Autonomic neuropathy

Autonomic neuropathy involves damage to the nerves that manage autonomic body operations, known as autonomic nerves. These nerves regulate functions such as body temperature, blood pressure, breathing and bladder function.

This damage can cause significant impact to areas of the autonomic nervous system such as the heart, circulatory system and sweat glands.

The most frequent cause of autonomic neuropathy is diabetes. However, other health conditions, such as viral or bacterial infections, or certain medications can also cause it. Autonomic neuropathy symptoms and treatment methods differ depending on which nerves are affected.

Your Advocate Health Care specialists use the latest diagnostic tests available to create the best possible autonomic neuropathy treatment plan.

Symptoms of autonomic neuropathy

Autonomic neuropathy symptoms can vary depending on the affected nerves and may include problems with heart rate and blood pressure, difficulties in digestion, urinary problems, sexual issues and sweat abnormalities.

Other symptoms may encompass changes in body temperature, troubles with vision and difficulties in managing blood glucose levels.

Common autonomic neuropathy symptoms may include:

• Abnormal heart rate (tachycardia or bradycardia)
• Changes in blood pressure
• Fainting or lightheadedness upon standing
• Difficulty swallowing
• Trouble emptying your stomach
• Nausea and vomiting
• Diarrhea or constipation
• Sexual dysfunction
• Difficulty emptying the bladder or incontinence
• Excessive sweating or lack of sweating
• Problems with body temperature regulation, leading to intolerance to heat or cold
• Blurred vision
• Difficulty adjusting to light/dark changes
• Difficulty breathing
• Shallow breathing

Symptoms can vary from person to person, and the severity of symptoms may depend on the extent of nerve damage.

Autonomic neuropathy can also be associated with various underlying conditions, such as diabetes, autoimmune diseases or certain types of infections. Schedule an appointment with your provider If you suspect you have autonomic neuropathy.

Causes and risk factors of autonomic neuropathy

The autonomic neuropathy causes can stem from underlying medical conditions, lifestyle factors or genetic predispositions. Diabetes is the most common cause of autonomic neuropathy, commonly referred to as diabetic autonomic neuropathy.

Prolonged high blood sugar levels in individuals with diabetes can lead to nerve damage over time and can lead to various types of neuropathies, including peripheral neuropathy or mononeuropathy.

Other causes of autonomic neuropathy include:

• Autoimmune diseases: Conditions such as lupus, Sjögren's syndrome and rheumatoid arthritis may result in nerve damage affecting autonomic functions.
• Infections: Conditions such as Lyme disease, HIV/AIDS and hepatitis C are examples where infections may lead to autonomic neuropathy.
• Hereditary factors: Some individuals may be genetically predisposed to neuropathic conditions, including autonomic neuropathy.
• Toxic exposure: Exposure to certain toxins or chemicals, either in the environment or through occupational hazards, can damage nerves and contribute to autonomic neuropathy.
• Alcoholism: Alcohol-related nerve damage can impact various bodily functions regulated by the autonomic nervous system.
• Other medical conditions: Various medical conditions, such as Parkinson's disease, multiple system atrophy and amyloidosis can be associated with autonomic neuropathy.

Understanding the underlying condition is crucial for proper diagnosis and management. A comprehensive evaluation by your doctor can help identify the specific cause and guide appropriate treatment strategies to manage autonomic neuropathy.

Diagnosing autonomic neuropathy

Autonomic neuropathy can arise as a potential complication linked to certain health conditions. The specific tests necessary for diagnosis depend on your symptoms and the presence of risk factors associated with autonomic neuropathy.

If you are already at risk due to conditions such as diabetes and you exhibit symptoms indicative of neuropathy, your doctor will conduct a thorough physical exam, review your medical history and ask about your symptoms.

If you are undergoing cancer treatment with medications known to induce nerve damage, your provider will actively check for signs of neuropathy at your regular appointments.

In cases where symptoms of autonomic neuropathy happen without identified risk factors, the diagnostic process becomes more complex.

Your provider may suggest specific tests to assess autonomic functions, including:

• Autonomic function tests: These tests gauge how your heart rate and blood pressure respond during breathing exercises.
• Tilt-table test: This examination monitors blood pressure and heart rate responses to changes in posture. It simulates the physiological adjustments that occur when transitioning from a lying to a standing position.
• Gastrointestinal tests: To investigate digestive concerns such as trouble swallowing, or gastric-emptying tests may be recommended.
• Thermoregulatory sweat test: This test involves tracking changes in sweat patterns as you are exposed to gradually increasing temperatures. The resulting patterns may contribute to confirming or suggesting causes for altered sweating.
• Urinalysis: For individuals with urinary symptoms, a series of tests can assess bladder function.
• Ultrasound: In cases involving bladder symptoms, your provider may recommend an ultrasound of the urinary tract using high-frequency sound waves to generate images.

Treatment options for autonomic neuropathy

Discovering that you have autonomic neuropathy can be overwhelming and scary. Your care team at Advocate Health Care will be with you every step of the way. Effective management of autonomic neuropathy often involves a multi-faceted approach tailored to individual needs and symptoms.

Addressing and managing the underlying conditions is the priority for autonomic neuropathy treatment. For instance, if diabetes is a factor, controlling blood sugar levels through medication, lifestyle adjustments and regular monitoring is crucial.

Managing symptoms is also a key component of treatment. Medications may be prescribed to alleviate specific issues such as blood pressure fluctuations, digestive problems or urinary dysfunction.

Physical therapy may be beneficial for individuals experiencing mobility issues or difficulties with balance and coordination. Therapeutic exercises can enhance muscle strength and promote better overall physical function.

Regular monitoring of symptoms and ongoing medical check-ups are essential components of managing autonomic neuropathy.