Many patients with postural orthostatic tachycardia syndrome (POTS) have decreased plasma volume. Current POTS guidelines recommend \~10 g of salt and 2-3 L of fluid per day. Despite this recommendation, there is no long term data evaluating the use of salt in POTS. This randomized, placebo-controlled cross-over trial will evaluate a high salt diet, compared to a normal salt diet over a period of 3 months. Participants will complete 3 in lab evaluations including autonomic function testing, tilt table testing, blood volume and urine sodium evaluation, plasma catecholamine measurements and and cytokine measurements.
Eligibility
Sex
ALL
Min age
18 Years
Max age
60 Years
Healthy volunteers
No
Inclusion Criteria:
* Physician Diagnosis of POTS as defined by the CCS Consensus Statement and as follows:
* Sustained, excessive orthostatic tachycardia ≥ 30 bpm within 10 minutes standing.
* Absence of orthostatic hypotension (\>20/10 mmHg decrease) within 3 minutes standing.
* Chronic orthostatic symptoms that improve with recumbence.
* Age 18-60 years old.
* Ability to attend the Calgary Autonomic Research Clinic in Calgary.
* Resident of Canada
Exclusion Criteria:
* Overt cause for postural tachycardia (i.e., acute dehydration, thyroid disease)
* Participants with somatization or severe anxiety symptoms will be excluded
* Pregnant (self-reported)
* Underlying causes of tachycardia including acute hypovolemia, endocrinopathy, anemia, anxiety, medication effects, recreational drug effects, and prolonged bedrest.
* Other factors which in the investigator's opinion would prevent the participant from completing the protocol, including poor compliance during previous studies
* Fludrocortisone use (due to effects on renal Na+ handling)
* Patients who have received IV saline in the 2 months preceding the study or who plan to receive it during the course of the study
Primary outcome measure(s)
Upright Heart Rate — 10 Minutes Upright heart rate measured during the tilt table test at the end of the moderate dietary salt plus additional salt arm compared to the tilt table test at the end of the moderate dietary salt alone arm
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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