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Autonomic Neuropathy: A Complete Guide

Neuropathy refers to general diseases of the nerve. A disease or an injury can damage the nerve at any location in the body. We classify neuropathy according to these locations or the type of nerves that sustain damage. However, we can also categorize it according to the disease that causes neuropathy. For instance, if an individual suffers from neuropathy because of diabetes, we refer to it as diabetic neuropathy.

Let’s delve into different types of neuropathy. 

What are Types of Neuropathy?

  1. Peripheral Neuropathy

This type of neuropathy occurs when an issue arises with the nerves outside the spinal cord and the brain. Such nerves are a component of our body’s peripheral nervous system. We can say that peripheral neuropathy is a type of neuropathy that affects the nerves of the extremities. That includes our hands, fingers, legs, feet, toes, and arms. 

  1. Cranial Neuropathy

Cranial nerves are the nerves that exit from the brain directly. Cranial neuropathy takes place when there is a problem with any of the twelve cranial nerves. Two types of cranial neuropathy are auditory neuropathy and optic neuropathy. 

Optic neuropathy is the damage of the optic nerve, which transmits visual signals from the eye’s retina to the brain. On the other hand, any damage to the nerve that carries signals from the inner ear to the brain is called auditory neuropathy.

  1. Focal Neuropathy

In this condition, there is damage to a single nerve. Focal neuropathies are more common in your hand or leg. But they also affect the torso and the head. Although this kind of nerve damage is not as common as autonomic or peripheral neuropathy, it usually affects diabetics. 

  1. Autonomic Neuropathy

This type of neuropathy damages the nerves of the involuntary nervous system. Such nerves are responsible for controlling our blood circulation and heart health. However, they are also responsible for regulating bowel and bladder function, perspiration, and sexual responses.

In this guide, we are going to focus on autonomic neuropathy and will give an overview of its symptoms and treatments. So, let’s begin our review. 

Autonomic Neuropathy 

Autonomic neuropathy involves a group of conditions caused by nerve damage. When someone experiences this type of neuropathy, they exhibit many symptoms such as night sweats, dizziness, and constipation.

Nerves are a part of our body’s autonomic nervous system. These nerves control numerous bodily functions such as.

  • Blood pressure
  • Body temperature
  • Digestion
  • Bowel movements
  • Heart rate
  • Urination

What are the Symptoms?

Every patient experiences different symptoms. The intensity of symptoms depends on the damaged nerves as well as the affected organs. But here are some of the most common signs and symptoms. 

  • Fainting and dizziness while standing because of a sudden drop in blood pressure
  • Urinary incontinence and infections
  • Complications in maintaining good sexual health
  • Erectile dysfunction and ejaculation problems
  • Low libido and vaginal dryness in women
  • Digestion problems, loss of appetite, constipation, bloating, diarrhea, and nausea
  • Heartburn
  • Swallowing problems
  • Hypoglycemia without any symptoms
  • Sweating abnormalities
  • Sluggish pupil reaction
  • Exercise intolerance

What are the Causes of Autonomic Neuropathy?

Autonomic neuropathy occurs when the nerves that are responsible for involuntary bodily functions receive damage. In this condition, nerve damage interrupts the transmission of messages between the brain and our body’s organs. It also affects areas of the nervous system, such as sweat glands, blood vessels, and the heart.

Diabetes is the most common cause of this type of nerve damage. But various health conditions can lead to autonomic neuropathy. In some cases, it is a side effect of certain treatment methods such as cancer treatments. Here are some other notable causes. 

Causes

Some common causes of autonomic neuropathy include:

  • Amyloidosis or an abnormal protein buildup in organs, which affects the nervous system and the body’s organs
  • Autoimmune diseases such as systemic lupus erythematosus, Sjogren’s syndrome, celiac disease, and rheumatoid arthritis. Another autoimmune disease that rapidly damages the nerves is the Guillain-Barre syndrome.
  • An abnormal response by our immunity that results due to some forms of cancers
  • Some medicines, including drugs used for chemotherapy 
  • Some bacteria and viruses such as HIV, Lyme disease, and Botulism
  • Inherited disorders can also lead to autonomic neuropathy.

What are the Risk Factors for Autonomic Neuropathy? 

Diabetes is the biggest risk factor for autonomic neuropathy, especially when it is poorly controlled. But other diseases such as hypothyroidism, Amyloidosis, cancer, and porphyria can increase the risk of this disease.

How to Prevent Autonomic Neuropathy

Even if you have a family history of diabetes or other inherited diseases, you can reduce your chances of acquiring autonomic neuropathy. Here are some steps you can take to prevent the onset of this condition.

