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We understand you may have a hard time dealing with dysautonomia. Knowing the disease and how it affects your daily life can help you manage it better. Read on to know its causes, symptoms, treatment options and tips to deal with it.
What is Dysautonomia?
It is a term for disorders that cause the malfunctioning of the autonomic nervous system. ANS is a part of the peripheral nervous system that exchanges information between the brain and other parts of the body through nerve signals.
It regulates the involuntary functions of the body that we can’t consciously control, such as
- Blood Pressure
- Sexual functions
- Digestion
- Skin temperature
- Breathing
- Salivation
- Bowel function
- Heart rate
- Bladder control and many more
When the nerves of ANS get damaged, as in dysautonomia, they don’t send or receive signals as they normally do. It causes significant changes in these systems due to which symptoms appear.
Autonomic dysfunction is not a rare disease. It nearly affects more than 70 million people all over the world.
DYSAUTONOMIA SYMPTOMS
Due to the various functions of ANS, dysautonomia symptoms can be extensive. Every patient experiences different signs and symptoms based on the location of dysfunction and the type of disorder.
In some patients, symptoms appear more frequently, while others experience them once in a while. These can come and go at any time, making it difficult to predict the onset.
The most common symptoms include:
Orthostatic intolerance ( a person can’t stand for long without feeling dizzy)
Tachycardia (increased heartbeat)
- Bradycardia (decrease in heart rate)
- Dizziness
- Syncope (fainting)
- Vertigo
- Anxiety
- Low blood pressure
- Fatigue
- Light sensitivity
- Insomnia (difficulty in sleeping)
- Shortness of breath
- Frequent urination or incontinence
- Migraines
- Erectile dysfunction
- Low blood sugar
- Visual disturbance
- Difficulty swallowing
- Brain fog
- Inability to concentrate
- Appetite disturbance
- Noise or light sensitivity
DYSAUTONOMIA CAUSES
Dysautonomia occurs due to the failure of the whole or a part of the ANS. It can happen for various reasons that are classified into two types.
If autonomic dysfunction occurs on its own without the presence of any other disease, it is termed Primary Dysautonomia. In some cases, malfunctioning of ANS occurs due to injury or any coexisting disorder known as Secondary Dysautonomia.
Some of the conditions that lead to autonomic dysfunction or autonomic neuropathy include:
- Celiac disease
- Diabetes
- Parkinson’s disease
- Rheumatoid arthritis
- Crohn’s disease
- Ulcerative colitis
- Muscular Sclerosis
- Sarcoidosis
- Sjogren’s syndrome
- Lupus
- Ehlers-Danlos syndrome
- Guillain-Barre syndrome
- AIDS
- Lupus
- Lyme disease
- Long Covid
- Charcot-Marie-Tooth disease
- Chiari malformation
- Amyloidosis
- Antiphospholipid syndrome
- Vitamin Deficiencies
- Mitochondrial disease
- Fabry disease
- Chronic Inflammatory Demyelinating Polyneuropathy
TYPES OF DYSAUTONOMIA
Dysautonomias are a group of disorders that affect ANS. Researchers have identified at least 15 different types. The most common of them are pots and neurocardiogenic syncope.
● POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME
Stats suggest that it affects nearly 1-3 million people in America. Dysautonomia with pots causes an abnormal increase in heart rate (40 bpm in teens, 30 bpm in adults) within 10 minutes of standing.
Pots symptoms appear in multiple organ systems and include tachycardia, chest pain, impaired thermoregulation, shortness of breath, dizziness, exercise intolerance, and many more. It is not a life-threatening disorder, but it can impact your quality of life.
Some scientific studies suggest that autoimmune disorders may be the underlying cause of dysautonomia pots. Autoimmune disorders are those in which the body attacks its own cells and tissue.
● NEUROCARDIOGENIC SYNCOPE
Neurocardiogenic syncope, also known as vasovagal syncope, affects more than 10 million people worldwide. It causes a sudden drop in blood flow to the brain that causes syncope or fainting.
