Which doc for suspect Autonomic Neuropathy?
 

After 6 years with sensorimotor PN, I've noticed new symptoms suggestive of Autonomic Neuropathy these past 4 months. These include GI related symptoms and an almost complete lack of perspiration. These Sx began prior to being on any PN meds, suggesting that these Sx are not adverse effects. Should I see a primary care MD first, or go directly to my neurologist?

Thanks.

bob

Although autonomic neuropathy is a neurological condition, it involves many systems and therefore sometimes requires more then one specialist. If you know the root cause, then your neurologist should address that. however, if not known or untreatable, then you should seek care from a GI doctor for your GI complaints, cardiologist if you have any BP or heart rate manifestations, neuro for neuro symptoms, etc.

There is not much in the way of overall treatment...it's more supportive care based upon symptoms...from the appropriate specialist.

Some have found supplements help, but that may be for toxic causes or diabetic complications. It really all depends on the cause.

There are several tests that can determine if autonomic neuropathy/dysautonomia is present. Not all hospitals have full autonomic testing, but most can handle the basics (tilt table, GI empty studies, holter monitor, etc). QSART should be available in some teaching hospitals.

Thank you that was most helpful. Hopefully, in time i'll be able to shed the idiopathic title and know the underlying cause.

Hi bob and welcome...
 

I have PN also for a pretty short time less than 2 years but I also have what you described recently as far as the GI symptoms, I get dizzy and short of breath. It very annoying to say the least and bit scary. I am currently working with my neurologist for my PN and have brought my other symptoms to the attention of my GP. She then referred me out to the appropriate specialists. For the GI symptoms so far I have only been prescribed some medication for GERD probably mainly because my throat is killing me all the time! I also saw a cardiologist which all tests came back normal. So my suggestion would be to see your regular doctor about those new symptoms and see where that goes, but of course it won't hurt to mention them to your neuro at your next appointment. I wish you all the best!!!

I have autonomic neuropathy that is the cause of my Dysautonomia/P.O.T.S. Cardios are not helpful since the heart itself is usually ok with this. I have only been helped with integrative MD's since they know how to help the nerves heal.

Integrative MD's would certainly be helpful...and maybe they would even work with other specialists or your GP. There are a few autonomic specialists out there also...for severe cases.

Not all have cardiac symptoms that actually need treatment, but by-in-large, cardiac involvement is one of the most common elements of autonomic dysfunction. Involving heart rate and BP, where sometimes medication or pacemaker is the only option that works. A cardio is the appropriate specialist IF treatment is needed. The heart itself may be okay, but function can be greatly affected.

http://en.wikipedia.org/wiki/Dysautonomia


Bobmar, It comes down to the cause (which is often never known) and severity of your symptoms. Your autonomic testing and clinical presentation would gauge what type of treatment you need. Some toxic dysautonomia can resolve on it's own (when toxin is eliminated, of course) in time...and from what I've read here, supplements will help this process and nerves to heal. Getting diabetes under control can also help secondary dysautonomia. However, some have permanent and debilitating dysautonomia from other causes, and it can be very difficult to treat.

Have you had any autoimmune work up?

What can you tell us about your PN...how is started, what meds you take, testing done, etc.

Have you had your B12 tested? What about diabetes testing?

Thank you Keeping Faith, I made an appt for Primary Care Physician for tomorrow as a first step. Thank you

Hi Sally, right now its seem that my heart is being cooperative. What does an Integrative MD do?

They work with you as a team to heal the body. Prevention is a big part also. They know more about blood testing, different treatments, diet and of course supplements.

Thought this was interesting.

http://mayoresearch.mayo.edu/mayo/re...omic_nerve.cfm