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What Is Autonomic Neuropathy

author avatar Dr. Eric Berg 08/31/2023


Have you ever heard of autonomic neuropathy diabetes? It’s a serious condition, but many people don't realize they have it until significant damage has occurred.

Autonomic neuropathy diabetes develops when high blood sugar levels damage nerves throughout your body. These nerves control automatic bodily functions, including your heart rate, blood pressure, digestion, bladder function, and even sexual response.

It is a common complication of diabetes and often gets overlooked or mistaken for other conditions. This post will shed light on autonomic neuropathy diabetes, including its symptoms, causes, and potential treatment options.

Early detection is crucial in managing this condition effectively, so let's dive into what you need to know.

Understanding Autonomic Neuropathy Diabetes

Your autonomic nervous system is like the quiet workhorse of your body. It's the intricate network of nerves that regulate crucial functions without you even having to think about them.

Your heartbeat, breathing, digestion, and even sweating – it's all under the control of this silent conductor.

When high blood sugar, a hallmark of diabetes, lingers, it wreaks havoc on these delicate nerve fibers, leading to diabetic neuropathy.

How High Blood Sugar Impacts the Autonomic Nervous System

High blood sugar damages blood vessels, including the tiny capillaries that supply nutrients to your peripheral nerve. This damage disrupts nerve function and leads to a wide spectrum of symptoms.

When blood glucose levels remain consistently high, it can lead to a condition known as diabetic mellitus.

The Different Sections of the Autonomic Nervous System:

  1. Sympathetic Nervous System: This part governs your "fight or flight" response. When faced with stress, danger, or excitement, the sympathetic nervous system kicks into gear, increasing heart rate and blood flow to muscles.

  2. Parasympathetic Nervous System: This system is all about rest, relaxation, and digestion. It helps you wind down after a stressful event and promotes digestion and nutrient absorption. This balance is crucial for overall well-being.

  3. Enteric Nervous System: Think of this as your gut's personal brain, residing within the GI tract. This complex network of nerves controls every aspect of your digestion, from swallowing to waste elimination.

Types and Symptoms of Autonomic Neuropathy Diabetes

The tricky thing with autonomic neuropathy diabetes is it doesn’t present in just one way. Its clinical manifestations impact various bodily functions, and symptoms may vary greatly from one person to the next. Let’s take a closer look:

Cardiovascular Issues

The heart often takes a hit with autonomic neuropathy. This means you may experience cardiovascular autonomic neuropathy with symptoms such as:

  • An unusually fast or slow heart rate, known as heart rate variability.

  • Dizziness or lightheadedness when standing, a condition called orthostatic hypotension.

  • Fainting, which can be dangerous in certain situations.

  • Chest pain, which can be mistaken for other heart problems like silent myocardial ischemia.

  • Irregular heartbeat (arrhythmia), which can lead to more serious cardiac events.

Digestive System Woes

The digestive system, particularly gastrointestinal autonomic function, also feels the effects of autonomic neuropathy diabetes, often resulting in:

  • Nausea and vomiting, which can lead to dehydration and malnutrition.

  • Bloating, making it uncomfortable to eat.

  • Constipation, sometimes alternating with diarrhea, a condition known as constipation diarrhea fecal incontinence.

  • Diarrhea, also potentially leading to dehydration.

  • Gastroparesis (delayed stomach emptying), which causes feelings of fullness after eating and can be a real challenge to manage.

Urinary System Problems

Autonomic neuropathy can also throw a wrench into the workings of your urinary system, often leading to bladder dysfunction. You may have trouble knowing when your bladder is full, have difficulty starting to urinate, and may notice:

  • Recurrent urinary tract infections (UTIs), which can be painful and disruptive.

  • Urinary incontinence, the involuntary leakage of urine, which can be embarrassing and impact quality of life.

Other Issues

But that’s not all; autonomic neuropathy can also affect several other areas of the body, including the sweat glands, and lead to:

  • Excessive or insufficient sweating, as your body struggles to regulate temperature properly. This is known as sudomotor function impairment.

  • Erectile dysfunction in men, impacting intimacy and self-esteem. This often presents as difficulty achieving or maintaining an erection.

  • Vaginal dryness in women, making intercourse uncomfortable or painful.

  • Vision problems, such as blurred vision, especially when going from a sitting to standing position. This occurs because of the sudden change in blood flow.

Glucose and ketone meter

Risk Factors

Several risk factors can increase your chances of developing autonomic neuropathy diabetes. Let's take a look at these:

  • Having diabetes for a long time: The longer you've lived with diabetes, the higher your chances of developing complications like autonomic neuropathy. This highlights the importance of long-term blood sugar control.

  • Poor blood sugar control: Consistently elevated blood sugar levels are incredibly damaging to your nerves, leading to diabetic neuropathy. Maintaining good glycemic control is paramount.