People with NCS may experience occasional or frequent fainting spills. It’s triggered by a long period of standing or sitting, emotional distress, alcohol, warm environment and dehydration. Avoiding these possible triggers may help patients with NCS who occasionally faint.
● FAMILIAL DYSAUTONOMIA
It is also known as Riley-Day Syndrome. It is an uncommon genetic disorder that only affects 350 people all over the world. There is only a 25% chance that you will get this disease if both your parents are carriers.
Although it can affect people of any race, it most commonly occurs in Ashkenazi Jews. Familial dysautonomia symptoms include:
- Difficulty in swallowing
- Fluctuations in blood pressure
- Vision problems
- Respiratory and digestive complications
- Autonomic crisis (high blood pressure and heart rate followed by cyclic vomiting and retching)
● BAROREFLEX FAILURE
Baroreflex is the body’s mechanism for regulating blood pressure. Baroreceptors detect high pressure in blood vessels and send signals to the brain via the baroreceptive nerves.
In baroreflex failure, damage to baroreflex structures occurs, and the brain doesn’t get information about blood pressure status. It causes the pressure to drop too low when a person is inactive or rises dangerously during stress.
Other symptoms include fluctuations in heart rate, headache, flushing, feeling of warmth and sweating.
● AUTONOMIC DYSREFLEXIA
It is a disorder that affects people with spinal cord injuries. Greater the injury, the higher the risk of AD. Studies show that 90% of patients with cervical or thoracic spinal injury develop AD.
In autonomic dysreflexia, damaged spinal cord prevents the brain from receiving information which causes a sudden rise in blood pressure to a dangerous level. Other symptoms include throbbing headache, excessive sweating, flushing, nasal blockage, nausea, vomiting, and much more.
● DIABETIC AUTONOMIC NEUROPATHY
As the name suggests, it’s the complication of diabetes. High Blood sugar levels damage the nerves that control gastrointestinal tract, heart, genitals, and many other organs. On average, about 20% of people with diabetes suffer from autonomic neuropathy.
Bladder paralysis is the most common symptom that appears in patients with DAN. It causes urine retention because nerves no longer respond to pressure in the bladder.
Other symptoms include
- Breathing problems
- Gastroparesis, a condition that affects the movement of the muscles in stomach
- Erectile dysfunction
- Increased heart rate
- Excess or no sweating at all
- Constipation
- Orthostatic hypotension
● INAPPROPRIATE SINUS TACHYCARDIA
It is a rare form of dysautonomia that only affects 1.2% of the population. It’s a condition where a person’s resting heartbeat is above 100 bpm.
The word sinus refers to a normal rhythm. So in IST, a heart beats in its normal rhythm, but it just beats faster than usual. Symptoms include weakness, dizziness, fainting, exercise intolerance and shortness of breath.
● MULTIPLE SYSTEM ATROPHY
MSA is a rare autonomic dysfunction that affects people above age 50. It is often misdiagnosed as Parkinson’s disease because of the common symptoms in the early stages. It has no specific cause, but scientific research shows that certain brain parts wear down in people with MSA.
On the basis of symptoms, multiple system atrophy is classified into two types. People with MSA-P have more parkinsonian-like symptoms that include:
- Difficulty swallowing
- Rigidity
- Resting Tremors
- Slow movements
In MSA-C, patients show predominant signs of cerebellar dysfunction that includes:
- Difficulty coordinating walking
- Poor hand coordination
- Slurred speech
- tremors
There’s no cure for MSA, and no treatment can slow down its progression. On average, 80% of patients get disabled within 5 years after the onset of motor symptoms.
● PURE AUTONOMIC FAILURE
It is a peripheral neurodegenerative disorder of ANS. PAF, also known as Bradbury-Eggleston Syndrome, affects middle-aged people. It is more prevalent in men than women.
Synuclein is a protein that helps transmit nerve signals. PAF is thought to be caused by excessive accumulation of this molecule, as per mayo clinic research. Progression of this disease leads to multiple system atrophy in some cases.
