Who else has Autonomic Neuropathy?

Posted by mstephen @mstephen, Mar 25, 2018

The Mayo Clinic in Phoenix diagnosed me with Autonomic Neuropathy in 2014. I don't see any reference to that form in any of the information or discussions. I know it effect's my balance, body temperature variance and possibly thinking. Any one have this diagnosis? Seems to be worsening as I age.

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Profile picture for gregoria @gregoria

Hi, I have laso been suffering a lot , my sfn started in legs and progressed to hands, I have erythromelalgia , digestive disconfort, pain, extreme fatigue, and lately my salivary glands are also malfunctioning, I feel extra salivation all the time and its a little bit and I have to swallow fast all the time to avoid drooling. Anybody has this wierd sensation??? I Will be having some tests , sudoscan I guess and tilt table, last time they all turned out fine,I all started in 2019, anybody having problems with saliva?? My fatigue IS also increasing, I feel lousy.

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I have gag reflex problems, active all the time. Have to brush my teeth dry, leaning far forward. A pain inn the neck but better then a continous gag. Live with problems individually.

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Autonomic neuropathy is also known as dysautonomia. The most common type of dysautonomia, such that there may have been more research and funding to identify it, is Postural Orthostatic Tachycardia Syndrome (POTS), but that does not encompass all of the different types of dysautonomia and symptoms that may go along with your personal diagnosis. Your doctor should have hopefully provided some support group information after your testing and diagnosis along with a symptom management plan.

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Hello all!
I was diagnosed with diabetic autonomic neuropathy when my toes had to be amputated approximately 2 years ago.
For that time my symptoms were tolerable, and I did not pay much attention but like 2 months ago the symptoms
have been escalating to the point of unbearable.
Now I experiment an extreme pain in my whole body from head to toe.
I can barely walk or stand up for only 15 minutes at a time and have reduced cognitive function.
Everything hurts even when wearing clothing.
I have no appetite and when I eat I can not digest food properly due to pain in the stomach muscles.
Other symtoms include: Bladder control, tremors. difficulty breathing, feeling cold all the time, Irregular heartbeats, fainting, loss of vision, electric zaps in the brain, permanent headache and a few more.

I ask this community what supplements or medications that can help at least with the autonomic pain?
Thank you all!

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Profile picture for hemaro @hemaro

Hello all!
I was diagnosed with diabetic autonomic neuropathy when my toes had to be amputated approximately 2 years ago.
For that time my symptoms were tolerable, and I did not pay much attention but like 2 months ago the symptoms
have been escalating to the point of unbearable.
Now I experiment an extreme pain in my whole body from head to toe.
I can barely walk or stand up for only 15 minutes at a time and have reduced cognitive function.
Everything hurts even when wearing clothing.
I have no appetite and when I eat I can not digest food properly due to pain in the stomach muscles.
Other symtoms include: Bladder control, tremors. difficulty breathing, feeling cold all the time, Irregular heartbeats, fainting, loss of vision, electric zaps in the brain, permanent headache and a few more.

I ask this community what supplements or medications that can help at least with the autonomic pain?
Thank you all!

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I wish I could help but I can’t even help myself.

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Profile picture for jager5210 @jager5210

Hi Swartzki,

So sorry to hear about your situation. Sadly, I can offer no help. However, you just described my symptom list. Fortunately, I'm retired but this disorder has recently cost me my marriage. My wife was 10 years younger and quite active. I devolved into a complaining, not for sympathy but just to let her know why I was unable to do the things we used to enjoy, miserable person. I am somewhat relieved we divorced because making her unhappy just put more pressure on me. To make matters worse, my beloved Boxer is a 3.5-year post-cancer survivor who is beginning to fade.

How did you get your diagnosis? I have all your symptoms which I have reported to a large number of doctors in various specialty areas but I just get blank stares back. A couple of doctors, one an Internist and another a rheumatologist, gave me lectures on what pain is like and that it doesn't move around from joint to ligament to muscle to bone as I reported.

