This super-common condition affects millions of young women, many of whom may not even know they have it.
Everyone's heart races every once in a while, and everyone gets a little dizzy from standing up too quickly sometimes—totally normal. But if those symptoms are happening on a regular basis, that's when it's no longer normal, and it could indicate a common yet little-known disorder called postural orthostatic tachycardia syndrome (POTS). And strangely, the treatment for POTS could be in your kitchen cabinet right now: Salt—lots of salt. Wait, what? To understand how salt could be your at-home Rx, first you should know something about POTS.
The disorder often starts feeling like a heart or digestive problem, but POTS is actually a disorder of the autonomic nervous system. That's the part of the body that regulates necessary-for-life systems like heart rate, digestion, breathing, urination, and even sexual arousal. When all is working as it should, it operates seamlessly behind the scenes. But when it goes wrong, it can suddenly feel as if even the most basic actions, like walking across the room, are a much more difficult task.
The primary symptom is tachycardia, or a fast heart rate when standing up, explains Jeffrey Mossler, M.D., a cardiologist and heart rhythm specialist at Indiana University Health who's been treating women with POTS for more than 25 years. To be officially diagnosed with the syndrome, your heart rate would have to increase at least 30 beats per minute or climb above 100 bpm when you move from lying down to standing up. That rapid heart rate may not sound like a big deal, but over time it leads to other symptoms like nausea, chest pain, light-headedness, shortness of breath, stomach aches, headaches, low libido, shakiness and, perhaps worst of all, crippling fatigue.
In everyday life, POTS can be extremely frustrating. Things that used to be easy, like carrying a basket of laundry, now feel like doing a high-intensity spin class. (And you can forget all about actually participating in your favorite spin class.) Thanks to the low blood pressure that often accompanies the condition, you may get blackout vision, or even faint after standing up quickly. But the symptoms go away once you lie back down. Basically, it's like your body forgot how to deal with gravity.
"All of these symptoms are the body simply trying to compensate for upright posture and not doing a good job of it," says Mossler.
Because the symptoms are so varied and commonplace, many women suffer for years, often being told they're just experiencing anxiety or depression before getting an accurate diagnosis, he says. And it's more common than you may think, affecting up to million Americans, with young women in their 20s and 30s making up a staggering 80 percent of patients, according to Dysautonomia International. So why haven't you heard more about it? Get ready to roll your eyes at the answer.
"To this day there's a certain bias that because it primarily affects young women, it's just hysterical females," says Mossler. "But it's not psychological, these symptoms are not just in your head and they have a very real physiological cause." [Whew, thanks, doc!] He explains that young women are particularly at risk because they can often experience low blood pressure and fluctuations in female hormones naturally—like during a menstrual cycle or pregnancy—which can trigger a POTS attack. Other triggers for the disorder include a viral illness or a period of high stress.
But Mossler says there is a treatment option available, and it's strangely simple: Eat a high-salt diet. Yes, you read that correctly, a cardiologist is instructing his patients to eat more salt. "Increasing salt and fluid intake can help increase blood volume and reduce symptoms," he explains. Beta blockers, a type of heart medication, are also used to treat POTS with great success. (In other weird salt news: Did you know that salt may actually help you run faster on race day?)
This doesn't mean everyone should see this as permission to pig out on pickles or binge on chips, however. For people with high blood pressure or other heart conditions, eating too much salt could make your condition worse in some cases, according to the American Heart Association. What's more, if you're trying to lose weight, excess sodium may actually hinder your success and prevent you from being able to drop the pounds.
If you've read through this and thought that any of these symptoms sound like you, there's good news. "POTS is a highly treatable condition and you can feel better," says Mossler. It's important to see a POTS specialist—often a cardiologist—so they can rule out larger issues like heart disease or low thyroid.