A tilt table test can be performed in a cardiology lab, that is where my first one was done. Other tests like the QSART and thermoregulatory sweat test require special labs. The other tests I had done at an academic center with an autonomic lab. It's been over 10 years and I would like to have them redone, but, the doctor that did the autonomic test on me left for Rush Presby in Chicago. I'm on an HMO, we just switched insurance and we will see what the new neuro says.


I was seen at Wisconsin Medical College in Milwaukee. I know Mayo has a center. I am sure Chicago has something. Vanderbilt in Nashville is very good and the top guy is Dr. Vernino in Texas, in San Antonio I think.

With insurance the way it is, it is hard to get to an autonomic lab, but you could ask for a tilt table test and a epidermal nerve fiber biopsy and if those are both abnormal, that is substantial confirmation and I would think that they would refer you to an autonomic lab. I haven't had the best continuity of care even tho I was with one neuro for 7 years. A lot less was known about this 10 years ago when I developed it.

AAG is considered quite rare. Part of that IMHO is that it isn't recognized but it is still considered rare. I think they look at if you flunk the tests and if you have neuronal antibodies or a positive ANA with negative ENA and a positive skin biopsy for small fiber neuropathy.