Is My Condition Autonomic Nervous System Dysfunction?

Do I have autonomic nervous system dysfunction?

Hello, doctor.
I would like to ask if the following situation is related to autonomic nervous system dysfunction.
In mid-July, I caught a cold and had a cough, so I visited a family physician and had a chest X-ray, which showed normal results.
At the beginning of August, I experienced vomiting and diarrhea, so I went to see the family physician again, who diagnosed me with gastroenteritis.
Blood tests and stool tests were conducted, and the results were as follows (my symptoms at the time included: vomiting, diarrhea, weakness in my limbs, and feeling nauseous even when drinking water).
I lost 5 kilograms, going from 78 kg to 73 kg.
The blood tests were normal, including liver function and kidney function.
The only abnormal results were slightly low lymphocyte count, slightly high neutrophil count, slightly high red blood cell count, slightly high sodium level, and slightly high carbon dioxide content.
The doctor said it was okay, just some electrolyte imbalance.
The stool tests for Helicobacter pylori and C.
difficile were both negative.
In mid-August, I visited the family physician again due to symptoms of weakness in my limbs, slight hand tremors, dizziness, bloating, belching, and loss of appetite, but I did not lose any more weight.
Now, at the end of August, after lunch and dinner, I still feel bloated and uncomfortable, and I am fatigued all day with weakness in my limbs, as well as a sensation of chest tightness.
Recently, I have been waking up at 3 or 5 AM, tossing and turning, unable to sleep.
However, after taking a shower at night and before going to bed, I tend to feel hungry and my energy seems better than during the day, with less weakness in my limbs.
In the morning, the discomfort returns.
Last week, I experienced palpitations and hand tremors after drinking high mountain tea (I hadn't had tea or coffee for a month and a half), but I felt better after not drinking it.
Could you please tell me what might be the cause of these symptoms and which specialist I should see?

Kevin, 30~39 year old female. Ask Date: 2016/08/29

Dr. Xiao Minghong reply Psychiatry

Hello Kevin,
Based on your description, you have experienced several physical symptoms since mid-July, including discomfort in the chest, gastrointestinal issues, limb discomfort, and sleep disturbances.
Since these symptoms are quite nonspecific, they can occur in many situations.
Currently, the test results appear to be mostly negative, so it is advisable to continue monitoring your condition.
If you are feeling extremely anxious or troubled due to the inability to find a cause, or if your sleep disturbances are affecting your work performance, you may consider visiting a psychiatrist for further evaluation.
The sudden palpitations and tremors after drinking high mountain tea could be symptoms of excessive caffeine intake.

Wishing you all the best.
Sincerely,
Dr.
Hsiang Ming-Hung

Reply Date: 2016/08/29

More Info

Based on your detailed description of symptoms and medical history, it seems you are experiencing a complex interplay of physical and possibly psychological issues that may indeed relate to autonomic nervous system dysfunction (ANS dysfunction). The autonomic nervous system regulates involuntary bodily functions, including heart rate, digestion, respiratory rate, and reflexes. When this system is out of balance, it can lead to a variety of symptoms, many of which you have described.

Understanding Your Symptoms
1. Physical Symptoms: You mentioned experiencing fatigue, weakness in your limbs, gastrointestinal issues (nausea, vomiting, diarrhea), and feelings of chest tightness. These symptoms can be indicative of ANS dysfunction, particularly if they occur in conjunction with stress or illness. The autonomic nervous system can be affected by infections, as seen in your case with the gastrointestinal infection, which may have triggered or exacerbated your symptoms.

2. Psychological Symptoms: The feelings of anxiety, restlessness, and difficulty sleeping you described could also be linked to ANS dysfunction. The body’s stress response can lead to increased sympathetic nervous system activity (the fight-or-flight response), which can cause symptoms like heart palpitations, tremors, and gastrointestinal distress.

3. Electrolyte Imbalance: The slight imbalances in your blood tests, particularly with sodium and carbon dioxide levels, could also contribute to feelings of weakness and fatigue. Electrolyte imbalances can affect muscle function and overall energy levels, which may explain some of your symptoms.

Recommendations for Further Evaluation
Given the complexity of your symptoms, it would be advisable to consult with a healthcare provider who specializes in autonomic disorders or a neurologist. They can conduct a thorough evaluation, which may include:
- Autonomic Function Testing: This can help assess how well your autonomic nervous system is functioning. Tests may include tilt table tests, heart rate variability assessments, and sweat tests.

- Blood Tests: Further blood tests may be warranted to check for additional electrolyte imbalances, thyroid function, and other metabolic parameters.

- Psychological Assessment: Since anxiety and stress can exacerbate physical symptoms, a referral to a mental health professional may also be beneficial. Cognitive-behavioral therapy (CBT) or other forms of therapy can help manage anxiety and stress, which may in turn alleviate some of your physical symptoms.

Lifestyle Modifications
In addition to seeking medical advice, consider implementing some lifestyle changes that may help manage your symptoms:
- Hydration and Nutrition: Ensure you are adequately hydrated, especially after experiencing gastrointestinal symptoms. A balanced diet rich in electrolytes (sodium, potassium, magnesium) can help stabilize your energy levels.

- Stress Management: Techniques such as mindfulness, meditation, or gentle exercise (like yoga or tai chi) can help regulate the autonomic nervous system and reduce stress.

- Sleep Hygiene: Establish a regular sleep routine to improve your sleep quality. Avoid stimulants like caffeine and high-sugar foods, especially in the hours leading up to bedtime.

Conclusion
Your symptoms are multifaceted and may indeed be related to autonomic nervous system dysfunction, especially given the context of your recent illness and ongoing symptoms. A comprehensive evaluation by a specialist will be crucial in determining the underlying causes and appropriate treatment strategies. Remember, it’s important to communicate openly with your healthcare provider about all your symptoms and concerns to ensure a holistic approach to your health.

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