Foods to Avoid with POTS

graphic with pink text that says "Foods to Avoid with POTS"

Have you been wondering about foods to avoid with Postural Orthostatic Tachycardia Syndrome (POTS)?

 

You’re in the right place!

 

This article walks through what foods may worsen POTS symptoms, plus shares some of the best foods for POTS as well.

 

As a registered dietitian with personal experience with POTS, I think it’s important to share this information with fellow patients. Let’s dive in!

 

What is POTS?

Dysautonomia International defines POTS as an autonomic nervous system disorder that causes an excessively fast heart rate and feeling dizzy upon standing. People with POTS often have additional symptoms that affect more than just heart rate and lightheadedness. Patients also often report experiencing fatigue, headaches, shaking, trouble concentrating, exercise intolerance, fainting, chest pain, shortness of breath, and nausea.

 

There are a few different types of POTS. One of the more common types in people with Ehlers-Danlos Syndrome is Hypovolemic POTS, which is associated with low blood volume (not enough fluid circulating in the circulatory system).

POTS symptoms

  • Lightheadedness
  • Fatigue
  • Headaches
  • Shaking
  • Exercise intolerance
  • Trouble concentrating
  • Fainting or feeling faint
  • Shortness of breath
  • Nausea

Nutrition for POTS

Does nutrition help POTS? Yes, some nutrition recommendations can help people with POTS reduce their symptoms.

Hydration and electrolytes

Increasing hydration and electrolyte intake are the most supported nutrition recommendations for POTS patients. This is because good hydration increases total blood volume (the amount of fluid in the circulatory system) which can improve POTS symptoms in some people.

Managing stomach aches and nausea

Some POTS patients experience frequent stomachaches after eating or frequent nausea. While more research is needed, experts believe that digestive symptoms in POTS patients could be related to gastric motility issues and/or changes in blood flow during digestion. These digestive symptoms can affect POTS patients’ nutrition, especially if it becomes challenging to eat enough food at meals and snacks.

 

Nutrition recommendations like eating smaller, more frequent meals and avoiding going too long without eating can be helpful for some POTS patients.

 

POTS patients with digestive symptoms should seek care from a registered dietitian for additional support in managing their symptoms. Dietitians can help ensure that POTS patients are getting the nutrition their bodies need to avoid things like nutrient deficiencies or accidentally losing weight without trying to.

Avoiding foods like alcohol and caffeine

It’s also important to note that foods or drinks that have alcohol or caffeine can actually make some POTS symptoms worse for some people. It could be worth avoiding coffee, caffeinated sodas, wine, beer, and other drinks with alcohol and caffeine if they make symptoms like fast heartbeat, dizziness, and feeling faint worse.

 

Nutrition for POTS is a combination of increasing hydration, increasing sodium intake, overcoming frequent nausea, reducing stomach aches, and avoiding alcohol and caffeine.

Nutrition recommendations for POTS

  • Increasing fluid intake to increase blood volume
  • Increasing sodium and electrolyte intake to increase blood volume
  • Overcoming nausea by finding well-tolerated foods (like smoothies and soups), taking anti-nausea medications as needed
  • Reducing stomachaches after meals by eating smaller, more frequent meals
  • Avoiding a few foods and drinks that might make POTS symptoms worse, like alcohol and caffeinated drinks

 

Graphic that shows cartoon images for foods to avoid with POTS and best foods for POTS

 

Foods to avoid with POTS

Are there foods that can make POTS worse? Yes! Both alcohol and caffeine may make POTS symptoms worse.

 

Foods to avoid with POTS include alcoholic beverages like wine, beer, and liquors as well as caffeinated sodas, coffee, espresso, and energy drinks.

Alcohol

People with POTS may want to avoid alcohol if it worsens their symptoms.

