Diagnosing and Treating Dysautonomia

Dysautonomia includes medical conditions characterized by a dysfunction of the autonomic nervous system. The autonomic nervous system controls involuntary movements of the digestive system, as well as blood pressure, heart rate, and more. Symptoms of the condition can include pain, fatigue, weakness, gastrointestinal symptoms, dizziness, and syncope (passing out).

The effects of dysautonomia can be distressing, and the condition doesn't usually cause abnormalities in the physical examination or laboratory tests.  In general, it takes time to get a diagnosis of dysautonomia because other, more common conditions are typically considered first.

Risk factors for developing dysautonomia include diabetes, autoimmune disease, Parkinson's disease, endocrine disorders, and more. There is a rare familial type of dysautonomia as well.

Finding an effective treatment can also be challenging. It can take some time and a lot of patience from you and your healthcare provider to find the right combination of therapies to get your symptoms under acceptable control. 

28 years old man is exercising outdoors. He have a headache, and he is lying down and trying to relax
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Diagnosing Dysautonomia

The diagnosis of dysautonomia is based on the symptoms and medical history, a physical examination, and possibly diagnostic tests. You may have tests to assess positional changes in your blood pressure and heart rate, the function of your digestive system, and more.

Sometimes, the diagnosis is preceded by a diagnosis of other similar conditions that closely correlate with the symptoms and diagnostic findings.

For example:

These conditions are more common than dysautonomia. Sometimes, having more than one effect of a dysfunctional autonomic nervous system leads to a diagnosis of dysautonomia.

If you think you may have dysautonomia, discuss your concerns with your healthcare provider.

Treating Dysautonomia

You and your healthcare provider will need to take the prolonged trial-and-error approach as you begin using therapies to reduce your symptoms to a tolerable level.

Since the underlying cause of dysautonomia is not well understood, treatment is aimed at controlling symptoms and is not typically effective at curing the problem.

Non-Drug Therapies

Maintaining an adequate daily level of physical activity is important for people with dysautonomia. Regular physical activity helps stabilize the autonomic nervous system, and in the long run, makes symptoms less frequent, less severe, and of shorter duration.

Physical therapy and alternative treatments such as yoga, tai-chi, massage therapy, and stretching therapy have been reported to help as well.

Dietary Supplements: Supplements have not been shown to help prevent or reduce symptoms of dysautonomia.

Drug Therapies

Pharmaceutical treatment is sometimes prescribed for treating dysautonomia and associated symptoms.

Treatments include:

  • Tricyclic antidepressants such as Elavil, Norpramin, and Pamelor have been used, in low dosage, to treat several of the dysautonomia syndromes.
  • Selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Zoloft, and Paxil have also been used to treat these syndromes.
  • Anti-anxiety drugs such as Xanax and Ativan help to control symptoms of anxiety, especially in patients with panic disorder.
  • Anti-low blood pressure drugs such as Florinef help prevent the symptoms caused when the blood pressure drops upon sitting or standing (a condition called orthostatic hypotension), a prominent feature of vasovagal syncope and in POTS.
  • Non-steroidal anti-inflammatory drugs such as Advil and Aleve can help control the pains associated with dysautonomia.

The tricyclics and the SSRIs appear to do more than merely control depression that might accompany the dysautonomias. There is some evidence that they might help to "re-balance" the autonomic nervous systems in some patients.

A Word From Verywell

If you have dysautonomia, it's important for you to know that dysautonomia usually improves with time. Research is progressing to define the precise causes and mechanisms of these conditions and to devise effective treatments.

13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
  • Furlan R, Barbic F, Casella F, et al. Neural Autonomic Control In Orthostatic Intolerance.Respir Physiol Neurobiol. 2009 Oct;169 Suppl 1:S17-20.
  • Staud R. Autonomic Dysfunction In Fibromyalgia Syndrome: Postural Orthostatic Tachycardia. Curr Rheumatol Rep. 2008 Dec;10(6):463-6.

By Richard N. Fogoros, MD
Richard N. Fogoros, MD, is a retired professor of medicine and board-certified in internal medicine, clinical cardiology, and clinical electrophysiology.