Salt - How much do you need?

The actual amount for each person is different. It depends on the individual and their body.  It probably even changes from month to month. If you crave salt, you can use that as a clue that your body needs more salt. Here are the recommendations from the medical literature for orthostatic hypotension (OH), neurally-mediated hypotension (NMH)and postural orthostatic tachycardia syndrome (POTS). 

 

Recommendations for people with orthostatic problems

It is recommended a person start with the recommended daily amount for the average person and then increase from there.

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Remember, you are taking it to help increase the fluid in your body so your BP doesn't drop so much when you stand up or your pulse doesn't go so high.  

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For OI:    the recommendation is to start with the minimum daily recommended amount - 1 tsp of salt or 2300 mg of sodium, increase from there

In the clinical studies that showed that taking salt helps, they took 6 to 7 gm of salt per day.^{3, 4}

Recommendations based on the literature would be
        -  build up to 1 1/2 teaspoon of salt. ^{13, 14}
        -  Increase up to 2/12 teaspoon if needed.
        - See the tab on 'What's Enough?' for how to tell when you have added enough.^1,11,12,15

More details to convert salt and sodium information and the specific recommendations in the literature - Tables on Salt, Sodium and Recommendations from the literature

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Be sure to talk this over with your physician and come up with a plan for how much you are going to start with, how fast you will increase and when you will be checking back to see how things are going and see if the plan needs to be adjusted.

The information is given here because it is what physicians who treat OI recommend and to let you know that if your physician suggests these amounts,

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Why You Need to Raise the Head of Your Bed - and How Much

 

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References

1. Figueroa JJ, Basford JR, Low PA. Preventing and treating orthostatic hypotension: As easy as A, B, C. Cleve Clin J Med. 2010 May;77(5):298-306. Abstract  Article PDF

2. Freeman, Roy. Neurogenic orthostatic hypotension.NEJM 2008;358(6):615-624. Abstract
3. Claydon VE, Hainsworth R. Salt supplementation improves orthostatic cerebral and peripheral vascular control in patients with syncope. Hypertension. 2004 Apr;43(4):809-13. Epub 2004 Feb 23.
4. El-Sayed H, Hainsworth R. Salt supplementation increases plasma volume and orthostatic tolerance in patients with unexplained syncope. Heart 1996; 75:134–140.
5. Thieben MJ, Sandroni P, Sletten DM, et al. Postural orthostatic tachycardia syndrome: The Mayo Clinic experience. Mayo Clin Proc. 2007;82:308–313
6. Personal experience of author.
7. Wieling W, van Lieshout JJ, Hainsworth R. Extracellular fluid volume expansion in patients with posturally related syncope. Clin Auton Res 2002;12:242-9.
8. Recommendations on salt. UK. Consensus Action on Salt & Health. Last accessed September 10, 2012.  
9. Rowe, Peter.General Information Brochure on Orthostatic Intolerance and Its Treatment. June 2010. Accessed from http://www.cfids.org/webinar/cfsinfo2010.pdf. Accessed May 28.2012.
10. U.S. Department of Agriculture, Agricultural Research Service. 2011. USDA National Nutrient Database for Standard Reference, Release 24. Nutrient Data Laboratory Home Page ,http://www.ars.usda.gov/ba/bhnrc/ndl  
11. Low PA and Singer W. Update on Management of Neurogenic Orthostatic Hypotension. Lancet Neurol. 2008 May; 7(5): 451–458. Abstract. Article PDF.
12. Low PA, Sandroni P, Joyner and Shen W. Postural Tachycardia Syndrome (POTS). J Cardopvasc Electrophysiology 2009; 20:352-358.  Abstract.  Article PDF
13. Jacob G, Costa F, Shannon JR, Robertson RM et al. The Neuropathic Postural Tachycardia Syndrome. N Engl J Med 2000;343: 1008-14.   Abstract.   Article PDF.
14. Fu Q, Vangundy TB, Galbreath MM, Shibata S, Jain M, Hastings JL, Bhella PS, Levine BD. Cardiac origins of the postural orthostatic tachycardia syndrome. J Am Coll Cardiol. 2010 Jun 22;55(25):2858-68. Abstract. Article PDF
15. "Iodine in diet". MedlinePlus. External Link. Last accessed 09.13.2012
16. Dietary Supplement Fact Sheet: Iodine. Office of Dietary Supplements. National Institutes of Health. External Link. Last accessed 09.13.2012.
17. Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academy Press: Washington DC, 2001. 2001. External Link

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