Salt, Glorious Salt

As most of you know, those of us with dysautonomia are prescribed a very high sodium diet by our doctors (5000-10000mg a day usually) to increase our blood volume and prevent drops in blood pressure. This can be a daunting task for those of us not used to such a huge amount of salt.

After my POTS diagnosis, I realized that salt was going to be a huge part of my life and, well, I wasn’t a big fan at that point (gasp!). So…I decided to search around and find as many different kinds of salts as I could to add some extra excitement to my meals. Once I started looking, I was amazed at how many different kinds of salts exist out there. And not only do they exist, they taste amazingly different! I had no idea that different salts added unique flavors to your meals. I had been a sea salt and kosher salt user, but that was the full extent of my knowledge. Now I know that the specific minerals from the area that the salt is mined add a different flavor to each type. For example, the red coloration of Alaea (Hawaiian sea salt) comes from the clay in that area. I know, it sounds gross, but it’s actually delicious. One of my favorites in fact.

Over the years, I have accumulated quite the unique and beautiful salt collection (in my opinion). Such a collection, in fact, that we installed a shelf in our kitchen that is dedicated only to my salts, and it is overflowing! I think it is quite lovely as well.

I encourage all of you POTSies out there to explore the different kinds of salts that the world has to offer. It definitely made my crazy salt consumption a little more exciting. Although I love many of the salts, I think my favorites are Alaea, Maldon, and Fleur de sel. And have you ever tried adding salts to the tops of different desserts? It can be quite lovely depending on the dessert (chocolate loves salt!). Have fun exploring the wide world of salt!

Some details about the salts that I have:

Many of these salts are hand harvested, which is part of the reason they are so expensive.

Maldon: a finishing salt that is best applied to a dish after it has been plated; b/c it is flake salt, it dissolves quickly and evenly and has a lovely flavor

Fleur de sel: means "Flower of salt" in French; has a lovely, delicate taste that is great to add as a finishing salt. I’ve even had it on chocolate…yum!

Alaea: Hawaiian sea salt contains a small amount of harvested Hawaiian clay that enriches the salt with Iron-Oxide (which makes it red). It has a great flavor, and I use it on all kinds of things, especially when I'm roasting vegetables/meats.

Grey Salt: a natural, unrefined sea salt that is supposed to retain many of the minerals from the clay where it was mined; many believe it to be one of the best salts available

Himalayan salt: this salt is harvested from deep in the Himalayan Mountains, and has a high mineral content that is often sought after for health benefits (there are a myriad of articles on the web about it)

Kosher salt: Great for using as an everyday salt, I add it to almost every recipe. It has a mild taste and doesn’t overpower your dishes.

And it doesn’t stop there: there are black salts with charcoal, salts mixed with every herb out there, even salt with vanilla. Try them out…It will definitely perk up the flavor of the dishes that you have to flood in salt every day!

Anti-Dysautonomia Non-pharmaceutical Tricks of the Trade!

All right POTSies...here are some of my tricks (or ones I've heard are helpful) for combating dysautonomia aka Postural Orthostatic Tachycardia Syndrome. Again, none of this should be considered medical advice. Ask your doctor before changing your salt intake or adding the therapies listed below. These are for educational purposes only.

SALT: It's the opposite of what we've been told our whole lives...that salt is bad for you. Well, not for us. We are prescribed by our doctors 5000-10000mg of salt a day!! Believe it or not, I had been placed on a LOW salt diet before my diagnosis...no wonder I got so sick! So, get used to everything you eat tasting like a salt block. Add salt to everything and liberally if you have POTS. Unfortunately, if you're one of us that have severe acid reflux symptoms, that can be exacerbated by too much salt, so you'll have to have the maximum amount you can stomach without causing severe GERD symptoms. Many of the fluids listed below also have a significant amount of salt in them, so they can help in this category as well. Many people try Thermotabs aka salt tablets, but I think that they are created to torture us! I took a couple of them, and found them to be painful, nausea inducing, and then didn't help at all. If you enjoy suffering, then definitely try them...:)

Fluids: You have to keep your fluid volume high and, to do that, you need to drink LOTS of fluids. Here are some of the ones that I have found to be helpful.

