Autonomic Neuropathy

Autonomic neuropathy is a group of conditions caused by damage to your nerves.

Those nerves are part of your autonomic nervous system. They control many different body functions, i.e.:

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

Damage to those nerves affects the signals between your brain and your organs. [2]

Risk Factors

• Alcohol misuse.
• Vitamin deficiencies, particularly B vitamins.
• Infections, such as Lyme disease, shingles, Epstein-Barr virus, hepatitis B and C, and HIV.
• Autoimmune diseases, such as rheumatoid arthritis and lupus, in which your immune system attacks your own tissues.[3]

Signs and symptoms of autonomic neuropathy depend on the nerves affected.

They might include:

Dizziness and fainting:

When standing, caused by a sudden drop in blood pressure (orthostatic hypertension).

Urinary problems:

Such as difficulty starting urination, incontinence, difficulty sensing a full bladder and inability to completely empty the bladder, which can lead to urinary tract infections.

Sexual difficulties:

This including problems achieving or maintaining an erection (in other words, erectile dysfunction) or ejaculation problems in men. Specifically, In women, problems include vaginal dryness, low libido and difficulty reaching orgasm.

Difficulty digesting food:

Such as feeling full after a few bites of food, loss of appetite, diarrhea, constipation, abdominal bloating, nausea, vomiting, difficulty swallowing and heartburn, above all due to changes in digestive function.

Inability to recognize:

Low blood sugar (hypoglycemia), because of the warning signals, such as getting shaky, aren’t there.

Sweating abnormalities:

Such as sweating too much or too little, which affect the ability to regulate body temperature.

Sluggish pupil reaction:

Making it difficult to adjust especially from light to dark and seeing well when driving at night.

Exercise intolerance:

Which can occur if your heart rate stays the same instead of adjusting to your activity level. [1]

Pathophysiology of Autonomic Neuropathy

Elements of the autonomic examination include variations in the pulse, postural measurements of blood pressure and heart rate, pupillary light reactions, skin coloration and temperature, patterns of sweating, and other organ-specific physical findings relevant to the individual patient’s presentation.

Especially important is the often neglected practice of measuring the blood pressure standing up, for orthostatic hypotension cannot be diagnosed by symptoms alone and is a common source of potential morbidity.

The examination should be carried out in the context of understanding the syndromic nature of abnormalities of components of the autonomic nervous system.[5]

Investigations of Autonomic Neuropathy

• Breathing tests
• Tilt-table test
• Gastrointestinal tests
• Quantitative pseudomotor axon reflex test
• Thermoregulatory sweat test
• Urinalysis and bladder function (urodynamic) tests
• Ultrasound[1]

Tests are as follow:

Breathing tests i.e.:

• These tests measure how your heart rate and blood pressure respond during exercises such as forcefully exhaling (in other words, Valsalva maneuver).

Tilt-table test i.e.:

• Generally, This test monitors the response of blood pressure and heart rate to changes in posture and position, simulating what occurs when you stand up after lying down.
• You lie flat on a table, which is then tilted to raise the upper part of your body. Additionally, normally your body narrows blood vessels and increases heart rate to compensate for the drop in blood pressure.
• This response either may be slowed or abnormal if you have autonomic neuropathy.
• A simpler test for this response involves standing for a minute, then squatting for a minute and then standing again while blood pressure and heart rate are monitored.

Gastrointestinal tests i.e.:

• In brief, Gastric-emptying tests are the most common tests to check for digestive abnormalities such as slow digestion and delayed emptying of the stomach (gastroparesis).

Quantitative pseudomotor axon reflex test i.e.:

• This test evaluates how the nerves that regulate your sweat glands respond to stimulation.
• A small electrical current passes through capsules placed on your forearm, upper and lower leg and foot, while a computer analyzes the response of your nerves also sweat glands.
• You might feel warmth or a tingling sensation during the test.

Thermoregulatory sweat test i.e.:

• You’re coated with a powder that changes color when you sweat.
• While lying in a chamber with a slowly increasing temperature, digital photos document the results as you begin to sweat.
• Your sweat pattern might help confirm a diagnosis of autonomic neuropathy or suggest other causes for decreased or increased sweating.

Urinalysis and bladder function (urodynamic) tests i.e.:

• If you have bladder or urinary signs and symptoms, a series of urine and bladder tests can evaluate bladder function.

Ultrasound i.e.:

•  If you have bladder signs and symptoms, your doctor might do an ultrasound in which high-frequency sound waves create an image of the bladder and other parts of the urinary tract. [1]

Your doctor mainly will treat the disease that caused your nerve damage.

For example, if you have diabetes, you’ll need to control your blood sugar with diet, exercise, and possibly medicine.

For autoimmune diseases, like Sjogren’s syndrome, you’ll get medicine to control your immune system and bring down inflammation in your body.

digestive symptoms i.e.:

• Change your diet.
• Eat smaller meals so you don’t feel too full.
• Add fluid and fiber to your diet to prevent bloating and constipation.
• Laxatives can help with constipation, and other medicines can treat diarrhea and belly pain.
• Sleep with the head of your bed raised to prevent heartburn.

 urinary symptoms i.e.:

• Drink fluids and empty your bladder at set times during the day. This can help your bladder hold more fluid.
• Oxybutynin (Ditropan XL) and tolterodine (Detrol) stop your bladder muscle from squeezing too often.
• Bethanechol helps you empty your bladder all the way.
• Use a catheter. This tube goes into your bladder to help empty it.

