Tagliatelle with Tomato Sauce, Feta, and Oregano

Symptom check-in

POTS: I had dizziness every time I stood up today, my heart rate jumped fast, and I got short of breath walking around today. I wanted something salty and carb-heavy, so I made pasta with a properly salted tomato sauce and plenty of feta.

Vestibular migraine: I had no vestibular migraine symptoms today — no vertigo, no nausea, no vomiting, and no light sensitivity.

Lupus: I had no rash, no body aches, no fever, and no nausea from my anti-rejection meds today.

Disorder safety check

Condition	Works?	Why
POTS	Yes	Pasta provides a substantial carbohydrate base, while feta, salted pasta water, and seasoned tomato sauce make it easy to build sodium into the meal
Vestibular migraine	Conditionally	Tomatoes and aged cheeses can be personal triggers, so this makes more sense on a symptom-free day
Lupus	Not specifically targeted	Tomato and olive oil are nutritious, but this meal is primarily built around carbs and sodium rather than inflammation

Recipe

Ingredients

Makes 2 generous servings

Pasta

• 6–8 oz tagliatelle, pappardelle, or fettuccine

• 1 tbsp kosher salt for the pasta water

• 1/2 cup reserved pasta water

Tomato sauce

• 1 tbsp extra-virgin olive oil

• 2 garlic cloves, finely minced

• 1 1/2 cups crushed tomatoes or tomato passata

• 1/2 tsp dried oregano

• 1/2 tsp kosher salt, plus more to taste

• Freshly ground black pepper

• 1/2 tsp honey or sugar, optional if the tomatoes taste sharp

Topping

• 4 oz pasteurized feta

• 1/2 tsp dried oregano

• Freshly cracked black pepper

• 1 tsp extra-virgin olive oil

Optional:

• Fresh basil

• Red-pepper flakes

• Small amount of grated Parmesan

Steps

1. Start the pasta water

1. Fill a large pot with water.

2. Bring it to a rolling boil.

3. Add about 1 tablespoon kosher salt.

4. Stir so the salt dissolves.

The pasta water should taste clearly seasoned.

2. Start the tomato sauce

1. Put a wide skillet over medium heat.

2. Add 1 tablespoon olive oil.

3. Let it warm for about 30 seconds.

4. Add the minced garlic.

5. Stir continuously for about 20–30 seconds.

Do not let the garlic brown.

3. Add the tomatoes

1. Pour in the crushed tomatoes or passata.

2. Add:

   • oregano

   • salt

   • black pepper

3. Stir thoroughly.

4. Reduce the heat to medium-low.

5. Let the sauce simmer gently for 10–15 minutes.

You want the sauce to thicken slightly and lose the raw tomato taste.

If it becomes too thick, add a tablespoon or two of water.

4. Taste the sauce

1. Taste a spoonful.

2. Add more salt if needed.

3. If the tomatoes taste overly sharp, add 1/2 teaspoon honey or sugar.

4. Stir and simmer another minute.

The sauce should taste savory and balanced before it ever touches the pasta.

5. Cook the pasta

1. Add the tagliatelle to the boiling salted water.

2. Stir immediately so the ribbons separate.

3. Cook according to the package directions until just al dente.

4. Stir occasionally so the noodles do not stick together.

Wide pasta can clump easily, so do not just drop it in and walk away.

6. Reserve pasta water

Before draining:

1. Scoop out at least 1/2 cup pasta water.

2. Set it beside the stove.

3. Drain the pasta.

Do not rinse it.

The starch on the noodles helps the sauce cling.

7. Add pasta to the sauce

1. Put the tomato sauce over low heat.

2. Add the drained pasta directly to the skillet.

3. Use tongs to toss the ribbons through the sauce.

If the sauce looks too thick:

4. Add 2 tablespoons reserved pasta water.

5. Toss again.

6. Add more pasta water a tablespoon at a time if needed.

The sauce should lightly coat the pasta rather than pool underneath it.

8. Let the pasta finish in the sauce

1. Cook the pasta and sauce together for about 1–2 minutes over low heat.

2. Toss continuously.

This lets the pasta absorb some of the tomato flavor.

3. Turn off the heat.

4. Drizzle in a small amount of olive oil.

5. Toss once more.

9. Prepare the feta

1. Drain the feta.

2. Pat the outside lightly dry.

3. Crumble it into large irregular pieces rather than tiny crumbs.

The photo has a generous mound of feta, so keep some big chunks.

10. Plate the pasta

1. Use tongs to twist the tagliatelle into a loose pile in each bowl.

2. Spoon any extra tomato sauce from the pan over the top.

3. Scatter feta generously over the center.

Do not mix all of the feta into the pasta. Leaving it on top gives you the hot-cold contrast.

11. Finish

1. Sprinkle dried oregano over the feta.

2. Add freshly cracked black pepper.

3. Drizzle with a tiny amount of extra-virgin olive oil.

4. Add basil or red-pepper flakes only if using.

Serve immediately.

For the POTS-targeted version

The sodium can come naturally from properly salted pasta water, seasoned tomato sauce, and feta. That works much better than making the sauce bland and then trying to fix the entire meal with salt afterward.