 

Alcohol may make POTS symptoms worse because it has a diuretic effect, which means it can contribute to dehydration. Dehydration can exacerbate POTS symptoms like fast heartbeat, dizziness, feeling faint, etc. because the total amount of fluid in the circulatory system decreases slightly, which can affect blood pressure and heart rate.

Foods and drinks with alcohol:

  • Beer
  • Wine
  • Tequila
  • Vodka
  • Mixed drinks

Caffeine

Does caffeine affect POTS? Yes, caffeine can lead to more POTS symptoms like shakiness, fast heartbeat, and feeling faint in some people.

 

Like alcohol, caffeine can have a small diuretic effect which can contribute to dehydration. Caffeine can also exacerbate other POTS symptoms like shakiness, fast heartbeat, and perhaps even shortness of breath.

 

It’s important to note though that some people with POTS actually feel better when they have caffeine, so it’s worth experimenting to see which category you may fall into.

Foods and drinks with caffeine:

  • Coffee drinks
  • Espresso
  • Chocolate-covered coffee beans
  • Sodas like Dr. Pepper, Mountain Dew, Coca-Cola, Pepsi, etc.
  • Green tea
  • Black tea
  • Matcha
  • Energy drinks
  • Foods with added caffeine like some CLIF bars and energy gels
  • Electrolyte supplements with added caffeine

Are there other foods that some people with POTS may avoid?

Are there other foods people avoid for POTS?

 

Some people report that meals rich in carbohydrates seem to worsen their symptoms. While more research is needed, the theory behind this is that carbohydrates may increase blood flow to the gut and may be associated with lower blood pressure after meals.

 

While it’s certainly not recommended to completely avoid or heavily restrict carbohydrates, people with POTS can experiment with slightly decreasing their portions of carbohydrate-rich foods in their meals and snacks and increasing their portions of fats or proteins instead. For example, a plate of spaghetti with a few small meatballs could be adjusted to have a little less spaghetti, more meatballs, plus non-starchy vegetables like roasted broccoli.

 

Slightly reducing the total amount of carbohydrates, or even choosing less processed carbohydrates, is worth a try for people with POTS to see if it noticeably improves symptoms.

 

High carbohydrate and processed carbohydrate-rich foods:

  • Pasta
  • Rice
  • Bread
  • Baked goods
  • Sweeteners like maple syrup, honey, agave, sugar
  • Potatoes
  • Chips
  • Oatmeal
  • Cereal

Best foods for POTS

The best foods for POTS are generally high in salt and fluids to help increase blood volume (how much fluid is in the circulatory system). This includes hydrating foods and drinks, such as water, sports drinks, fruits like watermelon and strawberries, and vegetables like cucumbers and celery. Salty snacks and foods, such as salted nuts, pickles, cured meats, and broths or soups, can also be beneficial.

Hydrating foods

Hydrating foods can be beneficial for POTS patients. These are foods that have a high water content, which can help in maintaining the fluid balance in the body, which may reduce some POTS symptoms.

 

Fruits are an excellent source of hydration. For example, watermelon is about 92% water, making it a great choice for hydration. Similarly, oranges are about 88% water. Strawberries are another excellent hydrating fruit, with about 91% water content.

 

Vegetables can also contribute to hydration. Cucumbers, for instance, are about 96% water, one of the highest water contents of any solid food.

 

In addition to contributing to hydration, fruits, and vegetables are also a good source of potassium, which is an electrolyte that plays an important role in hydration.

 

Beyond fruits and vegetables, bone broth and soups can also contribute to hydration. These options have the added benefit of being easy to tolerate even with digestive issues, and they often contain salt, which can be beneficial for POTS patients because the sodium in salt is an electrolyte.

 

In addition to these foods, drinking sufficient water throughout the day is important for maintaining hydration levels. It’s also important to note that hydrating foods are not a substitute for drinking water or other hydrating fluids, but rather a supplement to a hydration-focused diet.

