Electrolyte Supplements for POTS, EDS, and MCAS: A Comprehensive Guide

Living with conditions like Postural Orthostatic Tachycardia Syndrome (POTS), Ehlers-Danlos Syndrome (EDS), and Mast Cell Activation Syndrome (MCAS) can be challenging, especially when managing symptoms like dizziness, fatigue, and heart palpitations. One common recommendation made by doctors, such as those at the Tulane Hypermobility and Ehlers-Danlos Clinic, is to increase fluid and electrolyte intake, particularly sodium. This is crucial for people with dysautonomia to help regulate blood pressure and hydration.

If you've been diagnosed with POTS or instructed to use electrolyte supplements, here’s a breakdown of popular options and how they might suit your needs. Each product offers different benefits, so it may take some trial and error to find the right one.

Why Electrolytes Matter for POTS, EDS, and MCAS

Electrolytes, especially sodium, play a vital role in maintaining fluid balance and stabilizing blood pressure. For those with POTS, increasing sodium intake helps boost blood volume, reducing the dizziness and fainting that often result from a sudden drop in blood pressure. Similarly, for EDS, electrolyte imbalances may lead to fatigue and muscle issues, while in MCAS, increasing fluids can help manage vascular instability.

Key Factors to Consider

• Sodium content: If you have severe dysautonomia symptoms or low blood pressure, higher sodium levels may be necessary.
• Sugar content: If you are monitoring blood sugar or prefer a low-calorie option, this is important.
• Additional vitamins or minerals: Some formulas include nutrients like magnesium or folate, which can benefit specific conditions.
• Cost: Price varies significantly between products, so finding a cost-effective option for daily use is key.

The Role of Electrolytes in Fluid Balance for POTS

People with POTS often have difficulty maintaining fluid balance due to hypovolemia (low blood volume). This condition can arise from a dysregulated renin-angiotensin-aldosterone system (RAAS), fluid loss from nausea or diarrhea, or inadequate fluid intake. Electrolytes, especially sodium, help retain water, which increases blood volume, alleviating common symptoms like dizziness and rapid heart rate.

DIY Electrolyte Options: Can I Just Use Table Salt?

Yes! For those managing dysautonomia on a budget, using table salt in water is an affordable and effective solution. In fact, some electrolyte companies, like LMNT, even provide recipes for making your own salt-based drinks. Here’s a simple recipe:

• 1/2 teaspoon of salt (approx. 1,150mg sodium)
• A pinch of potassium chloride (for potassium)
• 1-2 teaspoons of sugar (optional for quick energy)
• Squeeze of lemon or lime juice (optional for flavor)

This mix can be combined with 16-20 oz of water. While convenient electrolyte supplements often include other minerals like magnesium, homemade options can work if your diet is balanced in these areas.

How Much Salt and Water Should POTS Patients Have?

According to the Cleveland Clinic, POTS patients should aim for 2-2.5 liters of fluids per day, including water, sports drinks, and broths. In terms of sodium intake, 3,000-10,000mg per day is often recommended. Since one teaspoon of table salt contains about 2,325mg of sodium, POTS patients may need significantly more sodium than the average person, depending on their symptoms and guidance from a healthcare provider.

Choosing the Right Electrolyte Supplement

When selecting an electrolyte supplement, look for products containing at least 500mg of sodium per serving to help meet your daily intake goals. Additionally, if you struggle with dehydration or low food intake, a supplement with added sugar may help optimize hydration. If dehydration isn’t a major concern, sugar-free options may be more appropriate.

Comparison of Popular Electrolyte Supplements

1. Buoy Electrolyte Drops

• Sodium: 50mg per serving
• Sugar: 0g (zero sugar)
• Extras: Includes B vitamins and antioxidants, can be added to any drink.
• Cost: $30 for 48 servings, about $0.62/serving.

Buoy is a great low-sodium option for those looking for a sugar-free, convenient hydration booster.

2. Vitassium

• Sodium: 500mg per capsule
• Sugar: 0g
• Extras: Includes potassium, tailored for POTS patients.
• Cost: $23 for 60 capsules, about $0.38/capsule.

Vitassium is ideal for those needing higher sodium without added sugars or flavors.

3. SaltStick

• Sodium: 215mg per capsule
• Sugar: 0g
• Extras: Contains potassium, magnesium, and calcium for muscle support.
• Cost: $22 for 100 capsules, about $0.22/capsule.

