Salt - From Food, the Shaker, and Salt Tablets

There are a number of ways to increase how much salt you take. In fact, most American eat more than is recommended. You may have avoided salt in your life so this will be a challenge to make the change.

Salt From Your Food

Do your best to increase the amount of salt in your diet. Spread it out over the whole day, just like your fluid intake.

The first way to get more salt is to add more salt to your food . This may be a challenge and take some time to adjust to the salty flavor. Some of the studies report that those who developed POTS tended to not eat much salt before they got sick. Some people reported that once they started increasing their fluid/salt intake, they began to want a little more salt on their food also.

   —Table Salt:- has about 2300 mg.g sodium per teaspoon (tsp).
   —Kosher Salt (Coarse): has 480 mg of sodium in 1/4 tsp. That would be 1760 mg of sodium (Na) in 1 tsp.

Eat more of salty foods : potato chips, pretzels, pop corn, pickles. The challenge is that you can only eat so much before it gets boring. If you seriously eat that much salt, it can become irritating to your mouth.

The USDA has a current list of salt content for foods - over 20 pages! You can get a copy here USDA Sodium/Salt Content in Food.
    [How to read this file: The sodium (Na) content of the food is in the third column - last column. The column for 'weight'
    is the weight of the food. For example: 1 teaspoon (tsp) of salt weights 6000 mg or 6 grams. It has 2300 mg of
    sodium (Na).]

If you check the USDA list, you will see that the foods with the highest salt content are prepackaged foods and fast-food. This can create a different health challenge if you eat a lot of fast-food for your additional salt content. They have higher calories and more partially hydrogenated fats. This can contribute to gaining weight when you don't want to.

Is one kind of salt better than another?

There are a number of different types of salt now available at the store. We are only interested in the amount of salt (sodium chloride-NaCl) they have.

Bottom line- The answer is 'no'. Based on their sodium chloride content, all the salts are the same. Iodized salt is available to supplement the iodine levels for people who live in areas where soil and diet are limited in iodine, e.g. the Midwest.

Salt From the Shaker - On your food or in water

If you are using table salt for your source for more salt/sodium, you can measure out the amount you need each day and store it somewhere easy to use. Add it to your food at each of your meals until it is gone.

Another option - Add some to water and drink it    Mix as much salt in a small amount of water - experiment to find the amount of salt & water you can stand to drink. Then, drink extra water after. It's easier to drink a small amount of something you aren't fond of and then wash it down with more fluids. . Be sure to take it around meal time with fluids so it is easier on your stomach and spread it out during the day.

Table Salt:
    • Morton’s Iodized table salt – ¼ tsp = 590 mg Na
    • Plain table salt – ¼ tsp = 590 mg
    • Sea salt ¼ tsp = 560 mg
    • All-purpose sea salt ¼ tsp=590 mg

Concerns: One concern is the amount of iodine being consumed if iodized salt is used in the higher amounts. This is addressed in the tab "Is it Safe?".

 

Salt Tablets

If you need to take salt tablets to get your salt intake high enough, here is some information to help.

Be sure to take your salt tablets with food and at least 8 oz of liquid. Eat either a whole meal or at least some crackers or fruit. This will help cut down the stomach irritation. It will provide fluids in the stomach while the salt dissolves and help dilute it while it dissolves. (see the Concerns.)

Concerns: One concern is that salt tablets alone in the stomach will draw fluids into the stomach to help dissolve it and dilute the amount of salt in the stomach. This could lead to diarrhea and removal of fluids from the body instead of increasing the amount of fluid being held in the blood vessels.

Where to get salt tablets - Salt tablets are not readily available at most stores on the store shelves. They may be in the pharmacy or behind the counter, just ask. They may also be willing to order for you.

Do you need a prescription for it?   You can get a prescription if you plan to get them from the pharmacy. This may have value with the IRS to submit the cost of the salt tablets as legitimate medical expenses, check with the IRS or an advisor on this. However, most insurers don't pay for salt tablets even with a prescription.

• Salt (NaCl) tablets - These are tablets of regular table salt. In the past, you could only get them from the pharmacy; you would need a prescription to get them from the pharmacy. They are now available online in bulk.


• Buffered salt tablets - Buffered salt tablets tend to be easier on the stomach than plain salt tablets. Most pharmacies don't carry them on the shelf even in summer but you can ask and ask them to order them for you. You can order them online.
  • Thermotab: Each tablet contains 452 mg of sodium chloride (NaCl). Two tablets would be almost 1 gm - it would be 904 mg.

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If you are taking Florinef: Florinef works best with a high salt intake. You may need to use salt tablets to get enough salt. Check out Florinef in the Medication section.

If you have to go into the hospital, take a supply of salt tablets and buffered salt tablets with you.⁷   They are not usually kept in hospital pharmacies. They take days to order & get there. lf you take your own, the pharmacy will verify what they are & then put them in your drug box so the nurses can give them to you as part of your medications.

 

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

 

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References

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2. Freeman, Roy. Neurogenic orthostatic hypotension.NEJM 2008;358(6):615-624. Abstract
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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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