To treat sweating problems i.e.:

• A few drugs can help you make less sweat, including glycopyrrolate (Robinul, Robinul Forte) and botulinum toxin.
• If you don’t sweat enough, stay inside when it’s hot outdoors.

To treat heart and blood pressure symptoms i.e.:

• Take a medicine that raises your blood pressure, such as fludrocortisone or midodrine and pyridostigmine (Mestinon).
• Take medicine to control your heart rate.
• Beta-blockers can help bring your heart back into a normal rhythm.
• Stand up slowly so you don’t get dizzy.
• Get extra salt and fluid in your diet to help raise your blood pressure.
• Only do this if your doctor recommends it. In some cases, it can raise your blood pressure too high or cause swelling.

sexual symptoms i.e.:

• Drugs like sildenafil (e.g. Revatio, Viagra), tadalafil (e.g. Cialis), and vardenafil (e.g. Levitra, Staxyn) can help men get and keep  an erection.
• Women can try a water-based lubricant to make sex more comfortable. [2]

While certain inherited diseases that put you at risk of developing autonomic neuropathy can’t be prevented, you can slow the onset or progression of symptoms by taking care of your health in general and managing your medical conditions.

Follow your doctor’s advice on healthy living to control diseases and conditions, which might include these recommendations e.g.:

• Control your blood sugar if you have diabetes.
• Avoid alcohol and smoking.
• Get appropriate treatment if you have an autoimmune disease.
• Take steps to prevent or control high blood pressure.
• Achieve and maintain a healthy weight.
• Exercise regularly. [1]

Homeopathic Treatment of Autonomic Neuropathy

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

Which includes

• The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.

What Homoeopathic doctors do?

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. Now a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improve with homeopathic medicines.

Homeopathic Medicines of Autonomic Neuropathy:

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy, potency and repetition of dose by Homeopathic doctor.

So, here we describe homeopathic medicine only for reference and education purpose. Do not take medicines without consulting registered homeopathic doctor (BHMS or M.D. Homeopath).

Causticum:

• It is useful when involuntary urination is worse in the winter and better in the summer.
• Various fears and apprehensions accompany the urination, especially fears that something bad will happen to them.
• They have a fear of going to bed in the dark.
• These people also tend to wet their pants when they cough or sneeze or even laugh.

Equisetum:

• This is for people who wet their pants or their bed for no known reason other than out of habit.
• It should be considered when the person has no other obvious symptoms.
• It should also be given when the person experiences wild dreams or nightmares when bedwetting.
• Besides this, they tend to dream of crowds of people.

Gelsemium:

• This medicine especially indicated in Autonomic Neuropathy.
• Centers its action on nervous system, causing various degrees of motor paralysis.
• Dizziness, drowsiness, dullness and trembling are the hallmark of this remedy.
• Trembling ranks the highest in this remedy, weakness and paralysis, especially of the muscles of the head.
• Paralysis of various groups of muscles like eyes, throat, chest, sphincters and extremities.
• Head remedy for tremors.
• Mind sluggish and muscular system relaxed.
• Staggering gait.
• Loss of power of muscular control.
• Cramps in muscles of forearm.
• Excessive trembling and weakness of all limbs.
• Worse by dampness, excitement, bad news. On the other hand, Better by bending forwards, profuse urination, continued motion and open air.

Agnus Castus:

• Homeopathic medicine Agnus Castus is used in cases where there is complete inability to attain penile erection during the sexual act.
• Homeopathic medicine Agnus Castus can be used in cases of erectile dysfunction and sexual weakness where the male has a mental aversion to indulge in sex, along with decreased physical strength.

Caladium:

• Good medicine for Autonomic Neuropathy.
• Homeopathic medicine Caladium is of great help for treatment of erectile dysfunction when the male is unable to have an erection despite having a sexual desire or urge.

 Acid Phos & Selenium:

• Acid Phos and Selenium can both help the males with Erectile Dysfunction when the erections last only for a short time with early or premature emissions.
• Both these medicines can be used if men attempting the sexual act experience relaxation of the sex organs.
• However, if there is involuntary semen discharge during sleep or while passing stool or during short erections, then Selenium can be of great help.
• Males requiring Selenium also suffer from lack of complete gratification from sex due to early emissions.

Diet and Regimen

1. Control Your Blood Sugar to Avoid Diabetic Neuropathy
2. Get Enough Vitamin B12 and Other Nutrients
3. Watch Your Intake of Vitamin B6
4. Avoid Mercury and Other Toxins in Your Food That Are Linked to Neuropathy
5. Limit or Avoid Alcohol to Help Prevent or Stop the Progress of Neuropathy
6. Understand Your Relationship to Gluten if Celiac Disease Caused Your Nerve Damage[7]

Frequently Asked Questions

What is Autonomic Neuropathy?

Autonomic neuropathy occurs when the nerves that control involuntary bodily functions are damaged.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Autonomic Neuropathy?

• Causticum
• Equisetum
• Gelsemium
• Agnus Castus
• Caladium
• Acid Phos
• Selenium

What are the symptoms of Autonomic Neuropathy?

• Dizziness and fainting
• Urinary problems
• Sexual difficulties
• Difficulty digesting food
• Inability to recognize
• Sweating too much or too little
• Sluggish pupil reaction

What are the causes of Autonomic Neuropathy?

• Diabetes
• Amyloidosis
• Autoimmune diseases
• HIV
• Parkinson’s disease
• Inherited diseases
• Spinal cord injury
• Surgery
• Chemotherapy drugs
• Chemicals (acrylamide)