Dr. Svetlana Blitshteyn, MD: Dysautonomia and hydration

Dr. Svetlana Blitshteyn, a dysautonomia expert, discusses strategies for managing dehydration in patients with conditions such as POTS. She emphasizes the importance of adequate salt intake, recommending that young patients without hypertension consume between 5 to 10 grams of salt daily, depending on their tolerance. Blitshteyn suggests various methods for increasing sodium intake, including using salt tablets, adding salt to water, and consuming salty snacks. She acknowledges that some patients might experience nausea with salt intake and recommends enteric-coated salt tablets or adding flavor to salted water to make it more palatable. For patients with severe gastroparesis or swallowing difficulties, she notes that oral intake may be challenging, and while chronic IV saline is generally not recommended, it may be beneficial short-term during acute health deteriorations, such as after viral infections. The goal is to manage dysautonomia symptoms through tailored and tolerable fluid and electrolyte strategies for each patient.