Am I Really Experiencing Autonomic Nervous System Dysfunction?

Q: Am I Really Experiencing Autonomic Nervous System Dysfunction?

Hello Mr. <br>Hsu： Anxiety often occurs alongside physical discomfort. <br>Sometimes, excessive anxiety can lead to physical symptoms or exacerbate existing discomfort. <br>If you have concerns regarding a diagnosis of anxiety or autonomic nervous system dysfunction, you may cons

Doctor, could you please tell me if I really have autonomic nervous system dysfunction?

In June 2014, I experienced a left-sided migraine.
When I lay down to rest, I felt a sudden sensation of dizziness, which was very uncomfortable (I thought I was going to die).
After sitting up, I gradually felt better, but I began to experience the following symptoms: chest tightness, fatigue, a sense of fear, occasional mild dizziness, poor balance, occasional nausea, and a feeling of imbalance while walking, along with an intolerance to heat.

In August 2014, I underwent examinations at Cathay General Hospital's Neurology and Cardiology departments, both of which returned normal results, but my condition did not improve.
In May 2016, during a health check, my weight was 81 kg, blood pressure was 135, and blood glucose level was 107.
By October 2016, my weight had decreased to 75 kg, and my blood pressure was 120 (I was taking half a tablet of Lercanidipine daily).

In early October 2016, the Family Medicine department at Taipei Hospital diagnosed me with autonomic nervous system dysfunction and prescribed Ambien for one month.
I have been taking it for two weeks now, but there has been no significant improvement.
The family physician only based the diagnosis on the consultation without conducting any tests.
Is it possible that there was a misdiagnosis?

Mr. Hsu, 40~49 year old female. Ask Date: 2016/10/21

Dr. Liang Sunyuan reply Psychiatry

Hello Mr.
Hsu: Anxiety often occurs alongside physical discomfort.
Sometimes, excessive anxiety can lead to physical symptoms or exacerbate existing discomfort.
If you have concerns regarding a diagnosis of anxiety or autonomic nervous system dysfunction, you may consider visiting a psychosomatic medicine clinic, autonomic nervous system clinic, or psychiatric clinic for an in-person evaluation.
Wishing you all the best.

Reply Date: 2016/10/21

More Info

It sounds like you have been experiencing a complex set of symptoms that can indeed be associated with autonomic nervous system (ANS) dysfunction. The autonomic nervous system is responsible for regulating involuntary bodily functions, including heart rate, blood pressure, digestion, and respiratory rate. When this system is out of balance, it can lead to a variety of symptoms, many of which you have described.

1. Connection Between Symptoms and ANS Dysfunction: Your symptoms, such as chest tightness, fatigue, feelings of fear, occasional dizziness, balance issues, and nausea, can all be linked to ANS dysfunction. The autonomic nervous system is divided into the sympathetic and parasympathetic systems. An imbalance can lead to symptoms like anxiety, palpitations, and gastrointestinal issues. The fact that you have experienced these symptoms over an extended period, despite normal test results, suggests that your body may be reacting to stress or other underlying factors that are not easily identifiable through standard medical tests.

2. Weight and Blood Pressure Changes: Your weight fluctuations and blood pressure readings are also noteworthy. While your blood pressure readings are within a normal range, the fact that you are on medication (Lopressor) indicates that there may have been concerns about your cardiovascular health. Weight loss can sometimes improve symptoms related to ANS dysfunction, as excess weight can contribute to increased strain on the heart and other bodily systems. However, it is essential to approach weight management in a healthy manner, focusing on balanced nutrition and regular physical activity.

3. Medication and Treatment: You mentioned being prescribed Ambien (presumably for sleep issues) without significant improvement in your symptoms. It is crucial to communicate with your healthcare provider about the lack of improvement. Sometimes, medications can take time to show effects, or they may not be the right fit for your specific situation. Additionally, the reliance on medication alone may not address the root causes of your symptoms. A comprehensive approach that includes lifestyle modifications, stress management techniques, and possibly therapy could be beneficial.

4. Further Evaluation: Given that your symptoms persist despite normal test results, it may be worth seeking a second opinion or further evaluation from a specialist in autonomic disorders or a neurologist. Tests such as tilt table tests, heart rate variability assessments, or even more advanced imaging studies could provide additional insights into your condition.
5. Lifestyle Modifications: In the meantime, consider implementing lifestyle changes that can support your autonomic nervous system. Regular exercise, mindfulness practices (like yoga or meditation), adequate hydration, and a balanced diet rich in whole foods can all contribute to better overall health and potentially alleviate some of your symptoms.
6. Mental Health Considerations: Anxiety and stress can exacerbate symptoms of ANS dysfunction. It may be beneficial to explore cognitive-behavioral therapy (CBT) or other therapeutic modalities to help manage anxiety and improve your coping strategies.

In conclusion, while it is possible that you are experiencing autonomic nervous system dysfunction, it is essential to work closely with your healthcare providers to explore all potential causes and treatment options. Your symptoms are valid, and addressing them holistically will be key to improving your quality of life.

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