I'm not salty enough

October 19, 2017 4:33 PM

I have postural orthostatic tachycardia syndrome and have been prescribed salt pills by my doctor. I feel sick every time I take them. Help?

I had previously been prescribed salt tablets, and couldn't tolerate those. My doctor suggested that instead I just take plain table salt and put it in a gel capsule (these are the ones I bought)--since it's more natural and doesn't have any other additives he said I shouldn't have any problem with it.

Well, I do. 5-10 minutes after taking the capsule, my stomach starts to feel bloated and sick. Sometimes this turns into actual pain and digestive upset. Drinking a ton of water beforehand seems to lessen the chance I'll be in pain, but the bloating and nausea seem to be present no matter how much water I drink. I always take them after food so my stomach isn't empty. The nausea/pain doesn't always last very long, but sometimes I feel pretty sick for up to an hour.

I'm supposed to take them three times a day and I can barely handle it once. I definitely can't take it on days when I have classes in the morning and over lunch, because I can't risk being sick in class. But I need to find some way to take them. I can't do the major thing my doctor suggested for my condition (aquatherapy) because, per his explanation, the reason I can't exercise for more than 5 minutes without dying is I don't have enough salt "fueling" me. I can't see him until December and I don't want to wait that long to start on aquatherapy.

A couple of questions:
1) Is this just a case of my body needs to get used to it? Should I start with one salt pill a day and work my way up? Will the awfulness eventually go away?
2) Is there anything else I can do to make the nausea/bloating/pain go away? Preferably, keep it from happening at all? I am willing to drink ten billion different kinds of magical herbal teas if that is what must be done.
3) Is just using any table salt fine? Or would a different type of salt be less likely to upset my stomach?

posted by brook horse to Health & Fitness (15 answers total)

Try salty foods. When you Google, you'll find foods to avoid if you're on a low-sodium diet, foods with surprisingly high salt content, and see if you can increase your intake of those foods.

For example, I didn't realize how salty pickles are, because you don't see the salt crystals on them like chips or taste it as strongly as in canned soup (at least to my taste), but it's obvious when you think about it; pickles are soaked in brine.
posted by Former Congressional Representative Lenny Lemming at 4:41 PM on October 19, 2017

I just add a bunch of salt to my food throughout the day. Sauces, dressings, and soups can be really salty. Soy sauce for sure. Chips too. Though peppermint helps bloating (peppermint leaf is gentle). Really the thing that helped me was compression socks, hydration, and trying to move around a bit in general. Plus Ativan and Zofran for flares. I have pretty severe POTS. Feel free to DM me.
posted by Crystalinne at 4:58 PM on October 19, 2017 [5 favorites]

Best answer: Hi! I have POTS too. Every doctor I've ever seen has recommended gatorade or other similar electrolyte drinks. I make my own which ends up being super cheap and less sugary--google turns up a lot of different recipes of varying complexity. I typically drink one electrolyte drink in the morning, to get going, then water throughout the day. However when I was first diagnosed, I would drink electrolyte drinks all day long. I've tried salt pills and they're just too gnarly on my stomach.

Also nthing salty foods. Pickles are great, as is the juice! ;)

I also recommend compression stockings. I was able to get a few pairs for free through insurance with a prescription from my doctor.

That said, POTS really sucks...because there's no perfect treatment or pill, it's a lot of trial and error with different off-label drugs and other techniques. At the beginning of my journey, I could barely get out of bed and had to drink electrolyte drinks all throughout the day, as well as prescription meds. Now I'm running marathons. I wish you the best in figuring out what works for you! Memail me if you have any more questions.
posted by eggs at 5:00 PM on October 19, 2017 [4 favorites]

Best answer: Also - the salt fueling you seems like a weird way to put it? Salt helps raise your blood pressure which gets your blood pumping since your body doesn't constrict your veins naturally. It sorta fakes your body into sorta working from a different angle. It's only one type of treatment to help with pots but isn't thought of like fuel the same way sugar or calories fuel your body. I saw a cardiologist out here who deals with POTS regularly and have done research - plus just having it.

Recommendations to me were firm compression socks, high salt diet, lots of hydration, avoid Trigger foods (wheat etc), avoid caffeine (some people can do caffeine and it helps them), eat small meals, light excercise, meds as needed.
posted by Crystalinne at 5:02 PM on October 19, 2017

Soy sauce is high in sodium and is tasty when added to a wide variety of foods. Try that?
posted by rtha at 5:56 PM on October 19, 2017

As addendum, I wonder if it's the gel capsules that are bloating you.
posted by batter_my_heart at 5:59 PM on October 19, 2017

Perhaps you'd do better with a liquid version, over the tabs or capsules? I'm thinking something like this. I don't have POTS but I get leg cramps, and I have had good luck with a concoction of lime juice, salt, and water.
posted by halation at 6:07 PM on October 19, 2017

You say you can't see your doctor until December but can you call? Maybe leave a message with his service (or whomever answers), saying you are having trouble tolerating the treatment and ask if he has a recommendation or thinks you should come back earlier.
posted by mcduff at 6:43 PM on October 19, 2017

Try sprinkling the salt on toast or mashed potatoes.
posted by yohko at 6:47 PM on October 19, 2017

Liberally use the cool salts... Smoked, celery, chilis... (Maybe not the bath)
posted by TheAdamist at 10:47 PM on October 19, 2017 [2 favorites]

What has your doctor said about it? IANAD and don't know anything about salt pills, but my doctor prescribed omeprazol to counter the nausea I suffer from a medication I take. You could ask whether this or a similar medication might be an option for you?
posted by rubbish bin night at 4:05 AM on October 20, 2017

My housemate has POTS and she drinks salt water constantly through the day. She said she got used to the taste and now it doesn't bother her at all. I made a bottle up for her once and I believe it was about 1 teaspoon table salt in 1 litre (about 2.1 pints) of tap water. Maybe you could try this? I think a slow intake of salt would have to be easier on your stomach than dropping a salt bomb in it.

Good luck!
posted by daisyk at 4:43 AM on October 20, 2017

Best answer: Salt water is weird. It makes some people very nauseated, but others like me can take a few gulps of sea water with no problem. I like the high sodium food suggestions. Typically they are so salty because it is there to make up for something missing that is too expensive. It's similar to the way sugar is used to the same effect in low sodium prepared foods. The lack of one can be largely offset by loading it up with the other. Your tongue doesn't care because it's getting an overload either way.

The point is, TV dinners and such often don't taste nearly as salty as they ought to given the sodium content. Similarly, if you add extra salt to dishes early in the process of cooking them, you can up the salt content quite a bit without it tasting salty like salt added near the end does. (It makes a difference in flavor, but doesn't taste salty, sort of like a small amount of salt on a raw tomato)
posted by wierdo at 9:53 AM on October 20, 2017

There are a lot of processed foods that have a ton of sodium. I just bought a bottle of Bloody Mary mix (Buffalo Wild Wings brand) on closeout for $0.99. A half cup is 55% of your daily sodium intake. No vodka necessary-- the lemon juice, horseradish, tomato juice, worcestershire and cayenne pepper make the salt almost deceptively subtle.

Other salt bombs:
-ramen
-miso soup
-bouillion
posted by Maxwell_Smart at 7:24 PM on October 20, 2017

"Sweet" white rice miso is super salty, and delicious. I dip apple slices in it to increase my sodium intake.
posted by Jesse the K at 8:40 AM on October 22, 2017