Dysautonomia: When the Autonomic Nervous System Malfunctions: Postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope and more +VIDEO {Lifestyle Medicine}

Dysautonomia–When the Autonomic Nervous System Malfunctions: Postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope and more.

{Lifestyle Medicine}

Dysautonomia refers to a group of several different medical conditions that cause an abnormality in the function of the autonomic nervous system. People with various forms of dysautonomia have trouble regulating some or all of the largely “automatic” functions of the autonomic nervous system, which can result in lightheadedness, fainting, unstable blood pressure, abnormal heart rates, malnutrition and more. 

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This post is part 2 of a series. For a general Overview of the Autonomic Nervous System check out part 1 here and check out the Survival Kit for Dysautonomia Management in part 3 here!

Dysautonomia and Autonomic Dysfunction

Although often missed, dysautonomia impacts over 70 million people worldwide. 

Common Causes of Dysautonomia

Primary dysautonomia can result from several different inherited or degenerative neurologic diseases. 

Secondary dysautonomia occurs from a variety of causes or processes that damage autonomic nerves or parts of the brain that help control body processes including:

• diabetes
• multiple sclerosis
• HIV/AIDS
• celiac disease
• Sjogren’s syndrome, rheumatoid arthritis, lupus, antiphospholipid syndrome, chronic inflammatory demyelinating polyneuropathy and other autoimmune disorders
• Ehlers Danlos Syndrome
• Mast Cell Activation Disorders
• craniocervical instability
• Chiari malformation
• Guillain-Barré syndrome
• Crohn’s disease and ulcerative colitis
• Lyme disease
• mitochondrial dysfunction
• amyloidosis
• sarcoidosis
• paraneoplastic syndrome
• toxicity
• Parkinson’s disease 

Dysautonomia can also occur due to deficiencies or imbalances of certain vitamins, including vitamins E, B1 (thiamine), B3 (niacin) B6 (pyridoxine), and B12 which are essential to healthy nerve function. 

Forms of Dysautonomia

Some of the forms of dysautonomia include:

• postural orthostatic tachycardia syndrome (POTS)
• neurocardiogenic syncope
• orthostatic intolerance
• multiple system atrophy
• familial dysautonomia
• baroreflect failure
• autoimmune autonomic ganglionopathy
• dopamine beta-hydroxylase deficiency
• pure autonomic failure
• and more.

Common Signs & Symptoms of Dysautonomia

The potential symptoms of dysautonomia are numerous and vary widely for each individual. In general, symptoms result from inefficient or unbalanced efferent signals sent via the sympathetic and/or parasympathetic systems (click here for an overview of the autonomic nervous system and its various components).

Common symptoms of dysautonomia include:

• lightheadedness, vertigo and dizziness
• presyncope and syncope (passing out)
• difficulty standing still due to blood pooling in the limbs
• fatigue
• exercise intolerance
• anxiety
• tachycardia (increased heart rate)
• decreased, increased or dysregulated sweating
• brain fog and mental clouding
• insomnia
• unstable blood pressure including orthostatic hypotension
• nausea and other GI symptoms
• blurry or double vision
• chest discomfort and/or palpitations (racing heart or feeling of missing beats)
• shortness of breath
• bowel or bladder incontinence
• constipation

Diagnosis of Dysautonomia

There are various tests that can be used to access autonomic function. These may include measuring heart rate and blood pressure in various positions utilizing a tilt table test, sweat testing and other investigations. The diagnosis of dysautonomia depends on the evaluation of the overall status of autonomic functions including investigating cardiovagal, adrenergic, and sudomotor functioning.

Have you experienced dysautonomia?

What do you wish people were more aware of about dysauotnomia?

References:

Bakkers M., Faber CG., Drent M., Hermans M.C.E., van Nes S.I., Lauria G., De Baets M. & Merkies I.S.J. (2010). Pain and autonomic dysfunction in patients with sarcoidosis and small fibre neuropathy. J Neurol. 257(12):2086-2090.

Bilora F., Biasiolo M., Zancan A., Zanon E., Veronese F., Manca F., & Sartori M.T. (2012). Autonomic dysfunction and primary antiphospholipid syndrome: a frequent and frightening correlation? Int J Gen Med. 5:339-343.

Flabeau O, Meissner WG, Tison F. (2010). Multiple system atrophy: current and future approaches to management. Ther Adv Neurol Discord. 3(4):249-63.

Gibbons C.H., Freeman R. (2005). Autonomic neuropathy and coeliac disease. J Neural Neurosurg Psychiatry. 76:579-581.

Goldstein D.S. (2015). Dysautonomia in Parkinson’s disease: Neurocardiological abnormalities. Compr Physiol. 4(2):805-826.

Griggoriou E., Boris J.R., Dormans J.P. (2015). Postural orthostatic tachycardia syndrome (POTS): Association with Ehlers-Danlos Syndrome and orthopaedic considerations. Clin Orthop Relat Res. 473(2):722-728.

Grubb B.P.  (2008). Postural Tachycardia Syndrome. Circulation. 117: 2814-2817. 

Hall WD. (199). Chapter 75: An overview of the autonomic nervous system. In Walker HK, Hall WD, Hurst JW (Eds.), Clinical Methods: The History, Physical, and Laboratory Examinations, 3rd edition. (1990).  Boston: Butterworths.

McLeod KA. (2001). Dysautonomia and neurocardiogenic syncope. Curr Opin Cardiol. 16(2):92-6. 

Reichgott M.J.  Chapter 76: Clinical evidence of dysautonomia. In Walker HK, Hall WD, Hurst JW (Eds.), Clinical Methods: The History, Physical, and Laboratory Examinations, 3rd edition. (1990).  Boston: Butterworths.

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