SaltStick is a balanced option for active individuals who need electrolyte support during physical activity.

4. Catalyte by Thorne

• Sodium: 485mg per scoop
• Sugar: Less than 1g
• Extras: Includes magnesium and methylated folate, suitable for those with MTHFR mutations.
• Cost: $23 for 30 scoops, about $0.77/scoop.

Catalyte is a good choice for individuals with more complex nutritional needs.

5. LMNT Recharge

• Sodium: 1000mg per packet
• Sugar: 0g
• Extras: Contains magnesium and potassium.
• Cost: $45 for 30 packets, about $1.50/packet.

LMNT is perfect for those needing a high sodium content and a sugar-free option.

6. DripDrop ORS

• Sodium: 670mg per packet
• Sugar: 14g
• Extras: Contains potassium, magnesium, and zinc.
• Cost: $35 for 32 packets, about $1.09/packet.

DripDrop provides a balance of sodium and sugar, making it great for dehydration relief.

7. Pedialyte Sport

• Sodium: 650mg per packet
• Sugar: 7g
• Extras: Contains potassium and magnesium.
• Cost: $37 for 24 packets, about $1.57/packet.

Pedialyte Sport is a trusted option for those needing a good balance of electrolytes with some added sugar.

What is the Best Electrolyte Supplement?

While there are many electrolyte options, the truth is, the “best” supplement depends on your personal needs and lifestyle. The most basic supplements are often just table salt and potassium salt, repackaged for convenience. There's no profit in advertising table salt, but there’s a big markup for branded products. If anyone can show me a real difference in ingredient quality, I’d be willing to reconsider, but for now, I believe many are just branded table salt with fancy packaging.

That said, I’m happy to pay for convenience. It’s far easier to toss an LMNT packet in your bag than carry a salt shaker. However, at home, I’ll stick to plain raw salt for an affordable and effective solution.

Convenience vs. Cost: What Are You Paying For?

Electrolyte supplements are popular because they’re convenient and often come in appealing flavors. But when you strip away the branding, most of them are just sodium and potassium salts, both of which can be bought cheaply at any grocery store.

While table salt costs next to nothing, it lacks the sleek packaging and added trace minerals of branded supplements. In most cases, you’re paying for the convenience and perceived value of a pre-packaged solution.

Are High-Performance Electrolytes Worth the Cost?

Some brands promote “high-performance” or “elite” electrolytes with trace minerals or extra vitamins, but they’re still based on the same essential ingredients—sodium, potassium, and magnesium. If convenience is a priority, pre-packaged supplements can be worth the cost. However, if you're managing symptoms at home, plain table salt and potassium salt work just as well for much less.

It’s About What Works for You

Ultimately, the best electrolyte supplement comes down to your daily routine, symptoms, and preferences. If convenience is key, products like LMNT or Catalyte might be worth the price. But if you're at home and budget-conscious, table salt is a reliable and cheap alternative.

Cost Comparison: Sodium Content and Price per Gram

To manage conditions like POTS, many patients need as much as 10 grams of sodium per day. Below is a breakdown of the cost per gram of sodium for each electrolyte brand, as well as table salt for comparison.

Table Salt

• Sodium per teaspoon: 2,325mg
• Cost: $1.00 for a 26 oz container (grocery store)
• Cost per gram of sodium: $0.0036 per gram
• Cost for 10g of sodium per day: $0.036/day (the cheapest option by far).

Cost Comparison of Electrolyte Brands (Sorted by Price per Day for 10g of Sodium):

1. Buoy Electrolyte Drops: $124/day
2. Pedialyte Sport: $24.20/day
3. DripDrop ORS: $16.30/day
4. Catalyte by Thorne: $15.90/day
5. LMNT Recharge: $15.00/day
6. SaltStick: $10.20/day
7. Vitassium: $7.60/day

Conclusion: Finding the Right Balance

While table salt is the most cost-effective way to increase sodium intake, electrolyte supplements provide convenience and added nutrients that can justify their higher cost. For those seeking the most affordable supplement, Vitassium and SaltStick are excellent options, while Buoy Electrolyte Drops is the priciest. Ultimately, the right supplement for you will depend on your lifestyle, needs, and budget.

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