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Sunday, January 25, 2009


An adult requires between 2000 and 3000 milligrams (mg) of sodium to maintain health. Although health advice in the last two decades has suggested that a low salt intake helps prevent heart disease and stroke, many individuals with orthostatic intolerance cannot tolerate this low salt diet. We believe that individuals with neurally mediated hypotension or postural tachycardia syndrome need to take in much higher amounts of salt.

The exact amount needed is different for each individual, and is often affected by your taste for salty foods, but it is difficult to take too much, provided that you have access to lots of fluids if you become thirsty. A few individuals have been unable to tolerate an increase in sodium intake without developing increased weight gain, headache, or agitation.

Table salt is also an excellent source of sodium, as it has 2300 mg of sodium per teaspoon. Salt tablets are a way of getting enough sodium without dramatically changing the taste of your foods. If you decide to increase your sodium intake with salt tablets, we suggest that you start slowly, and work gradually up to 900-1000 mg three times a day. Some patients tolerate even higher doses. The amount tolerated varies from person to person. By stepping up your dose slowly, you can determine how much is optimal for you within this range. Remember that if you change your diet to increase sodium intake from your food, you may not need as many salt tablets. Some of our patients report better tolerance of a buffered salt tablet (the commercially available brand contains 450 mg sodium chloride and 30 mg potassium chloride). Salt tablets are available without a prescription.

As for fluid intake, be sure to drink at least 2 liters of fluid a day. Water is fine, but some prefer sports drinks (which have the advantage of a higher sodium content), and other commercially available rehydration fluids contain substantially more sodium than sports drinks. The following are high salt foods to help with your needs:

Breads and cereals: Mg sodium
Noodles, potatoes, rice from instant mixes 500
Wheaties (1 cup) 400
Waffles (one) 355
All Bran (½ cup) 285
Cheerios (1 cup) 260
Rice Krispies (1 cup) 260
Saltine crackers (6) 200

Dairy Products:
Parmesan cheese (1 oz.) 450
Processed cheese and cheese spreads (1 oz.) 320
Cottage cheese (½ cup) 230

Meat, poultry, fish:
Enchilada 1300

TV dinner (1) 1200

Sweet-n-sour pork (1 serving) 1100

Lasagna (1 serving) 1000

Soup, canned (1 cup) 895

Fish-n-chips (1 serving) 750

Hamburger (1) 690

Hot dog (1) 550

Tuna, canned (½ cup) 535

Corn beef (1 oz) 530

Fried chicken (1 serving) 530

Pizza, cheese (1 slice) 500

Pork-n-beans, chili (1 cup) 460

Luncheon meat (1 slice) 300

Bacon (4 slices) 280

Snacks, condiments:
Pretzel Stix, 1 tray (28 g) 1460

Soysauce (1 tbsp) 870
Olives, green (4) 600

Salted nuts (½ cup) 420

Olives, ripe (4) 400

Fruit pie (1/8 pie serving) 355

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