May 28, 2024 • 10 min read

POTS Diet Plan: Best Foods & Foods to Avoid

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Postural Orthostatic Tachycardia Syndrome (POTS) is a form of orthostatic intolerance—or the inability to tolerate standing up—that is associated with an abnormally rapid heart rate (tachycardia). It is a disorder of the autonomic nervous system, which is what regulates heart rate and digestion.

Patients with POTS may experience a myriad of symptoms including brain fog, lightheadedness, tremulousness, blood pooling, gastrointestinal (GI) distress, nausea, and more. Simple activities such as eating, showering, or low-intensity exercise may exacerbate these symptoms. This can make it challenging to go about daily life for patients with POTS.

While most POTS patients need both pharmacological and non-pharmacological treatments, diet is a key component to managing symptoms.

If you have POTS, doing things such as staying hydrated, getting plenty of salt, and eating small meals frequently throughout the day can help. You should try to consume naturally salty foods, electrolytes, high-fiber foods, complex carbs, and protein-rich foods while avoiding alcohol, processed foods, fatty foods, and artificial sweeteners.

This guide goes over what a healthy POTS diet looks like including the best foods to eat, which to avoid, making sure you get enough salt and water, and more.

dietitian patient attending appointment

Manage POTS With Support From a Registered Dietitian

Insurance Accepted: 90% of Zaya Care patients pay $0 for visits with an RD

POTS diet tips

There is no perfect diet for POTS. Managing POTS symptoms through diet often involves increasing plasma and blood volume through high fluid and salt intake. This is especially beneficial for patients with blood pooling, hypovolemia, and hypotension.

Other diet changes may involve managing blood glucose to avoid lightheadedness and supporting digestion to avoid bloating, diarrhea, and constipation. Below are the most common recommendations to help manage POTS symptoms.

1) Drink plenty of water

Along with salt, increasing fluid intake is a common recommendation to increase blood volume and avoid dehydration. The general recommendations for fluid intake are typically not enough for patients with POTS

Increasing water intake to two to three liters per day is often recommended. The specific amount of fluids may vary for each person depending on their size and exercise routine.

Staying hydrated should be a priority for patients with POTS. This involves a combination of water and electrolytes. It is important to track your daily fluid intake to make sure you are getting the amount of fluid that you need.

2) Increase salt intake 

Along with increased water intake, high sodium intake is also recommended to increase blood volume. Like fluids, the general salt recommendation for most adults is usually not enough for patients with POTS.

Some patients may need to increase their salt intake to up to 10-12 grams per day (4000-4800 milligrams of sodium). Some patients may take salt tablets, if tolerated, to help reach this amount. For other people, increasing the amount of salt you consume through naturally salty foods may help.

3) Eat more frequent, smaller meals

Eating smaller, more frequent meals can help stabilize your blood glucose. Eating a large amount of food at once may cause your blood glucose to rise quickly, and going too long without eating can cause your blood glucose to get too low.

Low blood sugar may worsen POTS symptoms such as fatigue, dizziness, and lightheadedness. In addition to being consistent with your meals, it is important to eat a balance of lean protein, complex carbohydrates, and healthy fats with each meal to keep your blood sugar in control.

Eating smaller, more frequent meals not only helps stabilize blood sugar, but it also helps some people reach their caloric and nutrient needs by preventing them from becoming too full.

4) Limit or avoid alcohol

Alcohol can lead to a variety of negative effects on the body. Alcohol is known to be a diuretic, which means it increases fluid and electrolyte losses through urine, causing dehydration. Alcohol can also inhibit your body from absorbing important vitamins and minerals.

Some research suggests that alcohol may induce orthostatic hypotension and may be linked with syncopal (fainting or passing out) events. Because alcohol almost always worsens POTS symptoms, it is highly recommended to avoid it.

5) Talk to your doctor about caffeine

There is conflicting research on caffeine and POTS symptoms because individual responses to caffeine vary. One study suggests that caffeine intake may improve the constriction of blood vessels, therefore improving blood pressure. More quality evidence is needed to support or refute this.

For some people, caffeine may cause lightheadedness and nervousness, increase tachycardia, and affect sleep. POTS patients are often advised to avoid caffeine due to its potential to trigger or worsen symptoms.

When it comes to caffeine intake, it is best to consult your doctor. Your regular physician or POTS specialist can help you determine if caffeine would help or hinder your treatment.

6) Keep track of what foods trigger symptoms 

Certain foods may trigger symptoms in individuals with POTS. Caffeine and foods that are high in sugar are common trigger foods. Some patients with POTS also report worsened GI symptoms with gluten and dairy.

It is important to know what foods trigger your symptoms, so you know what to avoid. Keeping track of your food and symptoms in a food journal can help you identify links between specific foods and symptoms.

7) Watch out for gluten intolerances

There have been suspicions about a connection between POTS and celiac disease or gluten sensitivity. One paper published in 2016 showed that POTS patients had an increased risk for gluten sensitivity and celiac disease.  

Some studies have suggested that following a gluten-free diet, whether you have celiac disease or not, may reduce GI symptoms associated with POTS. If you experience GI discomfort, eliminating gluten may be beneficial for you.