I have a bit of a dilemma with my neurologist. I was referred to him by a primary care doctor who I saw for 18-20 years. (I've sort of disclosed this history before so I'm sorry I'm repeating it but the backdrop is important in this evolving drama.) 20 years ago, my symptoms began with partial paralysis of my face while doing my job. Symptoms spread down my body over the next few weeks as I recall although I've forgotten the detail. The worst pain settled in my tailbone making sleep or sitting impossible. I saw an orthopedic doc I had self-referred to a year earlier for my first ever back pain. At the time, I was a daily runner and an avid tennis, racketball and handball player. I was in good shape, ate well, and I've never been over my high school weight. The ortho doc referred me to a rheumatologist who diagnosed me with chronic pain and put me on Neurontin and Flexeril. I was able to sleep some at nights but the impact of this pain devastated my professional and personal life. I continued work for 8 years before retiring early due to the pain and fatigue from the medications. I resolved that when I was better rested and had the energy to tackle my pain issues anew I would work to find a way off of my meds.

Upon retirement, I slowly cut back on my meds taking lots of Ibruprofen, using meditation and different PT exercises. However, what I mistook for cold feet at night, requiring layers of blankets and socks, even in summer, gradually revealed itself as pain spreading up my legs. My primary care doc urged me to up my dosage of meds again but I had been having so much stomach and intestinal tract problems over the years, which I attributed to my meds, that I refused. I began searching the Internet for a better understanding of my issues thinking that my current neuropathy and long-standing gut issues were related to long-term Neurontin and Flexeril use. This search intersected with the law-suits regarding Levaquin. I had taken several rounds of Levaquin. I read that it was a serious drug and should only be prescribed if one had something serious like Anthrax, even though it's prescribed much more liberally than this. I was furious that I had never been informed of the possible side effects (there is a long & interesting history of how Levaquin's side effects were withheld from doctors and public but that's another story of big money corruption). Anyway, I did a couple of foolish things. The first was that I completed an online review of my primary care doctor and accused him of being motivated by incentives from big pharma as opposed to the well-being of his patients (Levaquin was not his 1st or 2nd bad call). The second was that I told a concierge doc who happened to be a friend of my primary care doc, that I had signed onto an online suit against JNJ claiming I had neuropathy stemming from Levaquin.

I never spoke with my primary care doc whom I'd seen for 20 years or so again. I do recall seeing an 'oh,oh' look of concern on my concierge doc's face when I mentioned the law-suit. I suppose he might have thought my intention in seeing him was to exploit our friendship so he would support me in my law-suit. This was a class-action suit. I made the cut but probably talked myself out of it when I told the legal aide my primary care doc told me he lost my records around the time of the initial onset of my symptoms. Records indicating prescriptions for Levaquin were still available but I was already on meds at this time, so it was impossible to determine cause and effect.

Anyway, my neurologist whom I was referred to by the primary doc whom I accused of being in bed with big pharma has done questionable things for the last 4 years which poses a dilemma for me in that I'm not sure what I should do. (Hint... this is where the board chimes in) When I initially saw him, he did an in-office conduction test and ruled out large fiber neuropathy. He said that a biopsy would be necessary to diagnose small fiber neuropathy but confirming this would not make a difference in treatment. He recommended Neurontin, Lyrica and Cymbalta, the typical salve for PN. I told him no thanks, I would stay with my reduced dosage of Neurontin and Flexeril and their known side effects while trying to find dietary explanations for the wide-ranging symptoms which varied in intensity.

