What’s wrong with your nervous system?
You’re sitting on the couch, watching TV, and get up to go to the bathroom. Upon standing, you notice that you feel dizzy and lightheaded. After a moment, it passes. You don’t think much of it until it happens again the next day when you stand up after working at your desk for a while. Why is this happening? Is there a treatment for it? Can you prevent it from occurring?
Definition
Dysautonomia, also called autonomic dysfunction or autonomic neuropathy, is actually the name for a group of disorders. In all cases, the autonomic nervous system (ANS) doesn’t work as it should, meaning your nerves don’t send or receive messages, or the message isn’t clear. The ANS is the part of your nervous system that controls bodily functions that you don’t have to think about, such as heart rate, blood pressure, breathing, skin temperature, digestion, and many more. This is why if it’s not working correctly, it can cause a wide variety of problems.
One of the most common symptoms is orthostatic intolerance, which is when you can’t stand up for a long time without feeling dizzy/faint. Other symptoms include balance problems, noise/light sensitivity, shortness of breath, chest pain/discomfort, dizziness, lightheadedness, vertigo, swings in body and skin temperature, ongoing tiredness, visual disturbances (blurred vision), difficulty swallowing, nausea/vomiting, constipation, fast/slow heart rate, heart palpitations, brain fog/ forgetfulness/can’t focus, significant fluctuations in heart rate and blood pressure, weakness, mood swings, fainting, sweat less than normal or not at all, sleeping problems, migraines/frequent headaches, dehydration, frequent urination, incontinence, erectile dysfunction, low blood sugar, and exercise intolerance.
Dysautonomia is relatively common. It can be present at birth or develop later. Symptoms appear suddenly or gradually and range from mild to severe. Both men and women are affected equally. If the condition occurs on its own, it’s called primary dysautonomia. Some examples of this type are neurocardiogenic syncope (NCS), postural orthostatic tachycardia syndrome (POTS), familial dysautonomia (FD), multiple system atrophy (MSA), and pure autonomic failure. With NCS (the most common form), also called syncope or vasovagal syncope, you have fainting spells that happen once or twice in your lifetime or multiple times every day. POTS results in problems with circulation where your heart beats too fast when you stand up, leading to fainting, chest pain, and shortness of breath. Those with FD inherit it from relatives and experience decreased pain sensitivity, lack of tears, and trouble regulating body temperature. This type is more likely to affect Jewish people (Ashkenazi Jewish heritage) of Eastern European descendent. MSA is a life-threatening form that develops in people over 40 years old and can lead to heart rate problems, low blood pressure, erectile dysfunction, and loss of bladder control. Those with pure autonomic failure have a drop in blood pressure when standing, causing them to have dizziness, fainting, visual problems, chest pain, and tiredness. These can go away if the person lies or sits down.
If the condition is the result of another disease, it’s called secondary dysautonomia. Several diseases can trigger it. Some include diabetes, Parkinson’s, muscular sclerosis, Rheumatoid arthritis, Lupus, Sjogren’s syndrome, Sarcoidosis, Crohn’s disease, Celiac disease, Guillain-Barre syndrome, vitamin B and E deficiencies, HIV, and Lyme disease. Other things can produce it, like alcohol consumption, dehydration, stress, tight clothing, and hot environments.
Treatment
There isn’t a cure for dysautonomia, so the focus of treatment is to control symptoms. One of the most common recommendations is to increase your daily water intake. This helps to add additional fluid volume to your blood. Another thing to help with this is adding extra salt (3–5 grams/day) to your diet. It would be best if you also tried to sleep with your head raised about 6 – 10 inches higher than your body. If these measures don’t help, your doctor will prescribe fludrocortisone or midodrine to help keep your blood pressure within normal range.
Prevention
Unfortunately, you can’t prevent dysautonomia from happening. Instead, you can manage your symptoms to prevent them from getting worse. Since symptoms can change in frequency, intensity, and duration, it’s helpful to keep a diary of them, possible triggers, and how you’re feeling emotionally. All of this information can help your doctor develop the best plan to help you.
Besides drinking extra water, increasing salt intake, and sleeping with your head elevated, it’s a good idea not to smoke, don’t drink alcohol, avoid caffeine, eat a healthy diet, maintain a healthy weight, get plenty of good quality sleep, and listen to what your body is telling you it needs (ex. rest if you’re feeling tired). When standing up, do so slowly and, if you feel dizzy, sit/lie down and elevate your feet. It’s a good idea to wear compression stockings and not to sit or stand for long periods. Avoiding heat is also advised.
Dysautonomia can be a scary thing to experience, but once you take steps to deal with your symptoms, you’ll be able to live life with less worry. If you have any questions or concerns about dysautonomia, please speak with your doctor. If you would like more information, please visit Dysautonomia International at http://www.dysautonomiainternational.org/page.php?ID=34