to 20 million people in the United States over age 40 have some type
of peripheral neuropathy. In
many, the impairment is predominantly in small nerve fibers, and the
clinical presentation consists of pain, burning, tingling, and
numbness in a length-dependent or stocking-glove distribution.
Autonomic neuropathy or small fiber neuropathy is
caused by damage to the smallest nerves that supply sensory
feelings, help regulate your heart rate, blood pressure,
perspiration and digestion, among other functions. Neuropathy means
damage to your nerves. Autonomic small fiber neuropathy is are
often due to diabetes, autoimmune diseases, infections or toxic
conditions. Your nerves transmit messages between your brain and
your organs. Damage to your autonomic nerves results in faulty
communication with your brain and the affected parts of the
body .Your nerves are composed of many types of fibers and the
smallest fiber is affected by this neuropathy so it is called
small fiber neuropathy. The condition is fully and easily
Signs and symptoms are variable on which nerves are affected but
can range from dizziness to trouble with digestion and urination to
sexual difficulties. Treatment involves addressing the underlying
cause, if possible, and managing the signs and symptoms.
Signs and symptoms of autonomic neuropathy depend on which parts
of your autonomic nervous system are most affected. They may
Severe drop in blood pressure on standing: This is caused when
the heart rate fails to accelerate on standing up.
- A drop in blood pressure on standing
(orthostatic hypotension), which can cause dizziness and
- Trouble with urination, including
diminished sensation, overflow incontinence and inability to
empty your bladder completely, which can lead to urinary tract
- Male impotence or weak erectile
- Numbness in toes very common and
may be the earliest and only symptom, feet or genitals,
abdomen. Tendency to trip easily. Burning sensation on skin.
Difficulty in judging accelerator position while driving.
- Trouble focusing eyes.
- Vaginal dryness and difficulties with
arousal and orgasm in women
- Difficulty digesting food (gastroparesis),
which can cause diarrhea, constipation, abdominal bloating,
nausea, vomiting, heartburn, feeling full after eating little
and loss of appetite
- Cardiovascular problems, such as heart
- Heat intolerance, especially during
exercise, and usually decreased sweating or increase sweating.
- Sluggish pupil reaction to light and
- Exercise intolerance, which causes your
heart rate to remain unchanged instead of increasing and
decreasing in response to your activity level
- Lack of the usual warning signs of low
blood sugar (hypoglycemia), which include shakiness, sweating
Signs to remember you may not get all of these signs.
- Urinary incontinence
- Urinary tract infection (UTI)
- Erectile dysfunction
- Erectile dysfunction in diabetes: Keys to prevention
- Vaginal dryness
- Diabetic gastroparesis
- Cardiovascular disease 101: Know your heart and blood
- Numbness feeling in toes, fingers or abdomen. Burning
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