Dysautonomia – or autonomic dysfunction – describes a range of disorders that cause the autonomic nervous system to not function properly. Dysautonomia can be present at birth or develop later in life due to genetics or trauma. Estimates suggest tens of millions of people worldwide are affected by some form of dysautonomia.
The autonomic nervous system is responsible for constantly regulating the “automatic” body functions that you don’t usually have to think about. These include heartbeat, blood pressure, digestion and regulating body temperature – to name just a few.
Patients often have several dysautonomias at one time, in addition to complementary conditions, such as Ehlers-Danlos syndrome, mitochondrial disease, mast cell activation syndrome, endometriosis, fibromyalgia, gastroparesis and autoimmune disorders.
Dysautonomias in children are believed to be the result of genetic mutations or problems that have occurred as the autonomic nervous system has developed. In adults, causes can be attributed to regulation issues with autonomic nerves, as a reaction to physical trauma, a disease or drug, and, rarely, genetic mutations. In the elderly, causes are often traced back to neurodegenerative disease.
Unfortunately, the causes of many dysautonomias are unknown, though symptoms can develop after a trauma, illness, pregnancy, surgery or other physically stressful event.
Neurocardiogenic Syncope – The autonomic nervous system doesn’t regulate the flow of blood throughout the body in response to changes in gravity. For example, a person with neurocardiogenic syncope may feel dizzy or pass out while standing because blood is not reaching the brain effectively.
Postural Orthostatic Tachycardia Syndrome (or “POTS”) – This dysautonomia affects both the heart and blood pressure. Someone with POTS can experience an increase of 30 beats per minute or more within ten minutes of standing, without their blood pressure decreasing. POTS may occur as the result of an autoimmune disorder, after an infection or trauma, or there may be no identifiable cause for the condition.
Chronic Orthostatic Intolerance and Orthostatic Hypotension – Refers to two different conditions. The first is an inability to stand for a prolonged period of time due to dizziness, lightheadedness or drops in blood pressure. The second describes a sudden drop in blood pressure as a result of moving from a lying down position to a sitting or standing position. Neither of these conditions is considered a diagnosis of dysautonomia. They are symptoms of dysautonomias or other health issues.
Ehlers-Danlos Syndrome – A genetic disease that affects collagen and proteins in connective tissue, often indicated by joints that move well beyond the normal range, stretchy skin, easy joint dislocation, pain and easy bruising.
Mitochondrial Disease – Describes metabolic disorders that affect cells’ ability to use energy properly.
Mast Cell Activation Syndrome – In Mast Cell Activation Syndrome (MCAS), these special immune cells, normally active during acute allergic reactions, become overactive or work inappropriately. This results in excess amounts of serotonin, histamines, dopamine and other chemicals being released into the body, which can cause flushing of the skin, brain fog, fatigue, wheezing, orthostatic intolerance, syncope, itching and gastrointestinal distress.
Endometriosis – Endometriosis is a condition where the tissue found in the uterine lining also grows on other structures in the body, including the ovaries, fallopian tubes, bladder, etc.
Fibromyalgia – This is a condition that causes widespread muscular and joint pain.
Gastroparesis – This condition describes the slow emptying of the stomach, due to the muscles not working correctly during digestion.
Autoimmune Disorders – Autoimmune diseases cause the immune system to attack healthy cells. There are more than 80 identified autoimmune diseases, including Addison Disease, Lupus, Guillain-Barre Syndrome, Multiple Sclerosis and Rheumatoid Arthritis.
Multiple System Atrophy – This condition causes symptoms similar to those seen in Parkinson’s disease, including widespread nerve damage. It can affect anyone, but is most common in men over 50. The cause of Multiple System Atrophy is unknown at this time.
Familial Dysautonomia – A genetic disorder that ocurrs primarily in people of Eastern European Jewish descent. Both the autonomic and sensory nervous systems are affected.
Diabetic Autonomic Neuropathy – A condition that results from damage to nerves that control parts of the autonomic nervous system due to the effects of diabetes. Damage to nerves can include those controlling cardiovascular, gastrointestinal, urinary, endocrine and reproductive functions.
Autonomic Dysreflexia – Caused by injury to the spinal cord, this conditon causes dangerously high blood pressure.
Baroreflex Failure – This condition causes changes in blood pressure, with periods of extreme high blood pressure, not caused by spinal injury.
Information on this page comes from Principles of Autonomic Medicine by Dr. David Goldstein, MD PhD