The neurologist also did some blood work which found I had 10 times the normal level of B6 which can cause PN. I told him repeatedly that my symptoms began 15 years earlier and that the re-emergence of the pins and needles, burning flesh symptoms worsened when I began to reduce my meds 4 years before I saw him, not when I began to take a multi-B complex which was a year before seeing him. I had gone to an expensive holistic practice in Atlanta because of not getting any relief from gastroenterologists for my worsening stomach and intestinal tract distress. They told me I had an intestinal parasite, intestinal bacteria, and virtually no B vitamins. As an aside, what I suspect is going on is that my 'leaky gut' does not allow for the absorption of vitamins and nutrients contributing to some of my health issues like osteopenia which I should not have because of my healthy diet and lifelong rigorous workouts.

So I stopped the supplement, returned to see him about a year later and my B6 was still about 5 Xs normal. I was not taking any supplement with B6. He dismissed me with don't take any B6. He was basically calling me a liar, indicating I was self-sabotaging my health, (what, for the class-action suit?) or that I had Munchausen syndrome. I left in despair not knowing what to do. I kept experimenting with diet because something seemed to make the symptoms worse and then lessen. Anyway, last spring, my symptoms were so serious that I suggested that we proceed with a biopsy because I began to doubt whether my neurologist believed that I had small fiber neuropathy. I felt if tests confirmed what he said he thought I had, then he might explore something beyond Lyrica and Cymbalta. Test results did confirm the SFN diagnosis. Unfortunately, the results were not faxed in until after my appointment was over and I was standing in the checkout line in his office, an open area. The doctor hurries up and tells me it's SFN. I ask what the significance is as I don't recall him telling me before and I never found it in my google searches. He told me it is the worse kind and gave me some extended-release Neurontin. Again, this was an open area, my appointment time had passed, and so I did not get to ask him any additional questions.

After trying the medication for a few days, I felt very bad. It felt like my chest was being crushed and I was depressed. A pharmacy assistant told me that extended-release meds often result in different side effects. I used My Chart to communicate with my doctor's office. I was only allowed a few characters to ask my questions. I ended up sending 5 messages because I had a lot of questions. I don't recall all of them, but one was why he seemed so surprised to find I had SFN when he told me he believed my symptom report from 3 years or so ago. Another was why he was recommending a higher dosage of Neurontin when I had already expressed concerns related to dementia and this drug. I also wanted to know why the more expensive extended-release was recommended instead of around the clock use of Neurontin since I was not working and I could easily do this?

This led to his nurse or PA calling me at 8:30 in the morning after one of my bad nights where I did not fall asleep until about 6 in the morning. She sounded flippant (2nd experienece like this I had with her but then again, I was half-asleep). She told me that the doctor did not have time to read notes but that he could see me in 5 months.

This led me to writing WellStar administrative offices suggesting they increase the number of characters allowed in communicating with a doctor. A Ph.D in WellStar called me and I explained the situation. He said the head of their neurology department would call me to help solve my problem. The Department head did call and asked if I wanted to go to Mayo, have an email Mayo consult or go to Emory which advertises they have a multi-disciplinary team to address PN. I have a Boxer that has lived 3 years longer than expected after amputation of his front leg for cancer and I could not leave him. My wife worked so I took the email consult on the condition that I be allowed to gather reports from other doctors from other disciplines I had seen over the years. They agreed but sent my neurologist's reports to Mayo before I had gotten any other information to them.

My neurologist got his MD from Duke and his residency at Harvard. Of course Mayo did not fault his conclusions based on his testing and notes. This was a huge waste of time. The only thing that might have made a difference would have been reports from other doctors. Mayo did say that I may have Fibromyalgia.

The neurologist's office contacted me and asked if I wanted to come in that week instead of waiting 5 months. I told them I had already made an appointment at Emory. (Sorry for those of you reading this and realizing I've posted this account previously). I saw this Ukranian neurologist at Emory. In attendance was a resident from India and a high school girl getting a leg up. They were doing the needle prick test on my feet and legs when I mentioned Dr. Perlmutter, a neurologist on PBS & the Internet who has theories about 'leaky gut' and SFN. The Ukranian doctor stood up, looked me in the eye and said; "Why don't you just go home and die". Exact words I swear. Also; "Why don't you just make an appointment with Dr. Google." She dismissed the resident and high school girl and told me there was nothing she could do. She was quite cold and made my case seem quite hopeless. She offered no reasoning for her conclusion.

