Your autonomic nervous system (ANS) controls many critical bodily functions. It is responsible for blood pressure, breathing, heart rate, digestion, and other functions. Autonomic system dysregulation can cause a condition called autonomic neuropathy. When autonomic neuropathy damages nerves, it can have systemwide effects.

Many chronic conditions can cause autonomic neuropathy. Correctly identifying autonomic neuropathy through an autonomic assessment can help medical professionals determine the source of the nerve damage. It can help members of a treatment team find the location of the damage, assess its severity, and develop an effective treatment plan.

This article will explore how an autonomic assessment can lead to better treatment outcomes for those living with chronic health conditions. You will learn:

  • What happens during an autonomic assessment
  • The role an autonomic assessment may play in diagnosing chronic conditions
  • What to expect after undergoing an autonomic assessment
  • Where to find an autonomic assessment and holistic health support

If you live with symptoms that disrupt your functioning, an autonomic assessment may help you get to the root of the problem and find effective treatment. Contact The Hartman Center specialists to learn more about autonomic assessment or to schedule an appointment.

What is Autonomic Assessment?

Autonomic assessment is a series of tests used to identify a condition called autonomic neuropathy. The symptoms of autonomic neuropathy can present in different ways depending on what part of the nervous system is damaged.

Here are some of the symptoms associated with autonomic neuropathy.

Gastrointestinal symptoms

People may experience GI and digestive symptoms related to autonomic neuropathy, including:

  • Constipation
  • Heartburn
  • Difficulty swallowing
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhea
  • Feeling too full after eating small amounts of food
  • Frequent bloating in the abdomen

Damaged nerves affecting the stomach and gut can lead to symptoms that significantly affect a person’s daily life.

Urinary symptoms

Autonomic neuropathy in the nerves controlling the bladder may result in urinary issues, including:

  • Frequent urination
  • Difficulty with urination
  • Leaking urine

An autonomic assessment can identify the damage and guide the treatment team’s approach to treating these symptoms.

Sexual symptoms

Autonomic neuropathy may cause sexual symptoms, including:

  • Vaginal dryness
  • Erectile dysfunction
  • Changes in libido

An autonomic assessment can determine if autonomic neuropathy is contributing to these symptoms.

Respiratory and cardiovascular symptoms

Damage to the nerves related to the cardiovascular and respiratory symptoms may cause symptoms like:

  • Fainting
  • Shortness of breath with activity
  • Weakness
  • Elevated heart rate
  • Dizziness

An autonomic assessment can help to determine the cause of these symptoms and guide treatment.

Other symptoms

Autonomic neuropathy can affect many areas of the body. Other disruptive symptoms of autonomic neuropathy include:

  • Dizziness upon standing
  • Fainting because of low blood pressure
  • Exercise intolerance (heart rate remains stable instead of rising during physical activity)
  • Delayed pupil reactions (the pupil does not adjust quickly to changes in light)
  • Lack of physical cues related to low blood sugar
  • Excessive or insufficient sweating

There are several tests a practitioner may use to assess people for autonomic neuropathy. It is critical to talk to a medical professional about new or worsening symptoms you are experiencing.

The Role of Autonomic Assessment in Diagnosing Chronic Conditions

Several chronic conditions can cause autonomic neuropathy. Some of these include:

  • Autoimmune conditions
  • Diabetes
  • HIV
  • Other infections

Some people may experience symptoms of autonomic neuropathy without knowing what causes them. Symptoms may be vague, widespread, or varying.

Clinicians can sometimes struggle to determine the cause of symptoms from history or general physical examinations. In many cases, additional testing is required to rule out conditions and pinpoint the source of the person’s symptoms.

Autonomic assessment can help to identify the affected area of the body, allowing medical practitioners to gain a holistic view of a person’s condition. Practitioners can examine many aspects of a person’s health, including:

  • How posture changes affect heart rate and blood pressure
  • The function of nerves related to sweating
  • How breathing affects blood pressure and heart rate
  • Bladder function

Research suggests that performing an autonomic assessment can help medical professionals determine if a person’s symptoms are related to a life-threatening or benign condition. It may help practitioners make an earlier and more accurate diagnosis.

