Autonomic dysfunction refers to the malfunctioning of our autonomic nervous system. Below are some of the most commonly asked questions that our team has answered!

1.)  Can you quickly explain to me what the different parts of the nervous system are?

The nervous system contains two main parts known as the central nervous system and the peripheral nervous system (Svorc, 2018). The central nervous system specifically refers to the spinal cord and brain, whereas the peripheral nervous system refers to the nerves that extend from the spinal cord and innervate the tissues in our body (Svorc, 2018).

2.)  What is the autonomic nervous system?

The autonomic nervous system is a part of the peripheral nervous system. What these nerves control include bodily functions and physiologic processes that are largely not thought about, and are involuntary processes. The three distinct divisions of the autonomic nervous system include the sympathetic nervous system (“fight or flight”), parasympathetic nervous system (“rest and digest”), and enteric nervous system, which helps control a great degree of gastrointestinal functioning (Svorc, 2018).

3.) Why do individuals with autonomic dysfunction have so many different symptoms?

Because the autonomic nervous system is comprised of three divisions that control so many different involuntary bodily functions throughout the body, it makes sense why individuals with autonomic dysfunction might experience so many different symptoms (Sánchez-Mans et al., 2022). The physiologic processes that can be impacted are responsible for important roles within your cardiovascular system, respiratory system, gastrointestinal tract, reproductive system, and urinary system to name a few (Sánchez-Mans et al., 2022). Examples can include the control of your heart rate, blood pressure, sexual arousal, urination, and even digestion.

4.) What are some forms of dysautonomia?

Some forms of dysautonomia (not all) include: Postural Orthostatic Tachycardia Syndrome, Orthostatic Hypotension, Inappropriate Sinus Tachycardia, Vasovagal Syncope, Familial Dysautonomia, Multiple System Atrophy, Autoimmune Autonomic Ganglionopathy, Pure Autonomic Failure, and Postprandial Hypotension.

5.) What causes dysautonomia?

Dysautonomia can be caused by something that is inherited (genetic), or something that is acquired through various potential triggers. When inherited, it is also possible that a separate inherited illness increases the likelihood that a patient will develop dysautonomia. An example of this is seen in individuals with Ehlers-Danlos Syndrome who often develop forms of dysautonomia. Those who develop acquired dysautonomia often experience one or many triggers which can include immunological stressors such as viral and bacterial illnesses, puberty, pregnancy, head trauma, other forms of trauma, surgery, underlying illness, and vaccination (Fedorowski, 2019).

6.) Why do so many not understand or know about dysautonomia?

There are a few reasons why many in the medical community and community as a whole do not understand or know about dysautonomia. First, most academic institutions do not include dysautonomia in their curricula. This can include medical schools, physical therapy programs, nursing schools, PA schools, and NP schools, just to name a few. If medical providers are not learning about forms of dysautonomia during their training, it is even less likely that the general public will be aware of what it is. Second, certain forms of dysautonomia such as POTS have been attributed to psychological causes in the past and still are by some (Raj et al., 2018). This has led many providers to dismiss these patients as anxious without doing further testing. Third, autonomic testing and understanding autonomic dysfunction is a very specialized area. We do not have enough autonomic specialists available to see individuals with dysautonomia and educate other providers who may have less familiarity. Many providers who are not autonomic specialists may not be as familiar with the testing individuals with dysautonomia require in addition to the diagnostic criteria and co-occurring conditions. Lastly, there is still a lot of ongoing research that is helping us gain more insight and understanding, but there are still questions we have about the autonomic nervous system and autonomic nervous system dysfunction.

7.) Why is there such a long diagnostic delay for individuals with dysautonomia symptoms?

There are many factors that can contribute towards the long diagnostic delay, but some include the limited access to autonomic testing, limited provider understanding, limited provider education, insufficient awareness specific to dysautonomia in the medical community, and limited understanding specific to the diagnostic criteria. Individuals who develop dysautonomia are also more likely to be female, who tend to be dismissed more often when their symptoms are less visible with standard medical testing (Moyer, 2022). We hope that more education, awareness, and understanding helps to reduce the diagnostic delays individuals with dysautonomia and their families experience and navigate.

Sources:

Moyer, M. W. (2022, March 28). Women are calling out 'medical gaslighting'. The New York Times. Retrieved August 15, 2022, from https://www.nytimes.com/2022/03/28/well/live/gaslighting-doctors-patients-health.html

Raj, V., Opie, M., & Arnold, A. C. (2018). Cognitive and psychological issues in postural tachycardia syndrome. Autonomic Neuroscience, 215, 46–55. https://doi.org/10.1016/j.autneu.2018.03.004

Sánchez-Mans, J. C., Gujarathi, R., & Varacallo, M. (2022). Autonomic Dysfunction.

Schmidt, L. L., Karabin, B. L., & Malone, A. C. (2017). Postural orthostatic tachycardia syndrome (POTS): Assess, diagnose, and evaluate for pots treatment (adept). Integrative Medicine International, 4(3-4), 142–153. https://doi.org/10.1159/000484205

Svorc, P. (2018). Chapter 1. Autonomic Nervous System.