By Carly Vandergriendt, 2023, Health Finds
Dysautonomia is when your autonomic nervous system doesn’t work properly, usually due to an underlying condition. There are several types, including postural orthostatic tachycardia syndrome (POTS).
Your autonomic nervous system (ANS) is responsible for functions that your body does without you having to think about them, such as pumping blood, digesting food, and breathing in and out.
When your ANS malfunctions, it’s called dysautonomia. Sometimes dysautonomia occurs on its own. Other times it’s due to another medical condition, such as diabetes or Lyme disease.
This article covers the types, symptoms, causes, diagnosis, and treatment of dysautonomia.
What are the types of dysautonomia?
Dysautonomia is a broad term that refers to any difficulty with your ANS. Since the ANS has many functions, dysautonomia has many forms.
For example, it can be confined to a single bodily function, or it can affect all automatic functions. Some dysautonomias are ongoing (chronic), while others are temporary.
Types of dysautonomia include:
- Familial dysautonomia: Also known as Riley-Day syndrome, this rare genetic condition mostly occurs in people of Ashkenazi Jewish descent. It’s associated with low sensitivity to pain, difficulties maintaining blood pressure and body temperature, and an inability to produce tears.
- Multiple system atrophy (MSA): This rare and serious condition affects all involuntary functions. MSA is progressive, which means symptoms tend to worsen over time.
- Postural orthostatic tachycardia syndrome (POTS): POTS is a circulatory condition that prompts an increase in heart rate when you stand up after sitting or lying down. You might experience chest pain, dizziness, and tunnel vision.
- Sinus tachycardia: People with sinus tachycardia have a faster-than-normal heart rate. Their resting heart rate is typically above 100 beats per minute (bpm), even when they’re at rest.
- Vasovagal syncope: Vasovagal syncope is otherwise known as fainting and is the most common example of dysautonomia. It occurs when your ANS overreacts to a trigger such as pain, blood, or heat, causing a sudden drop in blood pressure and temporary loss of consciousness.
What are the symptoms of dysautonomia?
There are many possible symptoms of dysautonomia, and they vary a lot from one person to the next. The following possible dysautonomia symptoms are grouped according to ANS function.
| ANS function | Related symptoms |
|---|---|
| cognition | brain fog, difficulty focusing, forgetfulness, headaches, insomnia, shifts in mood, migraine |
| sensory perception | blurred vision, sensitivity to light, sensitivity to sound |
| respiration | difficulty breathing |
| secretion | difficulty swallowing, dry eyes, dry mouth, impaired sweat production, impaired tear production |
| heart rate | anxiety, heart palpitations, unusually fast or slow heart rate |
| circulation and blood pressure | balance problems, difficulty exercising, difficulty standing still, dizziness after standing, erectile dysfunction, fainting, fatigue, pale skin, vertigo, weakness |
| digestion | abdominal pain, acid reflux, constipation, diarrhea, heartburn, low blood sugar, nausea, vomiting |
| excretion | dehydration, difficulties urinating or defecating, incontinence |
What causes dysautonomia?
There’s no single cause of dysautonomia. Some types of dysautonomia are inherited, which means parents pass them on to their children through their genes. Other types are acquired, which means they don’t have a genetic cause.
Most healthcare professionals distinguish between primary and secondary dysautonomia. Primary dysautonomia occurs on its own, while secondary dysautonomia means that ANS dysfunction is due to another condition.
Some conditions that can lead to secondary dysautonomia:
- Autoimmune disorders: Examples of autoimmune conditions linked to ANS dysfunction include:
- Cancer and cancer treatments: Certain types of cancer can cause paraneoplastic syndromes that affect the ANS. Cancer treatments such as chemotherapy and radiation can also trigger dysautonomia.
- Infections: Infections linked to secondary dysautonomia include:
- Medications: Orthostatic hypotension, a common sign of dysautonomia, is a side effect of alpha- and beta-blockers.
- Metabolic disorders: Uncontrolled diabetes is often linked to problems with blood circulation.
- Nutritional deficiencies: A diet lacking in essential vitamins and minerals can lead to headaches, dizziness, and other symptoms of dysautonomia.
- Neurodegenerative disorders: Parkinson’s disease and multiple sclerosis are two progressive conditions that can compromise ANS functions over time.
- Substance use disorders: Overuse of alcohol or drugs can affect ANS function.
- Traumatic injuries: Brain and spinal cord injuries can affect your ANS.
How do doctors diagnose dysautonomia?
A doctor will ask you about your symptoms and medical history. They’ll conduct a thorough physical exam and may also test your blood pressure and heart rate when you’re lying down versus standing.
If necessary, your doctor will order follow-up tests to pinpoint the cause of your symptoms and rule out other diagnoses.
Tests to diagnose dysautonomia may include:
- complete blood count
- electrocardiogram (ECG/EKG)
- spirometry
- sweat tests
- tilt table test
- ultrasound
- urine analysis
What can be mistaken for dysautonomia?
Dysautonomia can manifest in a variety of ways. As a result, it’s easy to mistake it for another medical condition. Some health problems that cause similar symptoms include:
- adrenal insufficiency
- anemia
- anxiety disorders
- blood loss
- dehydration
- drug and alcohol abuse
- electrolyte imbalances
- heart arrhythmias
- heart attack
- heart disease
- hyperglycemia
- hyperthyroidism
- medication use
- shock
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What is the treatment for dysautonomia?
There are many possible treatments for dysautonomia. It depends on your symptoms as well as the underlying condition. Some common treatments for people with dysautonomia include:
- adding salt to food
- avoiding dizziness triggers
- discontinuing medications
- doing physical therapy
- following an exercise program
- increasing your water intake
- sleeping with your head raised
- taking medication such as midodrine or fludrocortisone for blood pressure
- using compression socks
- wearing sunglasses
What is the outlook for people with dysautonomia?
Although dysautonomia has no cure, medication, therapy, and behavioral changes can often help with symptoms.
For example, most people with POTS see an improvement in their symptoms following simple lifestyle changes such as taking in enough fluids and adding extra salt to their diet.
If another condition is causing dysautonomia, treating that condition may help to resolve your symptoms. People with diabetes, for instance, may see an improvement in symptoms like tachycardia and orthostatic hypotension when their blood sugar is well-managed.
Frequently asked questions
Is dysautonomia serious?
Dysautonomia is sometimes serious. MSA and pure autonomic failure are two primary dysautonomias that can lead to severe symptoms.
Can COVID-19 cause dysautonomia?
Research has established a link between COVID-19 and dysautonomia. Signs of autonomic dysfunction such as fatigue, shortness of breath, brain fog, headaches, and orthostatic hypotension are often cited as symptoms of long COVID.
Does dysautonomia qualify as a disability?
Some types of dysautonomia may qualify as a disability. It generally depends on how much your symptoms affect your day-to-day life.
Is dysautonomia progressive?
Dysautonomia isn’t always progressive, but it can be. With progressive dysautonomias such as MSA and pure autonomic failure, symptoms tend to worsen over time.
Takeaway
Dysautonomia refers to ANS dysfunction. It can affect several unconscious functions, such as respiration, body temperature regulation, blood pressure, and digestion.
Orthostatic hypotension — a sudden drop in blood pressure when you stand up — is often a symptom of dysautonomia. Other common symptoms include shortness of breath, dizziness, and dehydration.
It’s important to talk with a healthcare professional if you’re experiencing symptoms that interfere with your everyday activities. They can help you take steps toward diagnosis and treatment.