Hydration

Adequate hydration is key to helping manage symptoms of dysautonomia.

Studies have shown that some individuals with autonomic dysfunction can have a reduction in the amount of fluid volume in the body, called hypovolemia. ¹ ² ³

Increasing hydration can help maintain an appropriate fluid balance while navigating orthostatic stresses throughout the day.

This occurs through increasing the pressure within the blood vessels and decreasing how hard and fast the heart has to work to get blood throughout the body. ¹⁰

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The specific amount of water each individual will need to consume should be directed by the provider.

Recommendations can range from 2-4 liters (approx. 8-17 8 oz. glasses or a half-gallon to one gallon) of water throughout the day. ¹¹ ¹²

Starting the day by drinking two cups of water on an empty stomach can help signal the stomach to empty fluids into the intestines faster for absorption through the body. Then, sips of water to meet your quota throughout the day will assist in hydrating faster. ¹³

Some experts suggest that at least half of the fluid consumed throughout the day should be composed of electrolytes, which will help maintain electrolyte levels and increase fluid volume. ¹⁴

Various companies offer products designed to assist with hydration that can be used easily on the go when mixed with water.

For example, Liquid IV, Nuun, Normalyte, Banana Bag Oral Solution, Gatorade, Powerade, and more offer options with differing levels of sugar and electrolytes.

For a more cost-effective solution, one can easily make their own electrolyte solution.

For example, 1 liter of water, ½ tsp of table salt, and some frozen fruit can make a healthy and tasty electrolyte solution. 

Some people struggle with consuming the recommended amount of fluid throughout the day. Sometimes starting smaller and working up to larger amounts can help

Nutrition Tips - DSN (1)

Reviewed by Medical Content Experts, 2021

REFERENCES

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Bryarly, M., Philips, L. T., Fu, Q., Vernino, S., & Levine, B.D. (2019). Postural orthostatic tachycardia syndrome: JACC focus seminar. Journal of the American College of Cardiology, 73(10). 1207-1222. {1, 7}

Freeman, K., Goldstein, D.S., & Thompson, C.R. (2015). The dysautonomia project: Understanding autonomic nervous system dysfunction for physicians and patients. Bardolf & Company. {11, 15}

Fu, Q., Vangundy, T. B., Galbreath, M. M., Shibata, S., Jain, M., Hastings, J. L. Bhella, P.S., & Levine, B. D. (2010). Cardiac origins of the postural orthostatic tachycardia syndrome. Journal of the American College of Cardiology, 55(25), 2858–68. {2} 

Hale, G. M., Valdes, J., & Brenner, M. (2017). The treatment of primary orthostatic hypotension. The Annals of Pharmacotherapy, 51(5), 417–428. {8}

Miwa, K., & Fujita, M. (2014). Renin-aldosterone paradox in patients with myalgic encephalomyelitis and orthostatic intolerance. International Journal of Cardiology, 172(2), 514–515. {3}

Raj, S. R., Biaggioni, I., Yamhure, P. C., Black, B. K., Paranjape, S. Y., Byrne, D. W., & Robertson, D. (2005). Renin-aldosterone paradox and perturbed blood volume regulation underlying postural tachycardia syndrome. Circulation, 111(13), 1574–82. {4}

Raj, S.R., Guzman, J.C., Harvey, P., Richer, L., Schondorf, R., Seifer, C., Thibodeau-Jerry, N., & Sheldon, R.S. (2020). Canadian cardiovascular society position statement on postural orthostatic tachycardia syndrome (POTS) and related disorders of chronic orthostatic intolerance. Canadian Journal of Cardiology, 36(3), 357-372. {5, 9, 12}

Sheldon, R. S., Grubb, B. P., Olshansky, B., Shen, W. K., Calkins, H., Brignole, M., Raj, S. R., Krahn, A. D., Morillo, C. A., Stewart, J. M., Sutton, R., Sandroni, P., Friday, K. J., Hachul, D. T., Cohen, M. I., Lau, D. H., Mayuga, K. A., Moak, J. P., Sandhu, R. K., & Kanjwal, K. (2015). 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart rhythm, 12(6), e41–e63. {10, 13}

Stewart, J. M. (2013). Common syndromes of orthostatic intolerance. Pediatrics, 131(5), 968–80. {6}

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