Q: What is autonomic nervous system dysfunction?
A:Autonomic nervous system dysfunction is a complex and often misunderstood condition that can significantly affect a person’s quality of life.
Unlike cardiovascular diseases, it lacks specific diagnostic biomarkers, and unlike common infections, it often presents without an obvious underlying lesion. Learning how to regulate emotional stress, restore physiological balance, and support overall well-being may help patients gradually emerge from the “fog” that affects both mind and body.
Ms. Lin, a woman in her forties, had previously been diagnosed with autonomic nervous system dysfunction. She frequently experienced palpitations accompanied by gastroesophageal reflux disease (GERD). Her bowel habits were irregular, alternating between constipation and diarrhea. In addition, she suffered from fragmented sleep, often awakening during the night and finding it difficult to return to sleep. Over time, these symptoms substantially impaired her daytime work performance.
Following a comprehensive Traditional Chinese Medicine (TCM) assessment involving inspection, auscultation and olfaction, inquiry, and pulse examination, she was diagnosed with a pattern consistent with Heart Yin Deficiency accompanied by rebellious Stomach Qi, resulting in impaired digestive function. She was prescribed Tian Wang Bu Xin Dan 6 g, Xuan Fu Dai Zhe Shi Tang 7 g, and Biota Seed (Bai Zi Ren) 2 g. At follow-up one week later, she reported overall symptomatic improvement. The frequency of nocturnal awakenings had decreased, and symptoms such as belching had also improved. Although emotional fluctuations could still trigger occasional insomnia or palpitations, these symptoms were markedly less severe than before. She also became more willing to engage in social interactions and participate in daily activities.
Q: What happens when the body’s accelerator and brake become dysregulated?
A:Dysautonomia is an umbrella term encompassing a group of disorders that impair the normal function of the autonomic nervous system (ANS).
The ANS regulates involuntary physiological processes, including heart rate, blood pressure, thermoregulation, gastrointestinal motility, and respiratory function. When autonomic regulation becomes impaired, patients may develop a broad spectrum of symptoms, including chest pain, mood disturbances, syncope, fatigue, and dizziness.
Dysautonomia may be congenital or acquired. Although it can occur at any age, symptom onset most commonly occurs between 50 and 60 years of age. It is estimated that more than 70 million individuals worldwide are affected by some form of dysautonomia. Because of its heterogeneous clinical presentation and multisystem involvement, diagnosis can be challenging even for experienced clinicians.
The autonomic nervous system consists of two major components: the sympathetic nervous system and the parasympathetic nervous system.
Using a vehicle analogy, the sympathetic nervous system functions as the body’s accelerator. During periods of stress, such as rushing to catch a train, sympathetic activity increases, resulting in pupillary dilation to enhance vision, increased heart rate to support physical exertion, bronchodilation to improve oxygen intake, reduced gastrointestinal motility to conserve energy, and relaxation of the detrusor muscle to suppress the urge to urinate.
Once the train has been caught and the stressful event has passed, the parasympathetic nervous system becomes dominant. The pupils gradually constrict, heart rate slows, gastrointestinal activity resumes, appetite returns, and bladder contraction promotes urination.
When the balance between sympathetic and parasympathetic activity is disrupted, the condition is referred to as autonomic dysfunction.
Q: What are the common symptoms of autonomic nervous system dysfunction?
A:
Common manifestations include:
• Abnormal sweating (hyperhidrosis, hypohidrosis, or focal sweating abnormalities)
• Dry eyes or excessive tearing
• Migraine or recurrent headaches
• Marked fluctuations in body temperature or skin temperature
• Excessive salivation
• Mood instability and anxiety
• Visual disturbances, including blurred vision and impaired light adaptation
• Exercise intolerance due to impaired heart rate regulation
• Rhinorrhea
• Vertigo
• Balance impairment
• Syncope, particularly upon standing
• Nausea and vomiting
• Brain fog, memory impairment, and difficulty concentrating
• Tachycardia or bradycardia
• Abnormal pupillary size (miosis or mydriasis)
• Constipation or diarrhea
• Chronic fatigue
• Sexual dysfunction
• Chest pain or chest discomfort
• Urinary frequency or urinary incontinence
• Dyspnea
• Pale, cool, or clammy skin
• Palpitations
• Sleep disturbances
• Dysphagia
• Cardiac arrhythmias
• Increased sensitivity to sound or light
• Orthostatic dizziness
• Hypoglycemia
Q: What types of autonomic nervous system dysfunction are there?
A:Autonomic nervous system dysfunction can generally be classified into two major categories based on etiology.
The first is primary dysautonomia, in which the underlying cause is unknown or genetically determined. Individuals with affected first-degree relatives or siblings may have an increased risk of developing the condition.
The second is secondary dysautonomia, which develops as a consequence of other diseases or pathological processes. Common causes include multiple sclerosis, Parkinson’s disease, and Long COVID, among others.
To be continued in Part 2: Invisible Imbalance, Visible Symptoms: Navigating the Fog of Autonomic Nervous System Dysfunction.
Q: How does Traditional Chinese Medicine interpret autonomic nervous system dysfunction?
A:From the perspective of Traditional Chinese Medicine, autonomic nervous system dysfunction is closely associated with the physiological functions of the zang-fu organs.
The ancient medical classic Huangdi Neijing states:
“The Heart stores the Shen, the Liver stores the Hun, the Lung stores the Po, the Spleen stores the Yi, and the Kidney stores the Zhi.”
Therefore, dysfunction or deficiency of any of the zang-fu organs may influence emotional and mental well-being…