What are the common causes of autonomic dysfunction?

From the Guidelines

Common causes of autonomic dysfunction include diabetes mellitus, Parkinson's disease, multiple system atrophy, autoimmune disorders, and amyloidosis, as well as medications, alcohol abuse, vitamin deficiencies, infections, and physical trauma, which can all impact morbidity, mortality, and quality of life. When evaluating patients with suspected autonomic dysfunction, it is essential to consider a broad range of potential causes, including diabetic screen, adrenal insufficiency, HIV, paraproteinemia, amyloidosis, and botulism, as well as chronic diseases such as Parkinson’s and other autoimmune disorders 1. Some key causes of autonomic dysfunction to consider include:

• Diabetes mellitus, which can cause resting tachycardia, exercise intolerance, orthostatic hypotension, constipation, gastroparesis, erectile dysfunction, sudomotor dysfunction, impaired neurovascular function, and hypoglycemic autonomic failure 1
• Parkinson's disease, which can disrupt autonomic function and lead to symptoms such as orthostatic hypotension and urinary problems
• Autoimmune disorders, such as Guillain-Barré syndrome, which can cause autonomic dysfunction
• Amyloidosis, which can cause autonomic dysfunction and other systemic symptoms
• Medications, such as antihypertensives, antidepressants, and chemotherapy agents, which can disrupt autonomic function
• Alcohol abuse, vitamin deficiencies (particularly B12), infections, and toxin exposure, which can all damage autonomic pathways
• Physical trauma, especially to the brain or spinal cord, which can damage autonomic pathways and lead to autonomic dysfunction
• Genetic disorders, such as familial dysautonomia and certain inherited neuropathies, which can cause autonomic dysfunction from birth
• Age-related degeneration of autonomic nerves, which is also a common cause of autonomic dysfunction. The autonomic nervous system controls involuntary bodily functions like heart rate, blood pressure, digestion, and temperature regulation, so dysfunction can manifest as orthostatic hypotension, gastrointestinal issues, urinary problems, sexual dysfunction, or abnormal sweating, all of which can significantly impact quality of life 1. Treatment depends on identifying and addressing the underlying cause while managing specific symptoms with appropriate medications and lifestyle modifications, with the goal of minimizing morbidity and mortality and improving quality of life 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Common Causes of Autonomic Dysfunction

Autonomic dysfunction can result from various factors, including:

• Primary autonomic disorders, such as multiple system atrophy (MSA) and idiopathic Parkinson's disease (IPD) 2
• Secondary autonomic disorders, resulting from traumatic, vascular, inflammatory, demyelinating, or neoplastic lesions involving the autonomic network 2, 3
• Orthostatic intolerance syndromes, including neurally mediated syncope, orthostatic hypotension, and postural tachycardia syndrome 4, 5
• Small fiber neuropathies, associated with autonomic failure, pain, or their combinations 4
• Diseases affecting the central nervous system, such as degeneration of the intermediolateral cell columns or damage to descending pathways 3
• Peripheral autonomic nervous system damage, including acute and subacute autonomic neuropathies or generalized peripheral neuropathy 3
• Neurodegenerative diseases, such as Parkinson's disease, multiple system atrophy, and dementia with Lewy bodies 6
• Secondary etiologies, including diabetes mellitus, amyloidosis, and immune-mediated illnesses 6

Specific Autonomic Syndromes

Specific autonomic syndromes that can cause autonomic dysfunction include:

• Diabetic neuropathy 4
• Primary hyperhidrosis 4
• Paroxysmal sympathetic hyperactivity 4
• Autonomic dysreflexia 4
• Neurogenic bladder and gastrointestinal motility disorders 4
• Postural tachycardia syndrome (PoTS) 5