  • Adopt a healthier lifestyle by incorporating exercise and healthy eating
  • Regulate your blood sugar through diet and lifestyle changes
  • Limit or avoid smoking and alcohol consumption.
  • Get suitable treatment if you suffer from an autoimmune disease.
  • Limit your salt intake and exercise for preventing high blood pressure
  • Take up an aerobic exercise to improve blood circulation 

When Should You See a Doctor? 

If any individual experiences the symptoms we listed above for more than two or three weeks, get in touch with your doctor. However, all diabetes patients must take extra care to prevent nerve damage. 

The American Diabetes Association recommends every patient with type 2 diabetes schedule an annual screening for autonomic neuropathy. This screening should be your priority as soon as you receive a diagnosis for diabetes. People with type 1 diabetes should also schedule a screening every five years, post-diagnosis.

Diagnosis

Consult your family doctor, who will recommend you to a specialist if there is any need. Generally, a doctor diagnoses autonomic neuropathy by asking these questions.

  • Do you have diabetes? 
  • Are your symptoms occasional or continuous?
  • How severe and frequent are your symptoms?
  • Do you have a family history of autonomic neuropathy?
  • Does anything seem to improve or worsen your symptoms?
  • Getting an early diagnosis is crucial because it can improve your outlook.

Once the doctor considers your symptoms, he may ask for these tests:

  • gastric emptying tests for assessing your gastric motility and muscle activity
  • breathing tests for evaluating your heart rate and blood pressure levels
  • QSART or a quantitative sudomotor axon reflex test for assessing nerve reactions related to sweat glands
  • a blood pressure test when you are sitting and standing
  • a tilt-table test for monitoring blood pressure levels during posture changes
  • a thermoregulatory test for examining your sweat patterns at different temperatures
  • urine tests for analyzing the function of your bladder
  • ultrasound for your bladder to examine its structure and condition 
  • abdominal X-rays for assessing your digestive tract

Treatment Methods for Autonomic Neuropathy 

The first method is to treat the underlying condition that is causing Autonomic Neuropathy. For instance, a patient may be undergoing nerve damage because of diabetes. They will have to make dietary and lifestyle changes to regulate their blood sugar levels. Unfortunately, the underlying cause of autonomic neuropathy remains unknown.

However, there are numerous ways to prevent the condition from worsening. Here are some of these. 

  1. Treatments for Relieving Digestion Problems 

Dietary Changes: Increase the intake of fluids and dietary fiber to avoid bloating and gas.

Medication for Relieving Constipation: Choose reliable over-the-counter laxatives for easing constipating.

Medication for Emptying your Stomach: Some prescription drugs help you empty your stomach quickly. Such medications increase the contractions of the digestive tract. Since these medications can cause drowsiness, they are not ideal for long-term use. 

Medication for Relieving Diarrhea: Many antibiotics and over-the-counter antidiarrheal medications work great for easing diarrhea.

  1. Treatments to Relieve Urinary symptoms

Medication for Controlling the Bladder: Get your doctor’s approval for a medication to treat an overactive bladder.

Retraining the Bladder: Increase your bladder’s capacity and retain it by performing exercises. These exercises are helpful for increasing the amount of fluids your bladder can hold and the time between emptying your bladder. 

Urinary Assistance (catheterization): In rare cases, a tube is guided through the urethra for emptying the bladder.

  1. Treatments for Sexual Dysfunction

For Men 

Medications for treating ED: If a man has erectile dysfunctions, a doctor will prescribe some medication such as vardenafil, sildenafil, or tadalafil. There could be some side effects of these medications, such as an upset stomach and low blood pressure. Inform your doctor if you have a history of heart disease or high blood pressure. Do not consume any such medication if you are on any kind of organic nitrates. If you have an erection that lasts longer than four hours, seek immediate medical attention.

External Vacuum Pump: The device pulls blood into the penis through a hand pump. A tension ring keeps the blood in place to maintain the erection for up to half an hour.

For Women

Flibanserin: Medication for premenopausal women with low libido 

Vaginal Lubricants: For easing dryness and making sexual intercourse more enjoyable

  1. Treatments for High Blood Pressure 

In most cases, autonomic neuropathy causes many blood pressure and heart rate problems. Here are a few ways to treat high blood pressure. 

Consume a high-fluid Diet: Limit the intake of salt in your diet. Pay attention to any signs that indicate inflammation, such as swollen ankles and feet.