Symptoms of PAF include:
- Dizziness upon long periods of standing
- Raised blood pressure when lying down
- Persistent neck pain
- Decreased ability to sweat
- Constipation
- Heat intolerance
● AUTOIMMUNE AUTONOMIC GANGLIONOPATHY
It is an autoimmune disorder where the body’s immune system attacks the receptors in autonomic ganglia. Autonomic ganglia is a cluster of nerve cell bodies in the autonomic nervous system.
When these receptors get damaged, the body doesn’t process information correctly. It leads to the impairment of some autonomic functions.
It’s a rare form of primary dysautonomia that only affects 100 Americans annually. People with AAG may experience a rapid onset or gradual presentation of symptoms. These include:
- Orthostatic hypotension
- Gastroparesis
- Urinary retention
- Fainting
- Dry eyes
- Dry mouth
- Dilated pupils
DYSAUTONOMIA DIAGNOSIS
The diagnostic journey for dysautonomia can be challenging and overwhelming. Some people may get the diagnosis right on their first visit to a doctor. While others have to see different specialists to get to the root of the problem, and they might receive misdiagnosis along the way.
Diagnostic tests for dysautonomia depend on the symptoms you experience. Your healthcare provider may ask you to undergo the following tests:
- Table tilt test is the most common test that measures fluctuations in heart rate and blood pressure when individuals shift their position.
- Autonomic Function tests measure heart rate and blood pressure during exercises, such as deep and forceful breathing.
- Cold pressor test assesses the patient’s sympathetic activity by placing his hands in ice-cold water for 1-2 minutes.
- Thermoregulatory sweat test measures one’s ability to sweat, as changes in the sweating pattern may suggest autonomic dysfunction.
- Gastric emptying time assesses gastroparesis by measuring how long it takes for food to move through the stomach.
- Other tests: These include ECG, ultrasound, CBC, catecholamine tests and skin biopsy for evaluation of nerve fibers.
DYSAUTONOMIA TREATMENT
Secondary dysautonomia prognosis can be improved by treating underlying conditions. However, there’s no cure for primary dysautonomia. Its treatment focuses on improving quality of life by managing symptoms.
Pharmacological treatment of this autonomic disorder is based on trial and error. It’s not necessary that the therapy that worked for others will be effective for you as well. Here’s a list of medications that your doctor may prescribe to you.
Note: Keep in mind this is not an inclusive list and doesn’t provide all the information. The guide here is to empower you to ask questions about your health from your doctor or pharmacist.
- Beta-blockers for controlling blood pressure and other symptoms
- NSAIDs for pain management
- Amphetamines for brain fog and fatigue
- Benzodiazepines for improving sleep quality
- Selective serotonin reuptake inhibitors for treating anxiety and depression
- Somatostatins for patients with signs of orthostatic hypotension, dizziness, fatigue, and impaired gastrointestinal motility
- Clonidine for management of orthostatic hypotension, tremors and insomnia
- Intravenous immunoglobulins (IVIG) to treat autoimmune autonomic disorders
Besides dysautonomia medications, exercise and physical therapy help patients cope with the challenges that come with this condition.
ALTERNATIVE TREATMENT
No, complementary therapies can’t cure this condition. But they may help deal with the symptoms more effectively alongside drugs.
These include:
● ACUPUNCTURE
It is a technique based on Chinese traditional medicines that involves inserting thin needles into the skin to activate pressure points. It is thought to affect peripheral nerves that control the release of cortisol, which is associated with stress.
● MASSAGE THERAPY
It is particularly useful for dysautonomia patients who experience headaches, muscle spasms and circulation problems. It helps improve blood flow, lymphatic circulation and joint pain.
● CHIROPRACTIC CARE (UPPER CERVICAL SPECIFIC)
Chiropractors mainly focus on the spinal cord that directly impacts ANS. Misalignments in the spine can put pressure on peripheral nerves that affect the communication between the brain and other organs. This impaired signaling can lead to autonomic dysfunction.
