Autonomic neuropathy

 

Overview

Autonomic neuropathy arises from nerve damage affecting automatic bodily functions, impacting blood pressure, temperature regulation, digestion, bladder control, and sexual function. The damage disrupts communication between the brain and other organs in the autonomic nervous system, including the heart, blood vessels, and sweat glands.

Symptoms

Signs of autonomic neuropathy vary depending on the nerves affected, including:

1. - Dizziness and fainting upon standing due to a sudden drop in blood pressure.
2. - Urinary issues such as difficulty initiating urination, loss of bladder control, and incomplete bladder emptying, which may lead to urinary tract infections.
3. - Sexual difficulties like erectile dysfunction or ejaculation problems in men, and vaginal dryness or low libido in women.
4. - Digestive problems including early satiety, loss of appetite, diarrhea, constipation, abdominal bloating, nausea, vomiting, difficulty swallowing, and heartburn.
5. - Impaired recognition of low blood sugar (hypoglycemia) due to absent warning signs like shakiness.
6. - Sweating abnormalities, affecting temperature regulation.
7. - Sluggish pupil response, impacting light adaptation and night vision.
8. - Exercise intolerance, where heart rate fails to adjust to activity levels.

When to see a doctor

Immediate medical attention is necessary upon experiencing signs of autonomic neuropathy, particularly for individuals with poorly controlled diabetes. For type 2 diabetes, annual screening is recommended upon diagnosis, while for type 1 diabetes, screening should commence five years after diagnosis.

Causes

Various health conditions and treatments, such as cancer therapies, can trigger autonomic neuropathy, including:

1. - Diabetes, especially when poorly managed.
2. - Amyloidosis, characterized by irregular protein buildup affecting organs and nerves.
3. - Autoimmune diseases like Sjogren syndrome, lupus, rheumatoid arthritis, and celiac disease.
4. - Certain medications, including some chemotherapy drugs.
5. - Infections like HIV, botulism, and Lyme disease.
6. - Inherited disorders.

Risk factors

Risk factors for autonomic neuropathy include poorly controlled diabetes, certain diseases, and cancer treatments.

Prevention

While some inherited diseases cannot be prevented, managing overall health and medical conditions can slow symptom onset or progression. This includes controlling blood sugar, avoiding alcohol and smoking, seeking treatment for autoimmune diseases, managing blood pressure, maintaining a healthy weight, and regular exercise.