  • High blood pressure: Uncontrolled high blood pressure compounds the damage high blood sugar inflicts on your blood vessels. This combination creates a perfect storm for nerve damage.

  • High cholesterol: Increased cholesterol levels also contribute to blood vessel damage and inflammation, increasing the risk of developing autonomic neuropathy.

  • Obesity: Carrying excess weight places added stress on the body and contributes to inflammation and poor circulation, further endangering nerve health. Weight management is crucial for overall health, including nerve function.

  • Smoking: This harmful habit narrows and damages blood vessels, further depriving your nerves of oxygen and accelerating nerve damage. Quitting smoking is one of the best things you can do for your health.

Diagnosis: Getting to the Root of the Problem

When it comes to autonomic neuropathy diabetes, your doctor will conduct a comprehensive evaluation to determine the extent of nerve damage and assess autonomic function. They may perform various autonomic function tests, including:

  • Physical Exam: Your doctor will check for signs of nerve damage, like changes in your heart rate or blood pressure when changing positions. This is a simple way to assess your body's response to changes in position.

  • Medical History Review: This involves asking questions about your symptoms, family history of diabetes or nerve conditions, and lifestyle habits that might contribute to nerve damage. Providing detailed information can aid in accurate diagnosis.

  • Nerve Conduction Tests: These tests, also known as nerve conduction studies, measure the speed of nerve impulses to see if nerves are communicating effectively. Slowed conduction can indicate nerve damage.

Autonomic neuropathy often sneaks up without making itself immediately obvious. Many of its symptoms overlap with other conditions, making diagnosis challenging.

Catching this condition early can mean slowing or even reversing some of the nerve damage, emphasizing the importance of early detection. So, always share even seemingly minor symptoms with your healthcare professional.

Turning the Tide: Managing Autonomic Neuropathy Diabetes

There is no one-size-fits-all answer for managing autonomic neuropathy because this condition is so complex. Treatment goals vary from person to person, depending on the specific nerves affected and the severity of the damage.

But let’s look at what you can do to help keep this condition from worsening:

The Power of Blood Sugar Control

Managing autonomic neuropathy diabetes effectively begins with keeping those blood sugar levels in check. Here's how:

  • Follow Your Doctor's Recommendations: They are there to equip you with the knowledge and support to effectively manage your condition, including setting realistic blood glucose targets.

  • Healthy Diet: Prioritize nutrient-dense, whole foods while minimizing processed goodies, sugary beverages, and refined carbs. This helps regulate blood sugar and prevent spikes.

  • Regular Exercise: Engage in at least 30 minutes of moderate-intensity physical activity on most days of the week. Exercise not only helps control blood sugar but also improves circulation, benefiting nerve health.

  • Stay Properly Hydrated: Dehydration can worsen some symptoms of autonomic neuropathy, so ensure you drink plenty of fluids, especially water.

  • Medications as Directed: Your doctor might recommend medications to help you maintain steady blood sugar levels, such as insulin or other blood sugar-lowering drugs. These medications can help protect your nerves from further damage.

By effectively managing your blood sugar, you're giving your nerves a fighting chance to recover or prevent further damage.

Lifestyle Changes

Embracing a healthy lifestyle can work wonders in managing autonomic neuropathy diabetes, improving overall health and well-being.

  • Quit Smoking: Ditch this harmful habit and watch as your circulation and nerve health gradually recover. Quitting smoking is one of the most significant steps you can take to improve your health.

  • Monitor Blood Pressure & Cholesterol Levels: Regularly check your blood pressure and cholesterol levels and work with your doctor to keep them within a healthy range. Controlling these factors reduces the strain on your blood vessels and improves blood flow to your nerves.

  • Exercise Regularly: Incorporate regular physical activity into your routine, as it benefits not only your physical health but also your mental well-being, helping manage the stress and emotional toll of chronic conditions.

  • Maintain a Healthy Weight: If you are overweight or obese, losing even a small amount of weight can positively impact your overall health, including reducing your risk of developing or worsening autonomic neuropathy.

Medications: Allies in Managing Symptoms

While lifestyle changes are essential in managing autonomic neuropathy, sometimes, medications might be needed to address specific symptoms and provide relief:

  • Blood Pressure Medications: ACE inhibitors are often prescribed to help manage blood pressure and improve blood flow, which can be beneficial for people with autonomic neuropathy affecting their cardiovascular system.

  • Medications to Improve Digestion: If you're experiencing gastroparesis or other digestive issues, your doctor might prescribe medications to help speed up gastric emptying or alleviate symptoms like nausea and vomiting.

  • Medications to Manage Urinary Issues: For urinary problems, medications can address issues like urinary incontinence or recurrent UTIs. For instance, medications can help tighten the bladder muscles or reduce the frequency of UTIs.

Medications offer supportive care to address specific issues related to autonomic neuropathy diabetes, improving quality of life.

