Dysautonomia Specialist

What is dysautonomia?

Dysautonomia is a catchall term that includes any dysfunction of the autonomic nervous system. The autonomic nervous system controls all of the involuntary functions in your body, which are the life-sustaining processes that your brain and nerves automatically regulate, such as:

• Heart rate
• Breathing
• Blood pressure
• Blood volume
• Digestion
• Body temperature
• Stress response

Your autonomic nervous system is extensive, traveling from your brain to the spinal cord and finally--by way of the small fiber autonomic nerves-- out to every organ, gland, and blood vessel in your body.

What conditions fall under dysautonomia?

Dysautonomia may be a primary disease, or it can develop due to another medical condition such as diabetes, vitamin deficiencies or immune-mediated disorders such as mast cell activation syndrome, antiphospholipid syndrome, Sjӧgren’s syndrome, and celiac disease.

A few examples of dysautonomia include:

• Gastrointestinal dysmotility
• Neurocardiogenic syncope
• Autoimmune autonomic ganglionopathy
• Postural orthostatic tachycardia syndrome
• Complex regional pain syndrome
• Neurogenic bladder
• Neurally mediated hypotension or syncope
• Familial dysautonomia

One of the most common types of dysautonomia is postural orthostatic tachycardia.

What is postural orthostatic tachycardia syndrome (POTS)?

It’s estimated that POTS affects 1 of every 100 teens. Teens and adults together add up to 1 million to 3 million Americans diagnosed with POTS.

POTS is a type of orthostatic intolerance, which means that blood is not flowing adequately to all the places it needs to when you’re in an upright position. When patients with POTS stand up, their heart rate accelerates excessively. They also have unusually rapid increases and decreased in blood pressure and heart rate, which contributes to the many symptoms patients with POTS experience.

What symptoms will I develop?

Because the autonomic nervous system regulates so many different bodily functions, when the system is not functioning properly, affected patients experience a wide variety of symptoms.

These are a few examples of symptoms you may experience, depending on the type of dysautonomia:

• Lightheadedness and fainting (syncope)
• Rapid heart rate (tachycardia)
• Shortness of breath
• Gastrointestinal problems
• Chest pains
• Fatigue, weakness and malaise
• Intolerance to exercise
• Migraine or other headaches
• Inability to tolerate anything intensive

Some patients have mild symptoms and can continue to participate in everyday activities. Others develop such severe symptoms that they struggle to get through the day or even get out of bed. At least 25% of patients with POTS are unable to work or go to school.

How is dysautonomia treated?

Dr. Schofield develops an evaluation and treatment plan that is tailored to each individual patient. Most patients with dysautonomia find that their symptoms improve at least partially with treatments such as:

• Increasing fluid intake
• Increasing salt consumption
• Wearing compression stockings
• Raising the head of their bed
• Recumbent exercises
• Healthy diet
• Limiting stress

More severely affected patients, may require medications that help compensate for the autonomic dysfunction. A subset of patients with severe dysautonomia and evidence for autoimmunity, may benefit from treatments that target the immune system, such as intravenous immunoglobulin (IVIG) or rituximab.  There are a number of other underlying causes that may be causing autonomic dysfunction. If one or more of these conditions is identified, other treatments may be recommended.

To schedule a comprehensive evaluation of your symptoms and history to determine which treatments might benefit you most, call the Center for Multisystem Disease or book an appointment online.

Addiontal Resources:

Curepots.org

Click here to watch Professor Hughes discuss Antiphospholipid Syndrome and Dysautonomia

Click here to watch Dr. Schofield discuss IVIG Therapy for Autoimmune Dysautonomias