolyte drinks for POTS is sodium content, this is why drinks like powerade, energade, game, and even rehydrate are not all that effective as they all have relatively low sodium content.

Some of the electrolytes available in South Africa with high sodium content include:

My personal favourite is the Revive Peach Flavour, but everyone seems to have their personal taste preference! Some other options if you don’t like any of these include drinking salty bone broths, adding salt to orange juice, or increasing how much fluids you drink and increasing how much salt you put on your food.

Julie Anne van Veenendaal

Julie Anne van Veenendaal (BSc/MSc OT) is an Occupational Therapist and a BASI Comprehensively Certified Pilates Instructor. Her clinical interest lies in supporting people living with chronic conditions towards recovery believing that health & wellness is about finding the freedom to live a joyful and meaningful life. Her approach is grounded in research, movement, occupational science, and neuroscience.

She regularly lectures for healthcare professionals' continuing education, sharing her expertise and passion for pain management and rehabilitation, and offers mentorship and training for movement teachers.

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