Autonomic neuropathy occurs when the nerves that control involuntary bodily functions are damaged. It can affect blood pressure, temperature control, digestion, bladder function and even sexual function.
The nerve damage interferes with the messages sent between the brain and other organs and areas of the autonomic nervous system, such as the heart, blood vessels and sweat glands.
While diabetes is the most common cause of autonomic neuropathy, other health conditions â even an infection â can be to blame. Some medications also might cause nerve damage. Symptoms and treatment vary based on which nerves are damaged.
Signs and symptoms of autonomic neuropathy depend on the nerves affected. They might include:
Seek medical care promptly if you begin having any of the signs and symptoms of autonomic neuropathy, particularly if you have diabetes that's poorly controlled.
If you have type 2 diabetes, the American Diabetes Association recommends annual autonomic neuropathy screening beginning when you receive your diagnosis. For people with type 1 diabetes, the association advises annual screening beginning five years after diagnosis.
Many health conditions can cause autonomic neuropathy. It can also be a side effect of treatments for other diseases, such as cancer. Some common causes of autonomic neuropathy include:
Autoimmune diseases, in which your immune system attacks and damages parts of your body, including your nerves. Examples include Sjogren's syndrome, systemic lupus erythematosus, rheumatoid arthritis and celiac disease. Guillain-Barre syndrome is an autoimmune disease that happens rapidly and can affect autonomic nerves.
An abnormal attack by the immune system that occurs as a result of some cancers (paraneoplastic syndrome) can also cause autonomic neuropathy.
Autonomic neuropathy is a possible complication of a number of diseases, and the tests you'll need depend on your symptoms and risk factors for autonomic neuropathy.
If you have conditions that increase your risk of autonomic neuropathy, such as diabetes, and have symptoms of the condition, your doctor will perform a physical exam and ask about your symptoms.
If you are undergoing cancer treatment with a drug known to cause nerve damage, your doctor will check for signs of neuropathy.
If you have symptoms of autonomic neuropathy but no risk factors, the diagnosis can be more involved. Your doctor will probably review your medical history, discuss your symptoms and do a physical exam.
Your doctor might recommend tests to evaluate autonomic functions, including:
Tilt-table test. This test monitors the response of blood pressure and heart rate to changes in posture and position, simulating what occurs when you stand up after lying down. You lie flat on a table, which is then tilted to raise the upper part of your body. Normally, your body narrows blood vessels and increases heart rate to compensate for the drop in blood pressure. This response may be slowed or abnormal if you have autonomic neuropathy.
A simpler test for this response involves standing for a minute, then squatting for a minute and then standing again while blood pressure and heart rate are monitored.
While certain inherited diseases that put you at risk of developing autonomic neuropathy can't be prevented, you can slow the onset or progression of symptoms by taking care of your health in general and managing your medical conditions.
Follow your doctor's advice on healthy living to control diseases and conditions, which might include these recommendations:
Several alternative medicine treatments might help people with autonomic neuropathy. Discuss treatments you're considering with your doctor to ensure that they won't interfere with your medical treatments or be harmful.
Research suggests this antioxidant might improve the measures of autonomic nerve function, but not necessarily the function of the nerves. More study is needed.
This therapy, which involves placing numerous thin needles in specific points in the body, might help treat slow stomach emptying and erectile dysfunction. More studies are needed.
Some studies have found that this therapy, which uses low-energy electrical waves transmitted through electrodes placed on the skin, might help ease pain associated with diabetic neuropathy.
Posture changes. Stand up slowly, in stages, to decrease dizziness. Sit with your legs dangling over the side of the bed for a few minutes before getting up. Flex your feet and make fists with your hands for a few seconds before standing up, to increase blood flow.
Once standing, try tensing your leg muscles while crossing one leg over the other a few times to increase blood pressure.
Living with a chronic condition presents daily challenges. Here are some suggestions to help you cope:
Factors that might increase your risk of autonomic neuropathy include: