Hydration Isn’t Simple When You Have POTS—Here’s Why
For people living with postural orthostatic tachycardia syndrome (POTS), staying hydrated isn’t just a daily checklist…it’s a whole strategy—one that takes planning, timing, a lot of trial and error, and more than just a water bottle.
The Hydration Formula
When you have POTS, not enough blood is reaching your heart and brain. Increased hydration boosts the amount of blood in your body to help with this problem, so that POTS symptoms can potentially become more manageable.
Since lots of fluids without electrolytes can lead to dehydration, adequate hydration for POTS requires more than just water. It involves a carefully crafted balance of:
water + sodium + other electrolytes + specific timing
The Right Timing
You have to think ahead—even before standing up. People with POTS often need to hydrate right away in the morning. Miss that window, and you might be playing catch-up with symptoms all day, or the next.
You can’t always match hydration to how you physically feel. By the time you feel POTS symptoms worsening, like feeling lightheaded or shaky, you might already be behind on fluids and electrolytes. But constantly sipping and salting everything just to stay ahead? That’s exhausting.
When you have POTS, you always need to know where the nearest restroom is. Planning your day around bathroom access can be incredibly stressful.
Pain and Discomfort
Delayed gastric emptying, or gastroparesis, can occur in some people with POTS. Drinking a lot of fluids at once or even not much at all can lead to bloating, nausea, or cramping when your stomach processes liquids more slowly.
Electrolyte supplements aren’t always the most flavorful and can sometimes worsen gastrointestinal (GI) symptoms. They often leave a chalky or overly salty aftertaste that can make staying hydrated even more challenging.
Since constant hydration leads to frequent urination, people with POTS often experience bladder discomfort. Over time, this can make it even more difficult to keep up with your fluid goals.
Hydrating for POTS is much more complicated than it sounds. It is an essential component of managing symptoms for most people, and can be quite challenging. Trying to meet hydration goals can be exhausting, stressful, and sometimes even painful.
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PMID: 39297140; PMID: 29549458
Reminder: Hydration recommendations for POTS can vary based on personal health factors. Some people may be advised by their healthcare provider to not significantly increase their fluid, salt, or electrolyte intake due to coexisting medical conditions.
Disclaimer: This blog post is for informational purposes only and shall not be construed as behavioral health or medical advice. It is not intended or implied to supplement or replace treatment, advice, and/or diagnosis from your own qualified healthcare provider.