POTS and The Role of Electrolytes

People with postural orthostatic tachycardia syndrome (POTS) are notorious for drinking pickle juice, double-salting their fries, and even eating salt right out of the shaker. In the early days of having POTS, I certainly had a thing for salami, green olives, and eating plain lunch meat by the metric ton, followed by enormous amounts of water. What I didn’t realize at the time was that my body was doing its best to compensate for low blood volume (and therefore low blood pressure) and insufficient circulation by giving me massive salt cravings.

You see, POTS is a condition that often causes symptoms such as lightheadedness, tachycardia, and passing out due to the body’s impaired ability to fight gravity and get blood to the upper half of the body. Sometimes the condition is actually caused by not having enough blood, and oftentimes it’s compounded by a combination of inappropriate levels of fight-or-flight chemicals in the body and/or dysfunctional nerves that control blood flow to the extremities. Regardless of the cause of POTS, one workaround to the symptoms is to manipulate the blood volume (by drinking water and eating salt) in order to fill the circulatory system fuller, so that the body has more material to work with in its pursuit of staying upright. My cardiologist instructed me to have an electrolyte drink first thing in the morning, another in the afternoon, and to eat plenty of salty foods with water throughout the day. 

That said, I’ve tried many kinds of electrolytes and continue to enjoy new brands, flavors, and types when given the chance. They each shine in their own way, and whether it’s emergency hydration or daily upkeep, I use a variety of products. Below is a collection of electrolyte brands and my thoughts:

Vitassium FastChews

The first time I ATE a salt packet at a restaurant was a POTS milestone that I was both proud of and repulsed by. I felt as though I was on the verge of passing out, and I was desperate to help my body hang on to consciousness. It was one of the more disgusting things I’ve done for POTS. {Side note: if you want to learn how surface area impacts taste, I dare you to try eating a bit of table salt and then eating the same amount of kosher salt. I believe you’ll find kosher salt to be a tolerable snack and rather enjoyable in comparison.} I have not repeated the stunt, but I have learned other ways to consume salt without searing my tastebuds. Enter Vitassium Fastchews. 

They are tasty chewable tablets for rapid symptom management, and as unique as it sounds, the brand actually has a soft spot for those with POTS. They list POTS on the product description as a condition that the chews can help, and by having a chronic illness, you can join (for free) the Vitassium Club on their website, which gives 25% off all their products. 

Vitassium Fastchews are probably my favorite emergency/quick-action solution to symptoms, and I keep them by my bed, in my backpack, and in my car. Whether eaten for daily sodium-boosting, or just rapid flare management, they are one of my favorite electrolyte choices. If it’s any proof, writing this article reminded me I ran out, so I just clicked to a new tab and reordered two bottles of the 60-count fruit punch chews. Cheers.

Liquid IV

Another product I reach for when I’m having significant symptom onset is Liquid IV. The brand touts a trademarked “cellular transport technology” which is a ratio of sodium, glucose, and potassium that is optimal for hydration. Instead of letting the body slowly take up the water via osmosis, the ratio causes the body to rapidly hydrate through active transport. You can learn more on their website. 

But science and theory aside, Liquid IV does help me feel better FAST. The high salt (500mg!) and added sugar in the drink mix makes it easy to slam (and you don’t feel all sloshy afterwards, even if you drink it fast), but it also means that it’s not something I love to have every day. Especially keeping dental health in mind, I like to swish with plain water after drinking such a sugary drink and choose other options for daily consumption.

Nuun

Nuun is another favorite, and was recommended to me via POTS-specific educational resources from Mayo Clinic. The tablets are a BLAST to watch dissolve (I must be easily amused), although they take a few minutes to fully dissolve and so if the situation is urgent I usually go for FastChews or Liquid IV. But for daily drinking, Nuun is delicious, refreshing, and easy to throw in a glass whatever time of day. They also have much less sugar (sometimes none), which is a bonus. 

Pedialyte

On a road trip I began feeling very presyncopal (like I might pass out), and so I quickly acquired and consumed a strawberry Pedialyte from a gas station. I was beyond impressed. It helped relieve symptoms within 5-10 minutes, and I quickly bounced back from the flare.

That said, the brand is far from “natural” and does not shy away from food coloring (hello, Red 40) and artificial flavors. Would I drink this on a road trip in a dire situation? Absolutely. In day-to-day life? Meh, probably not. 

Gatorlyte Rapid Rehydration

Another away-from-home special, Gatorade Rapid Rehydration has become my favorite gas station buddy. Similar to Pedialyte, I can’t say I love the ingredients, but the sheer quantity of sodium (490mg!) is enough to make any potsy swoon (err, ward off the swoon?). This comes in a square bottle, and Strawberry is my go-to flavor.

Buoy

I don’t ever click on ads. It’s kind of a personal code that I live by, but when I saw Buoy scroll past my eyes I took a long hard look, and ultimately succumbed. I’m a sucker for trying out new electrolytes because they’re fun (you get to drink them!), they’re important (a critical tool for POTS management), and they’re not hundreds of dollars (like so many other things I wish I could try). Buoy is unique from the other powders and tablets I’ve tried, being a small bottle of liquid that you squirt into your drinks with the goal of adding electrolytes and trace minerals to your coffee, juice, smoothies, and tea. It’s supposed to be flavorless, and they mention on their site that you might not feel a difference until a few weeks of use. 

If I were a healthy busybody keeping up with life, errands, and events, I might use this on a regular basis to help me feel like I’m getting the most of my water-drinking. However, as a person with chronic illness and a strong demand for proper electrolytes and blood volume expansion, this is not a product that I found to be very useful. It has a slightly odd taste and doesn’t make me feel more hydrated than plain water alone, so I usually skip it in favor of a different option (like Nuun), or just a glass of plain water with some potato chips or other salty snack.

Summary

Above are six kinds of electrolytes that I’ve tried – some I’ve loved, and some that I don’t. I’m always up for trying new ones, and will continue to experiment with things like Drip Drop, LMNT, and even coconut water. If you have a favorite and want to share, I’d love to hear what works for you in the comments or through the “contact me” page!