Best Electrolytes for POTS in Australia: How to Compare Them
"What is the best electrolyte for POTS?" is one of the most common questions in every POTS community I am part of. It is also a question with no single answer, because the best one is whichever gets you to your own sodium and fluid target, every day, in a way you will actually keep doing.
So rather than a ranked list, this is the checklist I use as a food scientist living with POTS. It works for any product on any shelf, including mine, and it will still work when the next new brand launches.
In this article
Start with your target, not the product
Before comparing a single label, you need to know what you are aiming for. The Canadian Cardiovascular Society position statement on POTS suggests around 3 litres of water and 10 grams of salt a day, and the Australian POTS Foundation suggests 2 to 3 litres of water and 10 grams of salt, which it equates to about 4,000 mg of sodium, under medical supervision.
Your doctor may set a different number for you. Whatever it is, write it down in milligrams of sodium, because that is what Australian nutrition panels use. If you need help converting salt to sodium, I walk through it in my guide to POTS and electrolytes.
Sodium per serve is the number that matters
Most electrolyte products are designed for exercise, not for a daily sodium target, so the range on the shelf is enormous. Go straight to the sodium figure in the per serve column of the nutrition panel. Per 100 g figures look impressive on powders but tell you very little about what is in one drink.
Then do the simple maths against your target. At 4,000 mg a day:
- A product with 250 mg per serve would take 16 serves to cover the whole target
- A product with 500 mg per serve would take 8
- A product with 1,000 mg per serve would take 4
Nobody gets all of their sodium from drinks, and food counts too. But the comparison shows why a low sodium product can be a perfectly good sports drink and still be an impractical way to reach a POTS level target. For a deeper look at how much sodium a single drink really needs in other situations, see this piece on sodium per serve.
Sugar adds up when you drink it daily
Sugar in an electrolyte drink is not automatically bad. In a sports drink it is there to provide carbohydrate for exercise, and in an oral rehydration solution glucose is part of the formula for a specific medical purpose. The issue for POTS is frequency. A drink you have once after a long run is very different from a drink you have three or four times a day, every day.
The World Health Organization recommends keeping free sugars below 10% of daily energy, and suggests below 5%, or roughly 25 grams a day, for further benefit. Check the sugars line on the panel and multiply it by the number of serves you would realistically have. If you want to know more about the sweeteners used instead, I cover stevia and monk fruit in this article on sugar free electrolytes.
Drinks, tablets, rehydration solutions and table salt
Sodium is sodium, whichever way it arrives. What differs is how easy each format is to live with. Most people I know with POTS end up using a combination.
| Format | Works well for | Watch for |
|---|---|---|
| Electrolyte drink sachets or powders | Getting fluid and sodium in together, portable, easy to pace through the day | Sodium ranges widely between brands, and some are high in sugar |
| Salt tablets or capsules | People who dislike salty drinks, travel, a fixed dose | You still need to drink the fluid separately, and some people find them hard on the stomach |
| Oral rehydration solutions | Their intended use, rehydration during illness such as gastro | The WHO formula is about 1,725 mg of sodium per litre, with glucose, so a typical single serve is well under that |
| Sports drinks | Fuel and fluid during exercise | Usually built around carbohydrate rather than sodium, so check both lines |
| Table salt on food | Cheapest by far, and easy to add at meals | Hard to measure accurately, and it does not bring fluid with it |
The oral rehydration figure comes from the WHO reduced osmolarity ORS formulation, which sets sodium at 75 mmol per litre. For a more detailed side by side of electrolyte drinks and sports drinks, see electrolytes vs sports drinks.
Check the category and the warnings
Electrolyte products in Australia generally sit in one of two regulatory categories. Many are foods, often labelled as a Formulated Supplementary Sports Food. Others, including many oral rehydration solutions, are therapeutic goods listed with the TGA. The category tells you what the product was designed for and which rules its label follows. I explain the difference in my general electrolyte buyer's guide.
Always read the warning statements. Formulated Supplementary Sports Foods, including Ritua Hydrate, must carry a statement that they are not suitable for children under 15 years of age or pregnant women. That matters in POTS more than people realise.
In a survey of 4,835 people with POTS, around half first developed symptoms in adolescence, most commonly at age 14.