Medical practitioners may use autonomic assessment to develop more effective treatments for chronic conditions and to monitor progress throughout treatment.

What Happens During an Autonomic Assessment?

If you have new symptoms or symptoms that seem to be getting worse over time, consult with your medical practitioner right away. Your practitioner may suggest an autonomic assessment to help identify the root of your symptoms.

Your practitioner may ask you to refrain from consuming alcohol, caffeine, or tobacco products before undergoing an autonomic assessment. They may advise you to drink plenty of noncaffeinated beverages to ensure you are well-hydrated before the testing begins.

There are several tests that may be used to identify autonomic neuropathy. Here is an overview of what to expect during several of these tests.

Tilt table test

The tilt table test examines how changes in posture affect a person’s heart rate and blood pressure. During the test:

  • The participant lies on an adjustable table with a footrest.
  • The practitioner uses soft safety straps to secure the participant.
  • The practitioner attaches electrodes to the participant’s chest. They attach a blood pressure cuff to the participant’s arm and finger.
  • The participant lies in a flat position for about 7 minutes.
  • After this, the practitioner raises the table so the participant is in a near-standing position. The participant remains in this position for up to 10 minutes.
  • The practitioner monitors the participant’s blood pressure, heart rate, SoO2 oxygen saturation, and ETCO2 End Tidal Carbon Dioxide throughout the procedure.

The tilt table test provides a safe, non-invasive way to assess how posture changes impact a person’s heart rate and blood pressure. In some cases, a practitioner may need to administer fluids through an IV during the test.

Bladder ultrasound

This testing assesses nerve damage related to the bladder or urinary tract. The participant empties their bladder. Then, a practitioner uses an ultrasound transducer to evaluate the bladder. This test can help to determine how accurately someone can assess bladder fullness. It can also help practitioners assess and treat uncomfortable or disruptive urinary symptoms.

Thermoregulatory sweat test (TST)

The TST assesses the functioning of nerves responsible for the sweat response. During the test:

  • The practitioner applies a special powder to the participant’s skin
  • The participant spends time in a room that becomes more warm and humid as time goes on
  • The practitioner examines the powder, which changes color in response to sweat exposure

This test can determine if a person’s sweat response is within the expected range. It is a safe and non-invasive way to assess this autonomic function.

Deep breathing test and Valsalva maneuver

A deep breathing test and Valsalva maneuver test explore how a person’s blood pressure and heart rate respond to different breathing patterns.

In a deep breathing test, the participant breathes deeply for a minute while the practitioner measures heart rate and blood pressure.

During the Valsalva maneuver, participants breathe through a mouthpiece while the practitioner measures blood pressure and heart rate.

Both tests can provide insights into potential nerve damage related to the cardiovascular and respiratory systems.

Quantitative sudomotor axon relex test (QSART)

The QSART test explores nerve function related to sweating. Practitioners use electrodes and monitoring systems to evaluate how sweat glands respond to electrical stimulation.

The QSART may take up to an hour to complete. Participants typically tolerate this test well but may experience mild tingling or warmth in areas being examined.

A holistic health practitioner can accurately perform these and other types of tests to identify autonomic neuropathy. They will assess the data and explain the results to you. Understanding the roots of your symptoms can help you develop an effective treatment program and track your progress as time goes on.

What to Expect After an Autonomic Assessment

Your health practitioner will recommend the proper tests to assess your unique symptoms. Once testing is concluded, your practitioner will review the results with you. Then, you can work together to create a practical, effective treatment plan.

Your treatment plan may include holistic therapies, lifestyle changes, and medications. Your treatment team will guide you on how to manage your symptoms and address any conditions that may be causing them.

In the case your symptoms are part of a chronic health condition, your practitioner will recommend treatment or refer you to specialists to help you manage it.

Get an Autonomic Assessment

An autonomic assessment can provide information about what may be causing your disruptive symptoms. Identifying the cause of your symptoms may lead to effective, comprehensive treatment.

If you are interested in scheduling an autonomic assessment, reach out to the specialists at The Hartman Center. Contact our team to learn about our holistic approach to wellness or to schedule an appointment. We look forward to supporting your wellness journey.