Dysautonomia: Types, Symptoms, Root Causes, And Treatment Options

Dysautonomia describes a group of disorders characterized by dysfunction in the autonomic nervous system (ANS). Your ANS is responsible for involuntary functions like heart rate, blood pressure, digestion, and temperature control.

People with dysautonomia can feel a wide variety of symptoms depending on the type of disorder they’re dealing with, but dizziness, extreme fatigue, and brain fog are common.

Living with dysautonomia can be disorienting and frustrating. Even though over 70 million people worldwide may be affected by some form of this condition, proper diagnoses are difficult due to the complexities of its symptoms.

If you’re dealing with a long list of symptoms that your doctor isn’t able to decipher, dysautonomia may be to blame. The goal of this guide is to provide you with the information you need to get to the root of what you’re feeling and improve your quality of life.

Types Of Dysautonomia

Researchers have identified at least 15 types of dysautonomia, each with a specific set of symptoms, underlying causes, and effects on the body. People can have multiple types of dysautonomia with overlapping symptoms, as well.

Here are a few of the more common types of dysautonomia:

• Postural orthostatic tachycardia syndrome (POTS): People with POTS experience orthostatic intolerance, or rapid heart rate and fainting when standing up. POTS often coexists with Ehlers-Danlos syndrome (EDS), a connective tissue disorder. (1)
• Neurocardiogenic syncope (NCS): Also known as vasovagal syncope, this condition involves sudden drops in heart rate and blood pressure, leading to fainting or loss of consciousness. (2) It can be triggered by chronic stress, dehydration, and pain.
• Orthostatic hypotension: More common in older adults, this condition involves a significant drop in blood pressure upon standing, causing dizziness, blurred vision, and fainting. (3) It can be triggered as a side effect of medications.
• Multiple system atrophy (MSA): This rare and progressive disorder can manifest with symptoms like tremors and movement control difficulties resembling Parkinson's disease (MSA-P) or symptoms affecting the ANS (MSA-A). (4)
• Pure autonomic failure (PAF): PAF is characterized by symptoms of orthostatic hypotension, such as drops in blood pressure when standing up. (5) It can also cause urinary problems, sweating, and sleep issues.
• Familial dysautonomia (FD): Also known as Riley-Day syndrome, this is a genetic disorder that affects the development and function of the ANS. It can lead to problems swallowing, a lack of tears, temperature regulation issues, and sensory problems.
• Autoimmune autonomic ganglionopathy (AAG): AAG is an autoimmune disorder where the body's immune system attacks autonomic nerves. (6) Symptoms include orthostatic hypotension, gastrointestinal issues, and abnormal sweating.
• Diabetic autonomic neuropathy (DAN): This is a complication of diabetes where high blood sugar levels damage autonomic nerves. (7) Symptoms can include digestive issues, abnormal heart rate, and bladder dysfunction.
• Baroreflex failure: In this condition, the body's baroreceptors that regulate blood pressure don’t work properly, causing severe blood pressure fluctuations and episodes of rapid heart rate. A history of head or neck trauma is a documented cause. (8)
• Inappropriate sinus tachycardia (IST): This is a condition where the heart rate is abnormally high at rest or with minimal activity. (9) It can lead to symptoms like palpitations, dizziness, chest discomfort, and fatigue.

If you’ve been diagnosed with an autoimmune condition, there is a path forward beyond medication management. Learn more from my self-directed course: Mastering Autoimmune Conditions & Inflammation With Functional Medicine.

Symptoms

Symptoms depend on the form of dysautonomia you’ve been diagnosed with and the part of the ANS affected by the condition. That’s part of what makes dysautonomia so challenging to diagnose. Patients can present with any of the following:

• Anxiety
• Brain fog
• Balance problems
• Blood pressure fluctuations (hypertension and hypotension)
• Blurred vision
• Chest pain or discomfort
• Dizziness or lightheadedness
• Difficulty swallowing
• Digestive distress (e.g. bloating, constipation, diarrhea)
• Excessive sweating
• Fatigue or muscle weakness
• Fainting or near-fainting spells
• Heart palpitations
• Headaches or migraines
• Hypoglycemia (low blood sugar)
• Insomnia
• Low libido
• Mood swings
• Nausea
• Poor body temperature regulation (chills, excessive sweating)
• Rapid or irregular heart rhythm
• Sensitivity to light and sound
• Shortness of breath
• Sleep problems
• Urinary incontinence
• Vertigo
• Vision changes
• Weight fluctuations

Severe cases of dysautonomia can be disabling for many. Conditions like POTS and MSA can cause severe fatigue, frequent fainting, and exercise intolerance, increasing your risk of developing additional chronic conditions.

In some cases, dysautonomia meets the criteria for Social Security disability benefits, especially if symptoms are well-documented and limit daily functioning. Matching your symptoms to a listed condition is the most straightforward way to access benefits, but you can also qualify based on symptoms through their medical-vocational allowance.

Root Causes

There is no single cause of dysautonomia, but there are several factors that can contribute to its development:

• Genetics: Some forms of pediatric dysautonomia, such as FD, are linked to specific gene mutations or abnormalities. For example, being of Eastern European or Ashkenazi Jewish heritage predisposes individuals to this type. (10)
• Autoimmune diseases: Conditions like Sjögren's syndrome, lupus, and multiple sclerosis can cause dysautonomia. (11) In these cases, autonomic dysfunction is a secondary effect of the primary autoimmune disease.
• Inflammatory disorders: Chronic inflammation of the autonomic nerves from conditions like rheumatoid arthritis and Guillain-Barré syndrome (GDS) can trigger dysautonomia symptoms. (12) This can then worsen the outcomes of these conditions.
• Diabetes: Long-term high blood sugar can damage nerves in the autonomic nervous system, resulting in DAN. (7)
• Physical trauma or injuries: Traumatic brain injuries, spinal cord injuries, or other physical trauma can disrupt nerve pathways and lead to dysautonomia symptoms.
• Infections: Viral or bacterial infections such as Epstein-Barr virus or Lyme disease can damage the nervous system and trigger dysautonomia. Researchers are also seeing a link between these disorders and patients suffering from long COVID. (13)
• Environmental factors: Exposure to toxins or chemicals can play a role in triggering dysautonomia or exacerbating symptoms in susceptible individuals.
• Nutritional deficiencies: Deficiencies in essential nutrients like vitamin B12 can impair nerve health and trigger symptoms of dysautonomia. (14)

Depending on the cause, you can be diagnosed with either primary dysautonomia or secondary dysautonomia. Primary dysautonomia occurs on its own without a specific cause. This is generally the case with inherited forms.

Secondary dysautonomia occurs as a result of a specific leading cause, such as an autoimmune condition, infection, toxin exposure, or injury. It’s also possible that the cause is unknown. In this case, your dysautonomic may be treated like other autonomic nervous system disorders.