Autonomic Nervous System Testing Creating Central Balance Overview of the Autonomic Nervous System Our nervous system is comprised of many different components. Some portions help us think, others give us control our emotions while other segments while other portions of our brain manage the movement and balance of our body. Control of the Autonomic nervous System (ANS) arises from the hypothalamus (a very evolutionarily primitive part of the brain) and the spinal cord. Simply put, the ANS essentially coordinates the function of every organ in the human body. Additionally, the ANS has 2 components known as the Sympathetic (S) and Parasympathetic arms (P). Think of these as a right and left hand that work together in unison. In the intestine for instance, when one contracts the intestine to push contents further down stream, the other relaxes area of the intestine to allow material to freely flow past. Research has demonstrated for many years that ANS balance between the Sympathetic and Parasympathetic arms is required for the maintenance of normal organ function and
overall good health. ANS imbalance tends to destabilize a patient s response to therapy and disease and over time lead to overt symptoms. What Symptoms Does Autonomic Nervous System Imbalance Cause Many people who feel normal live with the subtle effects of ANS imbalance while many others have severe ANS imbalance to such a degree that it causes significant symptoms on a daily basis. Common symptoms associated with ANS imbalance are: Lightheadedness Upon Standing Rapid Heart Rate Sleep Disturbances Frequent Urination, Day or Night Urinary Dribbling Abdominal Bloating Rapid Fullness with Meals Frequent Nausea Excessive Sensitivity to Light Erectile Dysfunction Inability to Ejaculate Sweating after Meals Flushing of the Skin Constipation Dry Mouth Heart Burn What Triggers Autonomic Imbalance? This is a difficult question to answer but my experience with working with patients points to 3 distinct groups of persons affected by generalized autonomic dysfunction. One group has had some of these symptoms since childhood and cannot recall not every experiencing their symptoms. The cause of this autonomic disturbance is difficult to understand is probably has a wide variety of triggers of imbalance. The second group can specifically describe a significantly stressful physical event that seemed to trigger their symptoms. Many women will tell me that childbirth caused their autonomic symptoms to begin almost overnight. Others will describe symptoms starting after a major surgery such as brain biopsy or cardiac bypass. Scientific data suggesting that a physically traumatic event can trigger autonomic imbalance is lacking but the pattern I notice among my own patients is quite apparent. The third group is by far the most common of all the patients I see and this group seems to have a slower onset of symptoms over a few to several years. I believe this groups autonomic imbalance is due to excessive carbohydrate consumption. I am uncertain if it is due to an excess of processed carbohydrates (which lead to more dramatic fluctuations of insulin levels and other hormones) or all carbohydrates (processed and natural) in general. Why Monitor for Autonomic Nervous System Imbalance? ANS imbalance does not happen over night; it occurs slowly over time. After a prolonged period, the imbalance leads to organ dysfunction thereby resulting in symptoms and possible permanent damage of the ANS itself. ANS dysfunction often precedes the symptoms associated with a variety of diseases. It can dramatically affect a person s quality of life (just ask someone who wakes up 3-6
times at night to urinate) and can reduce an individual s lifespan. ANS monitoring allows clinicians to identify an individual s unique physiologic differences, and more precisely monitor their response to disease and therapy. Diagnosis of Autonomic Nervous System Imbalance Research into the anatomy, function and clinical importance of the NAS has been ongoing for several decades but only recently has the science advanced enough to allow clinicians to diagnose and treat ANS imbalances. Treatments are available that can restore ANS balance, improve symptoms and ultimately lead to the discontinuation of one or several different medications being used to manage some of the symptoms listed above. We are now incorporating a new FDA-approved, non-invasive method called spectral analysis to digitally monitor both branches of the ANS. Prior to spectral analysis, cardiologist employed tilt-table testing which has been shown to be less precise than spectral analysis. Information about spectral analysis can be found at http://www.anshrv.com. In my opinion, spectral analysis has provided me with the most powerful tool to understand a patient s symptoms and to monitor treatment of the underlying cause as compared to the more common prescription of medications that simply mask the symptoms. ANS imbalance is a major contributor of symptoms is a wide variety of disorders such as: HIV Disease High Blood Pressure Diabetes Mellitus Multiple Sclerosis Sleep Disorders Post Heart Attack Heart Failure Coronary Artery Disease Abnormal Heart Rhythm Mitral Valve Prolapse Asthma COPD Menopausal Symptoms Hypothyroidism Depression Bipolar Disease ADD/ADHD PTSD Anxiety Morbid Obesity Neurological Disorders Relationship Between Insulin Resistance and Autonomic Nervous System Imbalance There is growing evidence that insulin resistance may not just be the effect of individuals being over weight as has been proposed. Unlike our pre-modern lifestyle, it is theorized that multiple aspects of our modern lifestyle such as increased carbohydrate intake, decreased physical activity and obesity are contributing to autonomic imbalance and insulin resistance. It is not fully understood if autonomic imbalance ultimately is the trigger for insulin resistance and its subsequently hazardous physical impact, but scientists believe there is a significant amount of bidirectional influence between the Autonomic Nervous System and the mechanisms of insulin resistance.
Some studies in rabbits seem to suggest that Insulin resistance and the subsequent autonomic dysfunction are an initial result of toxicity of the brain by carbohydrates. Combined this with the fact that the literature also suggests that our carbohydrate intake, especially processed carbohydrates, is the primary cause of many disorders of Insulin Resistance such as Hypertension, Diabetes Mellitus II, Sleep Apnea and coronary artery disease. Thus, if Insulin Resistance begins pathophysiologically as an autonomic disorder and Insulin Resistance is caused primarily a result of excessive carbohydrate intake, then it is quite possible that excessive carbohydrates may be the cause of many common autonomic disturbances. Following this theory, I have been pushing my patients with autonomic symptoms to reduce their carbohydrate intake to less than 125 grams per day (approximately 25% of total daily caloric intake). I chose 25% because a great deal of the scientific studies suggest most if not all disorders associated with Insulin Resistance will be greatly reduced if not completely put into remission with this level of carbohydrate intake. And on a practical note, I find this to be very true in my clinical practice. I have many patients whose Diabetes, Hypertension, Fatty Liver Disease, Acne and Sleep Apnea are now a thing of the past as long as they keep their carbohydrate intake down.
Likewise, their autonomic symptoms (heart burn, fatigue, urinary frequency/urgency, persistent hunger, lightheadedness) will also go into remission. Treatment of Autonomic Nervous System Imbalance Treatment involves determining the type and degree of ANS imbalance, a reduction n carbohydrates to less than 125 grams per day and the occasional utilization of certain medications to restore the balance at the level of the hypothalamus. For some individuals, treatment required for only 9-12 months and can be tapered off any medications, if necessary, leaving the ANS in balance. There are some individuals with rather severe symptoms who seem to require a longer course of low-dose medication to maintain their ANS balance. Fortunately, many of the medications used to re-establish ANS balance are very well tolerated and inexpensive.