At Vitality chiropractic center in Singapore, we specialize in upper cervical chiropractic care. Our specialists find the location of misalignment and perform necessary adjustments to remove the pressure from spinal nerves. So, what are you waiting for? Contact us right now to restore your spinal health.]
TIPS FOR LIVING WITH DYSAUTONOMIA
Living with this dysautonomia isn’t easy at all. But you can cope with its symptoms well by adopting the following lifestyle changes.
● HYDRATE, HYDRATE AND HYDRATE
Some people with dysautonomia may develop hypovolemia that causes loss of body fluid. So drinking water may help restore fluid balance.
● INCREASE SALT INTAKE
Sodium chloride is an important electrolyte for the functioning of nerves. It also helps to maintain blood pressure. But remember increasing salt intake isn’t for everyone, and you should discuss it with your doctor.
● EAT SMALL AND FREQUENT
Eating large meals loaded with fat and carbohydrates can divert blood flow to the stomach. It worsens symptoms, such as dizziness and lightheadedness.
● AVOID ALCOHOL AND CAFFEINE
Studies show that excessive consumption of alcohol and caffeine can cause dehydration, which can trigger some symptoms.
● EXERCISE
Exercise is an important part of the treatment plan for people with autonomic disorders. It helps stabilize ANS and manage many symptoms.
● ELEVATE YOUR HEAD DURING SLEEP
Healthcare providers recommend raising the head of bed by 4-6 inches. It is especially important for people who experience orthostatic hypotension.
● TRY COMPRESSION GARMENTS
Compression garments help prevent blood pooling in the lower extremities and maintain blood pressure.
SUMMARY
Dysautonomia is a term for a group of disorders that affect the ANS and cause significant changes in autonomic function. There’s no cure for autonomic dysfunction and the treatment focuses on managing symptoms. Besides drug therapies, non-pharmacological treatment and lifestyle modifications can help improve quality of life. Vitality Chiropractic Centre specializes in the upper cervical spine and can help dysautonomia patients restore nerve function.
REFERENCES
- About This Genetic Disorder | Familial Dysautonomia. (n.d.). https://familialdysautonomia.org/about-fd
- Coon, E. A., Singer, W., & Low, P. A. (2019). Pure Autonomic Failure. Mayo Clinic Proceedings, 94(10), 2087–2098. https://doi.org/10.1016/j.mayocp.2019.03.009
- Dani, M., Dirksen, A., Taraborrelli, P., Torocastro, M., Panagopoulos, D., Sutton, R., & Lim, P. B. (2020). Autonomic dysfunction in ‘long COVID’: rationale, physiology and management strategies. Clinical Medicine, 21(1), e63–e67. https://doi.org/10.7861/clinmed.2020-0896
- Dysautonomia International: Dysautonomia Awareness, Dysautonomia Advocacy, Dysautonomia Advancement. (n.d.). http://www.dysautonomiainternational.org/index.php
- Goldberger, J. J., Arora, R., Buckley, U., & Shivkumar, K. (2019a). Autonomic Nervous System Dysfunction. Journal of the American College of Cardiology, 73(10), 1189–1206. https://doi.org/10.1016/j.jacc.2018.12.064
- Goldberger, J. J., Arora, R., Buckley, U., & Shivkumar, K. (2019b). Autonomic Nervous System Dysfunction. Journal of the American College of Cardiology, 73(10), 1189–1206. https://doi.org/10.1016/j.jacc.2018.12.064
- Jellinger, K. A. (2018). Multiple System Atrophy: An Oligodendroglioneural Synucleinopathy1. Journal of Alzheimer’s Disease, 62(3), 1141–1179. https://doi.org/10.3233/jad-170397
- Vinik, A. I., Maser, R. E., Mitchell, B. D., & Freeman, R. (2003). Diabetic Autonomic Neuropathy. Diabetes Care, 26(5), 1553–1579. https://doi.org/10.2337/diacare.26.5.1553
