Eating nutrient rich foods in smaller, more frequent meals has been shown to improve POTS symptoms.

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Postural orthostatic tachycardia syndrome, or POTS, is a frustrating condition that can disrupt and negatively impact the quality of daily life. The normal, everyday movement of simply standing up triggers rapid heart rate, dizziness, or a drop in blood pressure that usually resolve upon laying down. Although the cause isn’t known, POTS seems to be an autoimmune disorder which affects the autonomic nervous system and is most common in women ages 15 to 50 years old. An estimated 500,000 to 1,000,000 people in the U.S. have the disorder, which commonly begins with pregnancy or when the immune system is triggered by vaccine, surgery, or virus, including COVID—2 percent to 14 percent of people develop POTS after a COVID infection. Fortunately, there are recommended ways, such as a POTS diet, to ease the impact of the symptoms.

There is no single or official recommended diet for people with POTS, but the goal to alleviate symptoms is to keep blood pressure at the right levels. These dietary changes to raise blood pressure levels with diet may help.

• Drinking water has been shown to benefit people with orthostatic (low blood pressure when standing up) syndromes, such as POTS by improving standing blood pressure and reducing standing heart rate. Staying hydrated can help maintain blood flow to the head, which can help resolve dizziness. People with POTS tend to be more sensitive to dehydration, so increasing fluid intake is a recommended dietary strategy. The fluid doesn’t have to be water and increasing water-rich foods, such as soups and fruits and vegetables, especially cucumbers, tomatoes, apples, celery, lettuce, and more, can help maintain hydration.
• Increase Salt. Higher amounts of salt can help increase blood pressure, so this is a common dietary recommendation for people with POTS. The amount of salt will vary by person, so it’s important to check with a healthcare provider. Indicators that you may need more salt include dry mouth, infrequent urination, dark colored urine, abdominal cramping, and dizziness upon standing. Including foods that have higher salt, or sodium, can help. Consider healthy soups, dry roasted and salted nuts, canned beans, and keeping the salt shaker at hand to add at meals.
• Eat Smaller, More Frequent Meals. Eating a large meal directs blood flow to assist in digestion, which means moving it to the lower part of the body, rather than the upper, where people with POTS need to maintain healthy blood volume and circulation to avoid dizziness. Eating smaller meals more frequently, such as six small meals rather than three large meals, has been shown to improve POTS symptoms.
• Choose Nutrient-Rich Foods. Some people with POTS have digestive issues, so eating more foods that support gut health is sometimes recommended. Include fiber-rich foods, such as beans, oats, broccoli, berries, popcorn, apples, and dried fruits; probiotic-rich foods such as yogurt, kefir, sauerkraut, kimchi, and other pickled vegetables; prebiotic-rich foods, such as garlic, bananas, onions, beans, chickpeas, and nuts.

These are the foods people with POTS may want to avoid:

• Caffeine. Although it’s not clear whether caffeine is helpful or harmful for POTS sufferers, it may worsen symptoms in some people, so it makes sense to avoid foods and beverages that contain caffeine. Talk to your healthcare provider if you want to consume caffeine. Common sources of foods and beverages with caffeine include:
  • Coffee
  • Tea
  • Energy Drinks
  • Soda
  • Chocolate

• High Carbohydrate Foods. There is some evidence that higher carbohydrate foods and meals can play a role in the lowering of blood pressure in POTS patients, especially those people who experience POTS symptoms after eating. Certain carbohydrates have been linked with gastrointestinal issues in some people who may not digest them as easily. These carbs, known as FODMAPS (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols), include certain dairy products, wheat, and onions. Ultra-processed foods, foods with added sugars, and foods sweetened with artificial sweeteners are often high in carbohydrates.
• Avoiding alcohol may help avoid POTS symptoms because alcohol is not only dehydrating, it may lead to low blood pressure, both of which can increase dizziness.

There is not yet a cure for POTS, but some relief of symptoms can be achieved with a POTS diet. In addition to dietary changes, your healthcare provider can suggest additional lifestyle changes, like exercise, healthy sleep habits, and keeping cool, that may further alleviate symptoms.