So I went back to my local neurologist out of desperation. I related my Emory experience and he said he was not surprised as if this is typical of what people report. He related that he could still get me an appointment at Mayo. This was the last time I saw him. I returned home and finally found someone to take of my dog so I could make the Mayo appointment. I notified his office, several months ago but never heard from him. Perhaps he was waiting until I was scheduled to see him in November but I had to reschedule and missed it. I also had reservations about seeing him again because I think he lies to me. This doctor is very personable one on one. I like him. He seems to be on my side. But maybe he is protecting the doctor who referred me to him and who may have prescribed Levaquin prior to the onset of all my symptoms. Maybe by indicating that he thought my SFN was due to me taking high levels of B6 protects the referring doctor by ruling out Levaquin as a possible cause.

This neurologist also recommended the trio of drugs already mentioned but after my Emory trip he said he knew they were ineffective. In four years he has not told me what to expect regarding symptoms or disease progression. He indicated that my blurring eyes and burning inner ears were not typical and doing so in a way that I interpreted him to mean I was feigning the symptoms or mistaken. I frequently mentioned my gut issues but not a peep from him in 4 years.

I went to a new primary care physician a few weeks ago who said he read my file and read my neurologist's report that indicated my SFN was due to high levels of B6 and stress. Maybe this is why the Emory neurologist told me to go home and die. Why would the neurologist put this in my file which I cannot see or question but doctors whom I depend on for treatment read? I explained several times that my SFN symptoms started in 4/99. This information should be in numerous doctor's reports if he was really interested in making a diagnosis. As for his diagnosis that the varying intensity of my symptoms is due to stress, I find this negligent, sloppy, and wrong. I am a psychologist. The only doctor in my entire life who has asked me about stress was my heart doctor and he just asked if there was any stressful event in my life preceding my attack. But this is not a formal assessment by any means. All the other doctors I've seen have always been in too much of a hurry to ask open ended questions. My neurologist never asked this question but he put it in his notes to round out his explanation for my reported symptoms. If other doctors read this and think that I am an attention-seeking, self-injuring patient interested in monetary damages from big pharma who has been openly critical of a doctor whom they all regard as a friend, then I'm screwed.

Thus, my question to the group is, should I trust this doctor? In 4 years he has not told me one thing about SFN. He told me in my initial visit he believed my reportage of symptoms and suspected I had SFN but he never suggested anything beyond Neurontin, Lyrica and Cymbalta. He believed my high level of B6 was the explanation of my PN despite me repeatedly telling him that my records would show this was not the case. His notes probably cost me an arduous drive and a copay as well as the affront by the Emory doctor.

My apologies for repeatedly posting parts of my frustration and history before. In a way, this is a bit cathartic in that my experience with doctors has gone down-hill since I began to ween myself from my meds and look for other explanations for 20 years of pain.

As a psychologist, I try to keep my difficulties in perspective, because regardless of how costly my health issues have been to my peronsal and professional life, I am blessed because I do not have monetary worries nor do I have to work with this challenge like Mr. Swartski. I'm also aware of how many kids have it so much worse right from day 1 on this planet.

Lastly, I thank this board for bringing me in contact with other persons like Mr. Swartski. His list of symptoms covers many of mine which is at least comforting in that I have not been able to get a single doc to look at my issues in a comprehensive manner. I wish I had something to offer you, Mr. Swartski other than keep trying as there are many knowledgeable posters on this board.

