Lightheadedness and Off Balance Feeling

Going to the ENT is a good idea. Another consideration is orthostatic hypotension, when someone gets lightheaded feeling when the body position changes. My brother-in-law has it, similar symptoms that you mentioned.
I looked it up on the web to make sure I got the name right, and found there a way to check for it:
Orthostatic BP Measurement:
Measure BP and heart rate while lying down (after 5 minutes of rest), then immediately upon standing, and again after 3 minutes of standing. A drop of ≥20 mmHg systolic or ≥10 mmHg diastolic confirms orthostatic hypotension. Although of course you’d want to see a doctor.
Who knew there was a test for it!? I always learn something new when people pose a question on the forum.

Medications are notorious for causing lightheadedness. I take a medication and at times when walking on the sidewalk, I feel I have a tendency to walk kind of like I had a few drinks. It can be disconcerting in that one has to be more careful of falling due to the lightheadedness. Good luck and good health .

The commonest cause of orthostatic hypotension is a prescribed medication especially in patients with hypertension. The above testing from seated to standing should be repeated on several occasions. It should also be checked while you are lying in bed to see if it is high in the morning. You may benefit from balance exercises
since you have an increased risk of falling. Ask your cardiologist to test you for orthostatic changes next visit. Fluid intake regulation to avoid dehydration is
most important.

Have you experienced a feeling that your heart is pounding and shortness of breath? If so it might be Afib. You would need to wear a Halter monitor, since you’re having episodic issues, which makes it difficult to diagnose. As other postings have mentioned, many meds can cause these symptoms. If it is simply a balance issue, you could also see try doing physical therapy. I’ve gone twice, as I have cervical dystonia - neurological disorder that affects my neck and upper back - and causes significant balance issues. My neurologist says it’s progressive, so therapy won’t cure the problem, but it helps slow it down. I actually have to carry a card that my neurologist provided, that explains the problem - so if I would ever get pulled over by the police for possible DUI, it explains why I can’t walk in a straight line and tend to stagger a bit.

@triciaot
Thank you for this insight. I will try this test measurement and mention the condition when I see the ENT.

@grandmira
Exactly, and I know that some medications have made me like this in the past.

@seniormed
Good suggestions. Thank you.

I am Looking into Persistent Postural- Perceptual Dizziness (PPPD)
It sounds like what I have been experiencing. Off balance, unexpected dizziness etc
I have had many tests, including two MRI on my brain for the dizziness with normal results. Blood tests, checking on my bp meds etc.
I heard of this condition on a zoom. As it was explained not many doctors, including ENT doctors know about it or have ever heard about this !
Searching on YouTube videos for explanation.

Seeing an ENT is a must! About 20 years ago I had my first bout with Meniere's. I had no idea that is what it was. I was driving on the highway of all things and I started to feel dizzy. I saw an ENT and he said I had a severe ear infection. I was not even aware of it because there was no pain. He determined it was Meniere's. This went on for a couple of years. I finally found and ENT in Dallas who had me keep a journal for a month and I found that I was dizzy 18 days out of the month. He then confirmed it was Menieres and put me on a low dose diazapam twice a day. Over time the dizziness came less and less. I experienced one vertigo attack which was awful. Fast forward, I am having balance problems. I am older and had double knee surgery last year so I attributed it to that. But I exercise for strength and balance every day so I really don't think that's it. I saw a new ENT recently and she was livid that I had been on valium for so many years. She said it was probably the cause of the balance problems. I had no idea! I am going to get a second opinion before I do anything and will let you know what I find out. Good luck and keep us posted on what you find out. We are all in this together!

@blips, here's more information from Mayo Clinic:
- Resolving persistent postural-perceptual dizziness (PPPD) https://www.mayoclinic.org/medical-professionals/otolaryngology/news/resolving-persistent-postural-perceptual-dizziness-pppd/mac-20596513

EXCERPT:
"Persistent postural-perceptual dizziness (PPPD) has only recently been recognized as a unique vestibular condition. The chronic condition causes nonspinning dizziness and unsteadiness triggered by active or passive movement, standing, and visually complex environments. It's often associated with migraine and mental health issues.

"Common misconceptions are that PPPD is purely psychological and that there's no cure — neither of which is true," says Colton T. Clayton, Au.D., Ph.D., an audiologist specializing in vestibular disorders at Mayo Clinic in Jacksonville, Florida. "As a result, many people will see five or six specialists before they land on a final diagnosis of PPPD and an effective treatment pathway."

Mayo Clinic takes a unique approach to diagnosing PPPD that involves a coordinated team and comprehensive testing. The vestibular team has developed a treatment protocol that significantly reduces symptoms in nearly all people with PPPD. "