After failing a Tilt Test at John Hopkins, they said I have NMH (neurally mediated hypotension), this falls in the family of POTS or orthostatic hypotension..as I recall being told. I failed it with 56/23, but did not die, as soon as I was tilted down, I was fine. I was prescribed a common drug to treat it..first, sodium chloride aka salt, but if that did not work, fludrocortizone, .1mg daily.

However, because my regular pulse and BP has always been historically low since my 20s, and I am almost 59, I decided to not take either drug. My incidents only happened in a sauna (stayed too long until I was pouring sweat outa my glands which I love to feel), hot tub while sipping alcohol, running in New Orleans or extreme heat 95 plus with excessively high humidity, or working out too hard to the point of exhaustion. I have been an avid runner, sports, etc all my life, so I just was surprised when all of a sudden this summer I had 2 episodes when I woke up in middle of night to pee, and had unexplained syncope (fainting) and really injured myself with my falls. This is what lead to the Tilt test. Until my recent NMH diagnosis, I was always eating a low salt diet because hypertension runs in my family..now I ADD salt to my diet, as I was advised to do so.

The main differences between you and I are: I LOVE DRINKING WATER which is crucial to treat our condition..I drink in excess of a liter often about 80 ounces daily...this helps your body absorb salt which helps increase BP.

I am avoiding the fludrocortizone because it is a steriod and I don't want the likely side effects (insomnia, weight gain, more sweating - I already suffer horrible hot flashes), but I have read NIH studies, and it apparently works to help reverse hypotension..don't know longterm results.. I tried taking the prescribed salt, but it gives bad after taste, yeck and is not proven to work longterm anyway.

To avoid syncope, I sit up in bed before rising, and move a bit to circulate my blood, BEFORE rising to walk to pee in middle of night. I avoid saunas and avoid hot tubs and avoid strenuous exercise in excessive heat.

It sounds like fludrocortizone will work for you. Maybe the reason you do not like water is because you are used to the sweet taste of sweet drinks? and sweet foods?

To control my A1C I stopped added sugar and sweets cold turkey in my 40s, and I never add any sugar in my drinks, not even artificial, and drink sparkling water with a hint of fruit flavor, BUT mostly water...your taste buds will adjust once you stop sweets, added sugar...and then maybe you will adjust and like the taste of water, which is really what you need to avoid dehydration.

I am praying for you from afar, take care dear

you have more complications, but