Dysautonomia, What Is It?

Dysautonomia is not a word you will or might have heard really often. In fact, for most of you, this will be the first time that they have heard about it.

However, Dysautonomia is a serious and major medical condition in the field of medical sciences.

Surprisingly, Dysautonomia is not a particular disease. It is a blanket term for the various disorders of the Autonomic Nervous System (ANS).

Definition:

So what is Dysautonomia? For those who are unfamiliar with it, Dysautonomia is known as a disorder of a part of the nervous system known as the autonomic nervous system (ANS) and its functions.

Dysautonomia is also sometimes referred to as autonomic dysfunction. It occurs when the nerves of the ANS undergo some sort of damage.

Sometimes the triggers that cause the problems are short-lived and reversible, whereas at some instances, they are chronic and tend to progressively worsen over time.

It is a complex, rather fatal disease and is to date incurable. Even though it has been observed that the life expectancy of Dysautonomia has increased over the past two decades, the symptoms put forward by this condition still immensely impact the daily life functions of the patients.

Sometimes Dysautonomia affects a small part of the ANS, whereas, in some conditions, it attacks the whole ANS.

What is the autonomic nervous system?

The autonomic nervous system (ANS) is that part of the brain that is majorly in charge of the most important involuntary actions of your body which include:

  • Breathing rate
  • Heart rate
  • Sensations
  • Digestion
  • Regulation of body temperature
  • Maintenance of blood pressure
  • Modulation of sexual arousal
  • Urination

The autonomic nervous system (ANS) is further divided into the sympathetic autonomic nervous system (SANS) and the parasympathetic autonomic nervous system (PANS).

When the body undergoes a stressful situation, the SANS incites a “fight or flight” response. That is, either to fight back in a life-threatening situation or to flee away from the potential danger or enemy.

On the other hand, the PANS conserves the energy of the body and restores bodily tissues for a range of functions.

Conclusively, the ANS also has a major role in stress management.

Since you do not have to think about doing all of these actions, it can be said that the ANS creates a connection between your brain and some body parts, including certain organs as well.

An example will be the connection between the stomach, the heart, the intestines, the mouth, etc.

What are the symptoms of Dysautonomia?

As said in the previous section, there is a range of bodily systems that are particularly affected by Dysautonomia, namely, cardiovascular, respiratory, digestive, excretory, reproductive, etc.

Hence, symptoms of Dysautonomia also revolve around these particular systems. Sometimes these symptoms occur internally, hence cannot be seen.

Even though there are as many as 15 types of Dysautonomia, a number of generalized symptoms are listed below:

  • A common symptom of this condition is the inability to remain in an upright position, hence leading to severe dizziness and frequent fainting. This is known as orthostatic intolerance and lying down makes one feel better
  • Irregular heartbeat, whether too fast or too slow
  • Migraines
  • A variety of sexual problems in both males and females for example, erectile dysfunction (which is the inability to retain an erection) as well as difficulty in ejaculation. In women, vaginal dryness and difficulty in reaching an orgasm are the main problems.
  • Anxiety
  • Breathing difficulties
  • Since the digestive system is also largely affected, problems including bloating, constipation, diarrhea, etc are common symptoms.
  • Chest pain
  • Nausea
  • Low blood pressure
  • Sweating abnormally, whether too much or too less
  • Blurred vision
  • Mood swings
  • A massive decrease in appetite
  • Sometimes tremors and muscle weakness also emerge as prominent symptoms in certain types of Dysautonomia
  • Urination problems, such as difficulty in urinating, too much urination, as well as the inability to completely empty the bladder
  • Oversensitivity to light and noise
  • Concentration and memory issues

The patient can undergo one or many symptoms, with any sort of combination which thus makes Dysautonomia a difficult disease to diagnose.

Why is Dysautonomia often misdiagnosed?

Like said previously, since Dysautonomia is not a specific medical diagnosis and can be used as a term to describe any sort of malfunction of the ANS, it is really difficult to diagnose it. One of the reasons for this is that a wide range of underlying diseases can lead to the development of the malfunction of the ANS.