Hydrating Foods for POTS Patients:

  • Cucumbers
  • Watermelon
  • Strawberries
  • Cantaloupe
  • Peaches
  • Oranges
  • Celery
  • Tomatoes
  • Cucumbers
  • Broths or soups

Hydrating Drinks

Hydrating drinks play a crucial role in managing Postural Orthostatic Tachycardia Syndrome (POTS) symptoms. Adequate hydration helps in increasing blood volume, which can help alleviate some of the symptoms of POTS.

 

One of the most common hydrating drinks for POTS patients are sports drinks. These beverages contain electrolytes such as sodium and potassium, which are vital for maintaining fluid balance in the body. Proper electrolyte balance aids in fluid retention, a hugely important factor in managing POTS symptoms.

 

Additionally, a simple mixture of water infused with a pinch of salt and lemon can also be beneficial for POTS patients. The salt aids in hydration by helping the body retain more water, while the lemon adds a refreshing flavor and provides a little vitamin C. This homemade drink can be a great alternative to store-bought sports drinks, especially for those wanting to avoid the high sugar content often found in some store-bought options.

 

Coconut water is another delicious hydrating drink. It’s rich in potassium and other electrolytes, and it’s often well-tolerated by POTS patients. Plus, it’s a natural drink without any additives, which could make it a good choice for patients with a variety of food sensitivities.

 

Herbal teas can also be a great choice since they do not contain caffeine. Many herbal teas, such as chamomile or peppermint, are a delicious way to enjoy more fluids throughout the day. They also can have other beneficial properties. For example, peppermint, spearmint, and ginger teas are known to help ease mild digestive symptoms.

 

Finally, plain water is always a good choice. It can be helpful to have a water bottle on hand throughout the day to encourage regular sipping. For some POTS patients, adding a slice of lemon, cucumber, or a few berries can make the water more appealing and increase their overall fluid intake.

 

While these drinks are beneficial, it’s important to note that drinks high in sugar or caffeine should be avoided, as they map exacerbate POTS symptoms in some people.

Hydrating drinks for POTS patients:

  • Water
  • Electrolyte drinks
  • Sports drinks
  • Coconut water
  • Herbal teas
  • Non-caffeinated beverages

Salty snacks and foods

Salt helps with POTS because the sodium in salt increases blood volume by retaining more water in the body. This can help alleviate the lightheadedness and fainting that occurs in POTS when standing up.

 

There’s a wide variety of salty foods that POTS patients can include in their diets.

 

Soy sauce is a flavorful way to add quite a bit of sodium to meals. Other condiments, like jarred salsas tend to be high in sodium as well.

 

Jerky, whether it be beef, turkey, or other varieties, is another savory snack that can provide a good dose of sodium.

 

Salted nuts or seeds serve as not only a rich source of sodium but also provide beneficial fats and protein. Fermented foods like pickles, kimchi, and sauerkraut are excellent sources of sodium and have the added bonus of being packed with probiotics which promote gut health.

 

Canned beans, while being a hearty and versatile ingredient in many meals, contain a substantial amount of sodium, too.

 

These foods can help manage POTS symptoms for some people, all the while adding an array of flavors and nutrition to your meals and snacks.

Salty Snacks and Foods for POTS:

  1. Soy sauce
  2. Kimchi
  3. Sauerkraut
  4. Canned Beans
  5. Canned Soups
  6. Salted nuts
  7. Beef jerky
  8. Pickles

Summary

For managing Postural Orthostatic Tachycardia Syndrome (POTS), it’s recommended to increase hydration and electrolyte intake, manage stomach aches and nausea by eating smaller, more frequent meals, and avoid alcohol and caffeine. Foods to avoid include alcoholic beverages and caffeinated drinks, and possibly meals rich in carbohydrates. The best foods for POTS are high in salt and fluids, including hydrating foods and drinks like water, sports drinks, fruits, and vegetables, and salty snacks like salted nuts, pickles, and broths.

 

 

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