If you are a parent looking for options for a teenager with POTS, speak with their paediatrician or specialist about which products and amounts are suitable. The same applies if you are pregnant. Do not assume an adult sports product is the right fit.
Compare cost per 1,000 mg of sodium
Price per pack is misleading when serve sizes and sodium levels vary so much. The fairest comparison for a daily sodium target is cost per 1,000 mg of sodium:
Pack price ÷ number of serves ÷ (sodium per serve ÷ 1,000)
As a worked example, Ritua Hydrate is $54.95 for 30 sachets with 1,000 mg of sodium each, which is about $1.83 per 1,000 mg, or about $1.56 on subscribe and save. A product with 500 mg per serve at the same price per serve would cost twice as much per 1,000 mg of sodium.
To be completely honest, table salt wins this comparison easily, and salt tablets are often cheap too. You are paying for convenience, taste and the fluid that comes with a drink. That is worth paying for if it is what keeps you consistent, but it is worth knowing what you are paying for.
A checklist you can take shopping
- Target: Do I know my daily sodium target in milligrams, set with my doctor?
- Sodium: How much sodium per serve, and how many serves would I need?
- Sugar: How much sugar per serve, multiplied by the serves I would realistically have?
- Volume: How much water does one serve go into, and does that fit my fluid target?
- Transparency: Is every ingredient and amount listed, with no proprietary blends?
- Category and warnings: Is it a food or a listed medicine, and is it suitable for me?
- Cost: What does it cost per 1,000 mg of sodium?
- Taste and format: Will I still want to drink this in three months? Is there more than one flavour?
The bottom line
The best electrolyte for POTS is the one that fits your own sodium and fluid target, keeps sugar low if you are drinking it daily, suits your stage of life, and that you will actually keep using. Compare sodium per serve and cost per 1,000 mg of sodium, not pack price or marketing.
I formulated Ritua Hydrate to meet my own checklist: 1,000 mg of sodium, 190 mg of potassium and 70 mg of magnesium per sachet, no sugar, every ingredient listed, in Berry and Lemon Lime. If you would like to try both flavours before committing, start with the four sachet sample pack.
This article is general information, not medical advice, and is not a substitute for guidance from your doctor, particularly if you are managing an existing health condition or taking medication.
Jasmine Meagher
BSc Food Science and Nutrition · Founder, Ritua
Jasmine is a food scientist who has developed more than 250 sports and wellness supplements, and she lives with POTS. She founded Ritua to bring evidence-based, TGA-compliant supplements to Australian women, and writes about the research behind every ingredient Ritua sells.
Common questions
How much sodium should an electrolyte for POTS have?
There is no fixed rule. Work backwards from the daily target your doctor sets. At a target of about 4,000 mg, a 1,000 mg serve covers a quarter of the day, while a 250 mg serve covers about 6%.
Are sports drinks good enough?
They are designed for exercise, so they usually provide more carbohydrate than sodium. Check both the sodium and sugars lines and do the maths for the number of serves you would need each day.
Can I use oral rehydration solutions every day?
Oral rehydration solutions are formulated for rehydration during illness, and many are listed medicines with their own directions. Follow the label and ask your doctor or pharmacist before using them as a daily sodium source.
What is the cheapest way to get sodium?
Table salt, by a long way. Drinks and tablets cost more because of convenience, measured doses, taste and, for drinks, the fluid that comes with them. Compare products on cost per 1,000 mg of sodium.
Is Ritua Hydrate suitable for teenagers with POTS?
Ritua Hydrate is a Formulated Supplementary Sports Food and is not suitable for children under 15 or pregnant women. For teenagers, please speak with their doctor about suitable products and amounts.
Sources
- Raj SR et al. Canadian Cardiovascular Society Position Statement on Postural Orthostatic Tachycardia Syndrome (POTS) and Related Disorders of Chronic Orthostatic Intolerance. Canadian Journal of Cardiology, 2020.
- Living with POTS. Australian POTS Foundation.
- Shaw BH et al. The face of postural tachycardia syndrome: insights from a large cross-sectional online community-based survey. Journal of Internal Medicine, 2019.
- WHO calls on countries to reduce sugars intake among adults and children. World Health Organization, 2015.
- Reduced osmolarity oral rehydration salts (ORS) formulation. World Health Organization, 2001.