Dietary sodium and health: How much is too much for those with orthostatic disorders?, 2022, Stock et al.

SNT Gatchaman

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Dietary sodium and health: How much is too much for those with orthostatic disorders?
Stock; Chelimsky; Edwards; Farquhar

High dietary salt (NaCl) increases blood pressure (BP) and can adversely impact multiple target organs including the vasculature, heart, kidneys, brain, autonomic nervous system, skin, eyes, and bone. However, patients with orthostatic disorders are told to increase their NaCl intake to help alleviate symptoms.

While there is evidence to support the short-term benefits of increasing NaCl intake in these patients, there are few studies assessing the benefits and side effects of long-term high dietary NaCl. The evidence reviewed suggests that high NaCl can adversely impact multiple target organs, often independent of BP. However, few of these studies have been performed in patients with orthostatic disorders.

We conclude that the recommendation to increase dietary NaCl in patients with orthostatic disorders should be done with care, keeping in mind the adverse impact on dietary NaCl in people without orthostatic disorders. Modest, rather than robust, increases in NaCl intake may be sufficient to alleviate symptoms but also minimize any long-term negative effects.

Link | PDF (Autonomic Neuroscience)
 
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Not had time yet to read this paper but might be of interest as adult son with ME has currently untreated orthostatic symptoms. His GP told us he has a couple of patients on his list with POTS and suggested increasing salt intake.

Not long after, a CT scan for an unrelated problem reported an incidental finding of atrophic left kidney, most likely from birth. Advised by urologist he is seeing for chronic urinary problems to be careful with his salt intake and to monitor BP as he gets older as he has a single functioning kidney. The other kidney is so small it cannot be visualised on US and CT scans. So he wasn't able to start increasing salt to see whether it helped with the orthostatic symptoms.
 
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