Should I Increase My Salt Intake During Hypotension? 

In the UK, public health advice typically focuses on reducing salt to prevent heart disease and strokes. However, for individuals experiencing symptomatic low blood pressure, the clinical advice is often the opposite. Salt, or sodium, plays a critical role in how the body maintains fluid balance and blood volume. Increasing salt intake can be a highly effective treatment for certain types of hypotension, but it must be managed carefully. This article explores the link between salt and blood pressure, the clinical reasons for increasing intake, and the essential safety considerations for managing sodium levels. 

What We’ll Discuss in This Article 

• The biological relationship between salt, water retention, and blood pressure. 

• Why salt is specifically recommended for conditions like orthostatic hypotension. 

• The difference between ‘table salt’ and electrolytes in clinical management. 

• How much extra salt is typically suggested by UK clinicians. 

• The risks of excessive salt intake, including strain on the heart and kidneys. 

• Practical and palatable ways to increase salt in your daily diet. 

• When you must avoid increasing salt despite having low blood pressure. 

How Salt Raises Blood Pressure 

Salt raises blood pressure because sodium acts like a sponge in your bloodstream, pulling in and holding onto water. When you increase your salt intake, your body retains more fluid, which expands the total volume of blood circulating in your system. A higher blood volume puts more pressure on the walls of your arteries and makes it easier for your heart to pump blood upward to your brain, directly counteracting the symptoms of hypotension. 

For people with healthy blood pressure, this effect can lead to hypertension. However, for those whose pressure ‘crashes’ when they stand up or eat, this extra fluid acts as a vital buffer. By keeping the ‘pipes’ of the circulatory system fuller, salt helps the body maintain stability during changes in posture or environment. This is why salt is often prescribed alongside increased water intake; salt provides the ‘holding power’, while water provides the volume. 

• Fluid Retention: Sodium prevents the kidneys from flushing out too much water. 

• Volume Expansion: More fluid in the vessels leads to higher systemic pressure. 

• Improved Perfusion: Helps ensure the brain receives a steady supply of oxygen. 

Clinical Recommendations for Salt Intake 

While the standard UK recommendation for adults is no more than 6g of salt (about one teaspoon) per day, a GP may advise an individual with symptomatic hypotension to increase this to 10g or even 12g daily. This is a significant increase and is usually reserved for those with severe orthostatic hypotension or autonomic nervous system disorders where lifestyle changes like hydration alone have not been successful. 

It is rarely recommended to simply eat more salty snacks like crisps, as these are often high in unhealthy fats. Instead, clinicians may suggest adding a measured amount of table salt to home-cooked meals or using salt tablets (sodium chloride) if a precise dose is required. In some cases, electrolyte drinks or rehydration salts are preferred because they also provide potassium and magnesium, which help maintain a healthy mineral balance in the body. 

Intake Level	Daily Amount	Clinical Context
Standard UK Limit	6g (1 tsp)	For the general healthy population.
Hypotension Support	7g to 9g	For mild, frequent dizzy spells.
Clinical Hypotension	10g to 12g	For severe autonomic failure or syncope.

When to Avoid Increasing Salt 

Increasing salt is not a safe option for everyone, even if they have low blood pressure. If your hypotension is caused by a heart condition, such as heart failure, adding salt can be dangerous. The extra fluid retention puts significant strain on a weak heart muscle and can lead to fluid building up in the lungs, a condition known as pulmonary oedema. Similarly, those with chronic kidney disease must be extremely careful with salt as their kidneys cannot process it effectively. 

You should only increase your salt intake if it has been explicitly recommended by a healthcare professional after a full review of your medical history. They will often monitor your kidney function and heart health through blood tests and physical exams to ensure the extra sodium is not causing hidden damage. If you notice new swelling in your ankles or find yourself becoming more breathless, you should stop the extra salt and seek medical advice immediately. 

Practical Ways to Increase Salt Safely 

If your doctor has advised increasing your salt intake, it is best to do so gradually and consistently throughout the day rather than all at once. Spreading your salt intake helps maintain a stable blood volume and is generally easier on the digestive system. Focus on adding high-quality sea salt or table salt to nutrient-dense foods rather than relying on processed ‘junk’ foods. 

• Salt your Water: Adding a small pinch of salt to your water can improve absorption. 

• Savoury Snacks: Choose nuts, seeds, or olives which provide healthy fats alongside salt. 

• Rehydration Salts: Use over-the-counter sachets designed for fluid replacement. 

• Soups and Broths: Naturally high in sodium and excellent for hydration. 

• Soy Sauce or Miso: Use these in cooking for a concentrated salt boost with flavour. 

Conclusion 

Increasing salt intake can be a powerful tool for managing symptomatic low blood pressure by helping the body retain the fluid needed to maintain blood volume. However, because salt has a direct and significant impact on the heart and kidneys, it must be treated with the same caution as a medication. For many in the UK, a guided increase in sodium, paired with plenty of water, can resolve frequent dizzy spells and improve daily function. Always consult your GP before making significant changes to your salt intake to ensure it is the right and safe choice for your specific health profile. 

If you experience severe, sudden, or worsening symptoms, or if you notice swelling in your legs or shortness of breath, call 999 immediately. 

Authority Snapshot (E-E-A-T Block) 

This article was written by Dr. Rebecca Fernandez, a UK-trained physician with an MBBS and extensive experience in cardiology, internal medicine, and emergency care. Dr. Fernandez has managed thousands of patients with complex fluid and electrolyte needs and has provided clinical guidance on the safe use of sodium in the treatment of autonomic dysfunction. Her expertise ensures that this guide to salt and hypotension follows current clinical frameworks for cardiovascular safety and patient health.