8) Watch out for symptoms of IBS

Symptoms of Irritable Bowel Syndrome (IBS) are commonly reported in patients with POTS. Patients may experience a wide array of GI symptoms such as nausea, vomiting, bloating, diarrhea, or constipation.

These symptoms, if not managed, can prevent a person from meeting their nutritional needs. Some trigger foods reported include fried foods, fatty foods, and dairy. To avoid GI discomfort, it is important to avoid your trigger foods and eat a balanced diet that includes adequate fiber and probiotics.

If you are diagnosed with IBS, consider working with an IBS dietitian that can help you make sure you’re eating correctly for the issue.

>> Find a POTS Nutritionist That Accepts Your Insurance

Best foods to eat with POTS

There are a variety of foods you can eat with POTS. Some foods may help improve symptoms by keeping you hydrated, supporting your digestive system, and providing you with adequate energy. Below are recommendations of specific foods you can incorporate daily.

  • Naturally salty foods. Consuming more naturally salty foods regularly can be an easy way to increase your overall salt intake. Canned vegetables, pickles, olives, and some cheeses naturally contain higher amounts of salt.
  • Electrolyte beverages. Electrolytes (such as sodium, potassium, and magnesium) are key to maintaining fluid balance. Electrolyte beverages will help your body retain fluids and stay hydrated. Sports drinks and electrolyte packets that are low in sugar are good options to help your body stay hydrated.
  • Complex carbs. Complex carbohydrates are less likely to spike your blood sugar, compared to simple carbohydrates. Brown rice, quinoa, oats, sweet potatoes, and whole grain products are common sources of complex carbohydrates.
  • High-fiber foods. Consuming adequate fiber helps you maintain a healthy digestive system. Consuming beans, lentils, whole grains, and fresh fruit on a regular basis can help you consume adequate fiber.
  • Foods with a lot of potassium & magnesium. Magnesium and potassium are important electrolytes your body needs to maintain fluid balance. Magnesium may also support digestion and fight fatigue. Spinach, avocados, and bananas are all rich in both potassium and magnesium.
  • Protein-rich foods. Protein helps support lean muscle mass. It is also important to help you recover from exercise. Protein-rich foods have little-to-no effect on blood sugar. Lean beef, poultry, fish, and eggs are great sources of protein. 
  • Probiotic foods. Along with adequate fiber, consuming probiotic foods helps support a healthy digestive system. Food sources of probiotics include Greek yogurt, kimchi, kefir, sauerkraut, and tempeh.
  • Foods with a lot of antioxidants. Research suggests that antioxidants provide a variety of health benefits, especially decreasing inflammation and the risk of developing cardiovascular disease. Adding berries, artichokes, pecans, cherries, dark leafy greens, and apples to your daily diet will boost your antioxidant intake.

Foods to avoid with POTS

Some foods may worsen symptoms that are associated with POTS. It is important for you to understand specific foods that trigger your symptoms. It is often recommended to avoid foods and beverages that can cause drastic changes in blood sugar, GI distress, and dehydration.   

  • Meals and drinks with a lot of simple carbs. Consuming a large amount of simple carbohydrates at once can cause your blood sugar to spike, then decrease quickly. A rapid increase and decrease in blood sugar can cause feelings of shakiness, lightheadedness, fatigue, and nausea.
  • Highly processed foods. Most highly processed foods often contain little-to-no nutrients. Diets high in ultra-processed foods have been linked with different health conditions such as heart disease and obesity.
  • High-fat meals. Meals higher in dietary fat take longer for your body to digest. This may cause you to feel drowsier after eating them.
  • Artificial sweeteners. Artificial sweeteners may promote harmful gut organisms and contribute to gut inflammation, glucose intolerance, and breakdown of the GI intestinal barrier. This can worsen GI symptoms.
  • Energy drinks. As mentioned previously, there is conflicting research on caffeine. Caffeine may be helpful to some patients with POTS but may exacerbate symptoms for others. It is best to avoid caffeine overall unless told otherwise by your physician.
  • Alcohol. Because alcohol often leads to dehydration, it almost always worsens symptoms of POTS and should be limited.
dietitian patient attending appointment

Manage POTS With Support From a Registered Dietitian

Insurance Accepted: 90% of Zaya Care patients pay $0 for visits with an RD

Example POTS diet plan

Here’s a sample POTS meal plan that includes around 2,000 calories and emphasizes the best POTS foods listed earlier on this page.

