Autonomic neuropathy refers to a group of symptoms, which take place whenever there is any damage to the nerves responsible to manage daily functions in a human body. These functions include heart rate, blood pressure, emptying of bladder and bowel, sweating and digestion. Autonomic neuropathy mainly involves damages to specific nerves responsible to carry information between the spinal cord and the brain. The, mainly reaches the blood vessels, heart, bladder, sweat glands, intestines, and pupils.(1)
Can Stress Cause Autonomic Neuropathy?
The autonomic nervous system is a prime neural pathway activated due to stress. Whenever individuals experience the situation of chronic stress, including any big depressive disorder, their sympathetic nervous system activates continuously without the counteraction of their parasympathetic nervous system in a normal way. Because of this, the immune system of such people with increase in pro-inflammatory cytokines levels.
Doctors have observed such inflammatory conditions in people suffering from depression. While searching for specific mechanism behind the contribution of depression due to The autonomic immune system, medical experts have found improved activity of indoleamine 2 as well as 3-dioxygenase because of pro-inflammatory cytokines have prime roles in it. The mentioned enzymes remain present in kynurenine pathway and they convert to kynurenine from tryptophan.
Elevated activity of the mentioned enzyme results in imbalances in the downstream metabolites of kynurenine. The imbalance may even induce neurotoxic variations in the brain and in turn, results in the formation of vulnerable glial-neuronal network to render the susceptibility of the brain towards depression.(3)
Other than this, whenever a person experiences uncontrolled or severe form of stress, his/her body ensures adrenomedullary EPI i.e. epinephrine releases. Later on, with the increase in stress levels, corticotropin-releasing factor present in the human body activates the sympathetic nervous system and leads to the release of adrenocortical steroids and adrenocorticotropic hormone. Stimulation of sympathetic nerves to muscles activates vasoconstriction and thereby, increases the resistance of peripheral vascular function. When the sympathetic pathway of one’s skin activates, it precipitates the flushing of the skin, perspiration or cold sweat. Because of this, palpitations, feelings of cold and warmth, nausea, tachycardia, diarrhea, abdominal pain, and constipation are consequences of an autonomic stress response.(4)
Autonomic Neuropathy Signs And Symptoms
Autonomic neuropathy signs and symptoms depend primarily on the affected nerves and they are as follows-
- Fainting and dizziness while standing, which mainly takes place because of a sudden drop in the blood pressure i.e. orthostatic hypertension
- Different types of urinary problems, like inconsistence urine, difficulty in starting of urination, difficulty to sense the full bladder and failure to empty the urinary bladder completely, along with urinary tract infections
- Sexual difficulties, like problems in obtaining erection i.e. erectile dysfunction and ejaculation problems in men, while low libido, difficulty to reach orgasm and vaginal dryness in women
- Difficulty in digestion of food, like appetite loss, feeling full even after having only two or three bites of food, constipation, diarrhea, nausea, abdominal bloating, difficulty in swallowing, vomiting, and heartburn, all of which take place because of changes in the digestive function
- Fail to recognize hypoglycemia i.e. low blood sugar due to the absence of warning signals, like becoming shaky
- Too little or too much sweating i.e. sweating abnormalities, which result in improper regulation of the body temperature
- Sluggish type of pupil reaction to cause difficulty in adjusting to the dark environment from light ones, while seeing properly while driving during the nighttime.
- Intolerance to physical exercise or even walking, which takes place mainly when you have same heart rate rather than adjusting to the respective high-intensity activity or physical workout level.(2)
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