FAQs about autonomic neuropathy diabetes

What are the autonomic symptoms of diabetic neuropathy?

Autonomic symptoms of diabetic neuropathy can be varied and affect multiple systems in the body. They include:

  • Cardiovascular issues: dizziness or lightheadedness when standing (orthostatic hypotension), fainting, chest pain, an unusually fast or slow heart rate (heart rate variability), and irregular heartbeat (arrhythmia).

  • Digestive system issues: nausea and vomiting, bloating, constipation, diarrhea, and gastroparesis (delayed stomach emptying). These can disrupt daily life and affect nutritional intake.

  • Urinary tract issues: urinary tract infections, urinary incontinence (leakage of urine), trouble knowing when your bladder is full, and difficulty starting to urinate. These can be embarrassing and affect quality of life.

  • Other issues: Excessive or insufficient sweating (sudomotor dysfunction), sexual dysfunction (erectile dysfunction in men, vaginal dryness in women), and vision problems (blurred vision). These symptoms can affect daily activities and relationships.

How do you treat diabetic autonomic dysfunction?

Treating diabetic autonomic dysfunction requires a comprehensive approach that addresses both the underlying cause (diabetes) and the specific symptoms:

  • Blood Sugar Control: Following a balanced diet, exercising regularly, and taking medications as directed by your doctor is key to preventing further nerve damage. This is the foundation of managing diabetic autonomic dysfunction.

  • Lifestyle Changes: Stop smoking, maintain a healthy weight, keep blood pressure and cholesterol levels in check, and incorporate regular exercise. These modifications can significantly impact nerve health.

  • Medications: Your doctor may prescribe medications to help with blood pressure, digestion, urinary issues, and other specific symptoms, providing relief and improving quality of life. The type of medication depends on the specific symptoms you are experiencing.

How do you test diabetic autonomic neuropathy?

Doctors utilize a combination of methods to diagnose diabetic autonomic neuropathy and assess the extent of nerve damage:

  • Physical exams allow the doctor to look for physical signs of autonomic neuropathy, such as changes in heart rate or blood pressure when changing positions from lying to standing. This can indicate problems with blood pressure regulation.

  • Medical history review is crucial for the doctor to learn about your symptoms, family history of diabetes or nerve conditions, and lifestyle habits that might contribute to nerve damage. This helps in building a comprehensive picture of your health.

  • Nerve conduction tests, also known as autonomic function tests, are performed to measure nerve function and detect any abnormalities. These tests can involve stimulating nerves and measuring the speed of electrical impulses.

What is the main cause of autonomic neuropathy?

While diabetes is a prevalent cause of autonomic neuropathy, especially when blood sugar control is poor, other factors can contribute to its development:

  • Alcohol use, particularly long-term heavy drinking, can damage nerves throughout the body, including those in the autonomic nervous system.

  • Autoimmune disorders, where the body's immune system mistakenly attacks healthy tissues, can target and damage nerves, leading to autonomic neuropathy.

  • Certain medications, such as chemotherapy drugs, can have side effects that damage nerves. Your doctor will consider your medication history when diagnosing autonomic neuropathy.

  • Genetic predisposition: Some people are genetically predisposed to nerve damage, making them more susceptible to developing autonomic neuropathy.

  • Exposure to toxins, such as heavy metals and industrial chemicals, can also damage nerves and lead to autonomic neuropathy. It's important to minimize exposure to these toxins.

  • Infections, such as HIV and Lyme disease, can sometimes lead to nerve damage, including autonomic neuropathy. Prompt treatment of infections is essential.

  • Nutritional deficiencies, especially deficiencies in B vitamins, can contribute to nerve damage. It's important to consume a balanced diet rich in essential nutrients. 

Brain illustration

Nerve Connections

Understanding the complexities of autonomic neuropathy, especially in the context of diabetes, is crucial for maintaining overall health. One promising solution is benfotiamine, a fat-soluble form of Vitamin B1.

Benfotiamine benefits include improving nerve function, reducing pain, and enhancing glucose metabolism.

By supporting nerve health and addressing complications associated with diabetes, this powerful nutrient can contribute significantly to better health outcomes, helping individuals lead more vibrant, fulfilling lives while managing their condition effectively.

Conclusion

While autonomic neuropathy diabetes is a serious complication of diabetes, it's essential to remember that it can be effectively managed with early diagnosis and proactive treatment.

Treatment focuses on controlling blood sugar, making healthy lifestyle modifications, and addressing specific symptoms with medications. Remember that early diagnosis and proactive management are key.

I've personally seen individuals reclaim their health and lead vibrant lives by taking charge of their condition. Please reach out to your doctor for tailored guidance based on your situation.

By understanding the condition, recognizing its symptoms, and working closely with your healthcare provider, you can improve your chances of delaying or even preventing its progression.

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