Breakfast:

  • Overnight Oats:
  • 1/2 cup of oats (150 calories)
    • 1 cup of almond milk (60 calories)
    • 1 tablespoon chia seeds (70 calories)
    • Topped with 1 sliced banana (105 calories) and a sprinkle of cinnamon

Morning Snack:

  • A handful of raw, unsalted almonds (1 oz) (164 calories)
  • 1 medium orange (62 calories)

Lunch:

  • Quinoa Salad:
  • 1 cup of cooked quinoa (220 calories)
    • A mix of colorful veggies: bell peppers, cucumber, cherry tomatoes (approx. 50 calories)
    • 1/4 cup of chickpeas for extra protein and fiber (72 calories)
    • A sprinkle of sea salt for added sodium and flavor
    • Dressing: 1 tablespoon olive oil (120 calories) and lemon juice

Afternoon Snack:

  • 1 cup of Greek yogurt, no added sugar (146 calories)
  • 1/4 cup of blueberries (21 calories)

Dinner:

  • 4 oz grilled chicken breast (184 calories)
  • 1 cup of steamed spinach (41 calories)—a great source of magnesium and potassium
  • 1/2 baked sweet potato (103 calories)—a good source of potassium and complex carbs
  • Seasoned with herbs and a sprinkle of salt

Evening Snack:

  • 1 slice of whole grain bread (69 calories)
  • Topped with 1 tablespoon of natural almond butter (98 calories)
  • Sprinkle of chia seeds (35 calories)

This is just a sample POTS meal plan and can be adjusted based on your personal preferences and tolerances. As with any diet plan, please consult with a healthcare provider or a registered dietitian to ensure it meets your specific dietary needs and health goals.

Why you should consider working with a POTS nutritionist

It’s important to note that no single diet will help all patients with POTS. Patients can experience a variety of symptoms and have different tolerances to certain foods. Working with a POTS nutritionist can help bring clarity to your own individual nutrition needs. 

Meeting your nutrition needs every day can be challenging to do by yourself. A nutritionist can help guide you in reaching your nutrition goals in your everyday life. Specifically, a POTS nutritionist can help you understand how to follow a higher sodium diet while avoiding potential nutrient deficiencies.

People with POTS often have unique nutrition needs that differ from general recommendations. A nutritionist who has experience working with POTS can help you formulate an individualized plan to improve your symptoms and overall quality of life.

Here at Zaya Care, we can match you with POTS nutritionists that are covered by your insurance. You can browse our network of POTS nutritionists and filter by things like visit type, languages spoken, insurance accepted, and more to find your fit.

Other lifestyle changes that can help

Most people with POTS need a combination of diet changes, medication, and lifestyle changes to reduce their symptoms. Individual responses to lifestyle changes may vary, so it is important to speak with your doctor before making any changes. Below is a list of common lifestyle changes that may be beneficial to someone trying to manage POTS symptoms.

  • Exercise regularly. Deconditioning (loss of muscle mass, strength, and mobility) may occur in some POTS patients due to prolonged bed rest or chronic inactivity. It is important to retrain the autonomic nervous system to allow for more exercise, which helps increase blood volume. Because POTS symptoms can worsen with exercise, exercise intensity should be slowly and carefully increased with expert supervision. Some POTS patients may require physical therapy to start slowly and advance based on tolerance.
  • Get plenty of sleep. Patients with POTS may experience increased daytime sleepiness and sleep disturbances. It is important to get the general recommendation of a minimum of seven hours a night to help support energy levels and prevent fatigue throughout the day. Having a consistent bedtime and avoiding screen time before bed can help you get the quality sleep that you need.
  • Consider compression garments. Compression garments are sometimes recommended for patients with POTS. Wearing lower-body compression garments may help reduce excessive blood pooling in the legs and reduce heart rate.
  • Avoid prolonged standing. For most people with POTS, the longer you stand, the more blood pools in the lower half of your body. For some patients, prolonged standing can mean two to three minutes. For others, it may be 10 minutes before they experience symptoms. Standing up too quickly can also trigger symptoms. If you must stand for a long time, moving your lower half while standing may improve blood flow back to your heart.
  • Elevate your head when sleeping. Patients are encouraged to elevate their heads four to six inches while sleeping to increase circulating plasma and blood volume. One study suggested that sleeping in the head-up position for three to four months can significantly improve orthostatic tolerance.
  • Reduce stress as much as possible. Chronic stress can have serious effects on the body. Stress may cause physical symptoms in any individual, including an increased heart rate and GI discomfort. Stress management is encouraged to avoid triggering or exacerbating symptoms of POTS. 
  • Avoid prolonged heat exposure. Being in the heat too long can be hard on anyone. Prolonged heat exposure can cause headaches, dizziness, and dehydration, especially for those with POTS. People with POTS often report heat intolerance. It is best to avoid being outside in extreme temperatures as much as possible. If you must be out in the heat, try to stay in the shade and prioritize hydration.

Here at Zaya Care, we can match you with POTS nutritionists that are covered by your insurance. You can browse our network of POTS nutritionists and filter by things like visit type, languages spoken, insurance accepted, and more to find your fit.

dietitian patient attending appointment

Manage POTS With Support From a Registered Dietitian

Insurance Accepted: 90% of Zaya Care patients pay $0 for visits with an RD

Kamryn is a Registered Dietitian who specializes in performance nutrition and weight management. She has experience in a variety of settings as a dietitian, including sports, clinical, and private practice. She currently provides individualized nutrition and fitness coaching to adult men and women. Kamryn is passionate about using evidence-based nutrition strategies to help people achieve long-term success with their fitness goals and to maintain a healthier lifestyle.