unexplained syncope finally diagnosed as NMH or in the POTS family

Been avid runner, athlete, gym rat, etc. whole life...always practiced a low sodium diet since hypertension is in my family, and have been regularly told by my docs that I have low blood pressure in general but no concern..many runners have low BP.

I'm 59 and throughout my life starting in 20s, I had 2 fainting episodes when running in 90ish weather in New Orleans, high humidity, and during intense boxing in an humid enclosed pool room swimming laps, then boxing..BUT I was always aware when it was coming on..saw little balck dots and was able to tell someone..hey I am going to faint..did briefly, drank something, sat up and was fine..

fast forward this past year I worked out hard, was in a sauna which I love to stay in as long as possible until sweat drips...got out, walked to lockers and was able to tell someone I was going to faint...then fainted..thank goodness i did no fall on the hard bench..and another time (twice) ecently soaking in extreme hot water which I love, in a hot tub (sipping alcohol)..same thing, thank goodness did not drown, I was able to climb out then I fainted...

BUT this past summer, I woke up in middle of night to pee, took a few stepss and blacked out, fell backwards on rim of bath tub and severely injured my back (went to ER), thank goodness after CT scan it was severe soft tissue only, I thought I had broken my back and would never play tennis or run again, then a week later at night woke up and fell again, forward, broke little finger..

so then my primary made me visit Cardiologist and Neurologist, had battery of exams, CT and MRIs, etc..they found nothing....

a friend of mine who is a retired MD suggested a tilt test, John Hopkins in the only place in my area that gives a tilt test, so made an appointment and 4 months of waiting, I failed the tilt test. Was fine relaced happy chatting with the nurse while laying down about 15 minutes, then when she slowly raised me up to stand, my BP went down to about 53/26 and I told her that I was going to faint, and did so..

JH diagnosed me as NMH (neurally mediated hypotension) in the POTS family, JH MD told me I was just under the threshold of being considered having POTS..He told me consider LAST taking fludrocortizone, and just try taking salt tablets, prescribed by my Primary.. he briefly added there were possible complication with fludrocorizone, so use it as last resort

but then at first my primary prescribed FLUDRO, but I told her no, it's a steroid, don't want to take it, and i had the JH doctor's comment in my mind, then she said, OK, take the 1 gram of salt daily with lots of water, but I took the salt pill ONCE and it made me nausas, horrible after taste about 20 hours, and I stopped taking it..

also i read an NIH article that longterm FLUDRO nor salt tablets are proven to even work...not enough studies have been done on FLUDRO and salt to treat POTS etc.. Also the top 3 side effects of FLUDRO were insomnia, sweating and weight gain, and with my miserable hot flashes 24/7, and daily struggle to keep weight controlled, the last thing I want is this drug..

I have always drank about 2 liters of water daily, with my daily sports I am thirsty, my doc told me to start adding salt to foods, and drink gatorades, etc.. I bought knee high compression stockings for night

at night I sit up and stretch FIRST before getting up to walk to pee.

my concern is I have read lots of articles that untreated POTS etc. can lead to all sorts of other bad things....

ANY THOUGHTS???