Have lupus. struggle w/low bp's,fatigue,lightheaded. also get episodes where my hr increases 30 points standing w/ massive fatigue. tilt table was normal so i was told i do not have pots but i felt ok that day. salt.fluids & help but not enough.help?

It's impossible to give you a correct advice if your doctor has all medical info (medical history, current meds and lab results, besides physical findings) but he (she) could not get a definite diagnosis or treatment. I assume primary adrenal insufficiency, also an autoimmune disease, has been ruled out. Good luck.

Some clinicians insist that POTS episodes are not intermittent, have to occur daily & that heart rates have to go up by 40 during a bout. However you may have some degree of autonomic dysfunction by virtue of your autoimmune disorder. Some people have orthostatic hypotension without reflex tachycardia. Get tested for adrenal gland deficiency also. Florinef &, compression stockings may help you.