If anyone has any ideas about what I should do with my relationship with my neurologist who is personable but who has not given me any information about this disorder, I would be appreciative. Based on what he put in his notes about me, is he a friend or foe? I did send his office the link of the Harvard professor who is in the forefront of research in PN and his staff replied several weeks later that they could not open the link (this may be a policy issue) but that if I could let them know what tests she recommends that my doctor has not done, then we could talk about it. Why am I paying a copay? I'm like the rest of you, seeking something that is probably just not there but it would be nice to know if this is actually the case or whether I'm just asking the wrong people. Obviously I screwed up in being negative towards a doctor and joining a class action suit but 20 years is a lot of pain.

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@jager5210 , I too have PN, Had a simple test (about 3 times) consisting of nothing more than pressing (very hard) 2 metal-pronged implement into the flesh on both sides of my shin-bone. I've no clue how this works...pain level? response? But each test was the same, the outcome was the same: you have Peripheral Neuropathy, or, we concur with the previous outcome. Whoopee. And since I've had a very bad reaction to Gabapentin, thatg was ruled out, and I've been taking Cymbalta for an eternity, my only advised solution was to take B12 (not a multi B). This seems to be (very) familial: my Dad's pain level was never addressed at all, but he went so far as to say 'no more visits to any cold temperatures,' including offspring in IL and CT. He also built a wooden contraption for under the covers, at the foot of his bed, to lift the bedding, because the contact made the pain worsen. My sister went thru an amazing journey of being passed from one specialist to another for a period of seven years before she too had the 'prong test' as I call it. Naturally, someone finally saw the result in print, and told her what the pain was.
I am the oddball in the family, since I have Reynaud's, as well. Just try explaining that your feet are blazing hot, it feels like you have small rock shards inside your shoes, yet the top side of each foot is freezing cold and discolored. Geat fun. I do know that the B12 is working, because when I ran out accidentally, the misery was back in 2 or 3 days! Perhaps you might consider dropping the multi-B, and switching to B12. I take 1000 units thrice daily, giving me a very over-dose blood leval, by all doctors here in CT have dealt with both of these foot conditions (my doctors in FL never never never allowed that I might have Reynaud's) and since B12 is quickly excreted, they just note the results and write it off as understood.
I'd find another Neurologist, if I were you. I had Parkinson's non-motor symptoms as well as tremors since grammar school, each popping up, then fading away, yet during my 20-year relationship with a single neurologist, he refused to address the tremors until I had a DAT scan. He was trying to prove to me that I didn't have Parkinson's but the test results proved the opposite! Then being shunted off to a Movement-Disorder Neurologist, I was told "I don't believe that you have Parkinson's, and I doubt seriously that you've actually had any seizures" totally disregarding that diagnosis on three trips to an ER! Bad doctors? No, I believe these folks have tunnel vision. They ignore what is outside of the norm of their sub-specialty until you give them proof that is undeniable...but that first M-D Neurologist? That was totally out of line, so I found someone new twice....but to no avail. So, now I'm being seen by 3 different Neurologists and one Neurologist, plus about 9 more for various symptoms and disorders.
I guess it all boils down to being our own researchers and advocates. After all, it's OUR health.
Take care and keep on trucking. 🙂 :\

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Profile picture for sharon1943 @sharon1943

I have gag reflex problems, active all the time. Have to brush my teeth dry, leaning far forward. A pain inn the neck but better then a continous gag. Live with problems individually.

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@sharon1943 Me too. Got a swallow test, and a referral to an ENT has me waiting in hope of a cure/answer/alleviation.

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In reply to @mstephan , What do you mean when you say 'my temperature'.....I'm trying to figure out how to say this to a doctor! I don't mean my temp is 98.6, I mean Look at my skin! I get goosebumps on my skin and feel frozen to the bone regardless of the weather or temp in the room, and just as suddenly I'm sweating enough for everone to see beads of moisture all over. Is this what you have?
Thanks in advance for your reply.

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In reply to @mstephen, Oh, great! I tried to reply to @mstephen but I typed @mstephan instead. Okay, I'm going to confuse that person, but I cannot undo a sent reply. And I'm too sleepy to retype. I'll try again later.

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