Compression Garments: Wearing compression stockings can improve the blood flow for regulating blood pressure levels.

Medication for Regulating Heart Rate: Beta-blockers are a class of medication that regulates the heart if it beats too hard during physical activity.

Alternative Methods for Treating Autonomic Neuropathy 

  1. Acupuncture

This traditional therapy involves inserting numerous thin needles in troubled areas of the body. Many research studies validate the use of acupuncture for controlling the autonomic nervous system function. These functions include skin conductance, blood pressure, skin temperature, and heart rate, etc. The biochemical changes that happen due to acupuncture stimulate our natural healing abilities. Hence, it relieves the autonomic neuropathy symptoms.

  1. Transcutaneous Electrical Nerve Stimulation (TENS)

Many trials and studies reveal the benefits of TENS on easing pain due to diabetic neuropathy. This treatment method makes use of low-energy electrical waves that transmit through electrodes when placed on the skin. In this method, a small device delivers the current near the affected nerves for blocking or changing the patient’s perception of pain.

  1. Hot and Cold Packs

If you experience sore muscles or stiff joints, hot and cold packs can provide great relief. Let’s start with the benefits of applying a cold pack to the affected area. 

Cold packs can numb the affected area as well as reduce the pain or swelling. That’s because cold constricts blood flow for relieving the affected nerves. If you don’t have a cold pack, you can fill a water bottle with ice and cold water and place it on the affected joints.

You can also use other items for cold therapy, such as:

  • Zip-lock plastic bags filled with water and ice.
  • A hand towel dipped in ice-cold water
  • A bag of frozen peas or vegetables

Hot packs also work because they help relax your muscles. Since heat dilates the blood vessels and sends more oxygen and blood to the affected area, that’s why heat does a great job in reducing pain.

The best way to use a heat pack is to use a commercial heat pack or a heating pad. But here are some other ways to benefit from the heat at home. 

  • Soak in a hot tub
  • Take a hot shower
  • Soak a hand towel or washcloth in hot water and apply it to painful muscles or joints

Whether you are using a hot pack or a cold pack, here are some important tips to follow. 

  • Use the heat or cold pack for a maximum of twenty minutes at a time.
  • Wrap the hot or cold pack in a towel
  • Avoid using cold packs if you have vasculitis
  • Always test the temperature before using a cold or hot pack.
  • Avoid using any heat rubs or creams on the skin when using a cold or hot pack.
  • Heating pads can cause severe burns if left on for too long.

Before using a hot or cold pack for relieving pain or swelling, don’t forget to get your doctor’s approval. 

  1. Ointment

If you would like a more natural method to deal with the pain and numbness, you can try out Joint Mud. Although it is primarily used for joint pain, it can still help out with day-to-day mobility and discomfort.

Tips for Living a Productive Life with Autonomic Neuropathy

Living with a chronic condition such as autonomic neuropathy presents a host of challenges. The physical and sexual symptoms of this condition can make it difficult for the patient to live a normal life.

Here are some strategies to cope up with autonomic neuropathy for living a healthier and happier life. 

Organize and prioritize: Make sure you accomplish the important tasks when you have the most energy. For example, paying bills or grocery shopping should be for morning or evening, whenever you feel most active.

Accomplish the most important tasks: Do tasks such as paying bills when you have the most energy and save less important tasks for later. Stay active, but don’t overdo it.

Accept and Seek Help from Family: The right attitude can help you live a normal life with autonomic neuropathy. However, don’t shy away from asking friends or family when you need emotional or financial assistance.

Contact a Therapist: In some cases, professional advice from a therapist or a counselor can go a long way to deal with the symptoms of this condition. If you are experiencing erectile dysfunction or combating depression due to autonomic neuropathy, get in touch with a professional therapist.

Join a Support Group: Consult your doctor for joining a local support group. People dealing with autonomic neuropathy can support each other in fighting the symptoms and outcomes of the condition together. 

Bottom Line

The sooner you get a diagnosis for autonomic neuropathy, the faster you will be able to manage its symptoms. Follow our guide if you or your loved ones are undergoing any symptoms that indicate nerve damage. Once your doctor diagnoses the condition, he will recommend the best course of treatment to relieve the pain and symptoms of autonomic neuropathy.

Sources

https://www.mayoclinic.org/diseases-conditions/autonomic-neuropathy/diagnosis-treatment/drc-20369836

https://www.webmd.com/diabetes/autonomic-neuropathy-overview

https://my.clevelandclinic.org/health/diseases/15631-autonomic-neuropathy-or-autonomic-dysfunction-syncope-information-and-instructions

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