Two examples of the chronic conditions that lead to the rise of Dysautonomia include diabetes and Parkinson’s Disease.

What are the underlying causes of Dysautonomia?

Apart from diabetes and Parkinson’s Disease, there is an extensive list of underlying conditions that can result in the development of Dysautonomia.

Some of these include:

  • Antiphospholipid Syndrome
  • Charcot-Marie-Tooth Disease
  • Celiac Disease
  • Amyloidosis
  • Chronic Inflammatory Demyelinating Polyneuropathy
  • Vitamin deficiencies
  • Deconditioning, which is a physical condition that occurs as a result of decreased activity
  • Toxicity
  • Mitochondrial diseases
  • Crohn’s Disease and Ulcerative Colitis
  • Chiari Malformation
  • Ehlers-Danlos Syndrome
  • Diabetes and Pre-diabetes
  • Parkinson’s Disease
  • Delta Storage Pool Deficiency
  • After undergoing surgery, physical trauma or pregnancy
  • Mast cell disorders
  • Sjogren’s Syndrome
  • Sarcoidosis

What are the different types of autonomic disorders?

There is an estimated number of 15 types of Dysautonomia, following are a few, most common ones:

  1. Familial Dysautonomia
  2. Orthostatic Hypotension
  3. Pure autonomic failure
  4. Multiple system atrophy
  5. Afferent Baroreflex Failure
  6. Postprandial Hypotension

Can Dysautonomia be cured?

Since autonomic disorders like the ones listed above severely affect our respiratory and cardiovascular systems among others, Dysautonomia can be potentially life threatening.

It is, however, true that if the underlying conditions that cause Dysautonomia are treated or controlled, then the condition of the patient can drift towards betterment as well.

Otherwise, since Dysautonomia covers such a large field of mental conditions, there is often no specific cure for it. And in such a situation, the betterment of the patient’s health is dependent upon the treatment of the symptoms only and effort to treat the symptoms is the only method in which the patient can get better.

What kind of doctors do patients go to?

Well, since the condition is regarding the autonomic nervous system, the patient is referred to a doctor who specializes in neurology and neurological disorders, commonly known as a neurologist.

Side by side however, there is a chance that the patient is also asked to see a doctor which specializes in the region that is most affected by their Dysautonomia. For example, a cardiologist for cardiovascular issues such as disturbed blood pressure or breathing or a urologist or endocrinologist if the excretory system is affected.

How can one be tested for Dysautonomia?

When a person is symptomatic of an autonomic disorder but has no symptoms that can be risk factors, like diabetes, then a doctor carries out physical exams alongside reviewing the patient’s medical history.

A number of tests which can be performed are as follows:

  • Tilt-table test:

This test involves the use of a table and the patient’s blood pressure and heart rate is monitored in simple stress situations. The patient lays on a table which is tilted from the upper body side and the blood pressure and heart rate is monitored for speed or abnormalities.

  • Breathing tests:

These tests are carried out to monitor how your blood pressure and breathing rate fluctuate during certain exercises.

  • Quantitative sudomotor axon reflex test:

This type of test judges the response of the nerves that regulate your sweat glands to certain stimulations. Capsules are placed on the foot, forearm, upper leg and lower leg which generate a small electrical current. During this, a computer monitors the response of the nerves and the sweat glands to search for any abnormalities.

  • Gastrointestinal tests:

Stomach-emptying tests are carried out by a gastroenterologist if the patient is suffering from slow digestion or incomplete emptying of the stomach and other abnormalities like these.

  • Ultrasound:

If the patient is undergoing some sort of urination or bladder issues, then their doctor carries out a high frequency ultrasound of the bladder and the urinary tracts.

  • Urodynamic test (bladder function) and urinalysis:

If a person has symptoms regarding the bladder and the urinary tract, then a urodynamic test or a urinalysis can be carried out to seek for abnormalities.

  • Thermoregulatory sweat test:

This is a test in which the patient’s body is covered with a powder that reacts to the release of sweat by changing its color. The patient is made to lay in a chamber in which the temperature starts to increase gradually and machines monitor the patient’s sweat pattern by taking digital photos to spot any abnormalities.

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