Pedialyte: my personal favorite for fighting dehydration. I find that when my symptoms are really bad, having a liter of pedialyte makes me feel worlds better, which the others can't seem to do. I highly recommend. You might want to try the plain flavor, but if you can't stomach it by itself, then try adding just a TINY bit of a crystal light packet to it to make it more palatable.

Ceralyte: nice for travel b/c it is in packet form and can be mixed with water wherever you are. Like all of the electrolyte mixes, it has to be used quickly. It is not the greatest tasting stuff (made from rice and tastes like it) but is great for freezing into ice cubes and adding to smoothies later or if you need electrolyte help when traveling.

Gatorade: super easy to get and cheap, but super high sugar content and doesn't seem to work as well for me as the other mixes. If you don't mind drinking gallons of the stuff, then it is probably helpful, but I tend to have it only occasionally because it is so sweet and not as effective for me. The same goes for powerade and similar drinks (although I haven't tried propel).

Water (of course): I drink close to 3 L a day of the stuff and (literally) can't live without it. It is a requirement for all of us. Some people say that 2 L is adequate, but each person has to do what feels best for them. Carry it or another liquid with you at all times and if a major attack of POTS is coming on, down about 16oz fast and that might help stem the tide.

Homemade Electrolyte Mix: 1 qt water, 2 Tbsp honey, 1/4 tsp salt, 1/4 tsp baking soda. Combine until dissolved. Will last in fridge up to 24 hrs only. Great if you're in a pinch and dehydrated. Doesn't taste as good as some of the name brands, but not bad.

Countermaneuvers: I find it helpful to cross your legs or flex your thigh and calf muscles while standing if you are having an increase in symptoms, to lean forward onto a surface, or to walk in place. Others listed by dinet.org include sitting in a low chair, sitting in the knee to chest position and leaning forward with your hands on your knees when sitting and tightening the buttocks. These may increase the amount of time that you can remain upright, but they are usually only temporarily helpful.

Compression stockings: These can be really helpful for a lot of POTSies by combating the pooling of blood that can take place in the legs. 30-40mm Hg compression is usually needed to see any results and often need to be waist high; these can be prescribed by your doctor.

Pace yourself: Pacing is extremely important to prevent exhausting yourself for several days after a period of activity. By doing small amounts at a time, and frequently resting, you can prevent or reduce the number of days that you are super sick and unable to move. There is a good summary of how to pace yourself (this one is for fibromyalgia and CFS, but the principles are the same) at about.com that is worth checking out.

Frequent small meals: Large meals can cause too much blood to be diverted to the abdomen, and can increase symptoms in many people with dysautonomia; so, eating frequent small meals can help prevent these symptoms, and also helps to keep blood glucose levels stable throughout the day to increase energy.

Elevating the head of the bed: Doctors frequently recommend elevating your head at least 6 inches because it can help increase overall blood volume; It can also help with the frequent GERD that many of us deal with daily.

Exercise: even small amounts of exercise can make a difference (I know how hard this can be). Try not to allow yourself to get overly debilitated by staying in bed. It's very important to get up frequently, even for short periods just to keep your body at work. Many people find that exercising for 5 min increments each day makes a significant difference in how they feel. Resistance training, especially of the legs, can also be helpful over time.

Sitting in the shower: try using a shower seat when taking a shower...it can help reduce the risk or feeling that you are going to faint. And I can tell you from personal experience that it is NOT fun to faint in the shower! Also, taking a lukewarm shower can help reduce dizziness and lightheaded-ness during the shower.

I'm sure that I have managed to miss a bunch of helpful techniques, but this should at least be a good starting point. If I think of more things, I will add them to the blog in the future. If I've missed any helpful techniques, please comment on this post so that everyone can benefit from your discovery. Good luck to all of you in managing your POTS! :)