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Autonomic neuropathy

Medically reviewed by Last updated on Jul 7, 2022.


Autonomic neuropathy occurs when there is damage to the nerves that control automatic body functions. It can affect blood pressure, temperature control, digestion, bladder function and even sexual function.

The nerve damage affects the messages sent between the brain and other organs and areas of the autonomic nervous system. These areas include the heart, blood vessels and sweat glands.

Diabetes is the most common cause of autonomic neuropathy. It can also be caused by other health conditions, viral or bacterial infections, or some medications. Symptoms and treatment vary based on which nerves are damaged.


Signs and symptoms of autonomic neuropathy depend on which nerves are damaged. They might include:

When to see a doctor

Seek medical care promptly if you begin having any of the signs and symptoms of autonomic neuropathy, particularly if you have diabetes that's poorly controlled.

If you have type 2 diabetes, the American Diabetes Association recommends annual autonomic neuropathy screening beginning when you receive your diagnosis. For people with type 1 diabetes, the association advises annual screening beginning five years after diagnosis.


Many health conditions can cause autonomic neuropathy. It can also be a side effect of treatments for other diseases, such as cancer. Some common causes of autonomic neuropathy include:

Risk factors

Factors that might increase your risk of autonomic neuropathy include:


Certain inherited diseases that put you at risk of developing autonomic neuropathy can't be prevented. But you can slow the onset or progression of symptoms by taking care of your health in general and managing your medical conditions.

To control diseases and conditions, follow your health care provider's advice on healthy living. That advice might include these recommendations:


Autonomic neuropathy is a possible complication of some diseases. The tests you'll need depend on your symptoms and risk factors for autonomic neuropathy.

When you have known risk factors for autonomic neuropathy

If you have diabetes or another condition that increases your risk of autonomic neuropathy and have symptoms of neuropathy, your health care provider will perform a physical exam and ask about your symptoms.

If you are undergoing cancer treatment with a drug known to cause nerve damage, your provider will check for signs of neuropathy.

When you don't have risk factors for autonomic neuropathy

If you have symptoms of autonomic neuropathy but no risk factors, the diagnosis can be more involved. Your health care provider will probably review your medical history, discuss your symptoms and do a physical exam.

Your provider might recommend tests to evaluate autonomic functions, including:


Treatment of autonomic neuropathy includes:

Digestive (gastrointestinal) symptoms

Your health care provider may recommend:

Urinary symptoms

Your health care provider may suggest:

Sexual dysfunction

For men with erectile dysfunction, health care providers might recommend:

For women with sexual symptoms, health care providers might recommend:

Heart rhythm and blood pressure symptoms

Autonomic neuropathy can cause heart rate and blood pressure problems. Your health care provider might prescribe:


If you sweat too much, your health care provider might prescribe a medication that decreases sweating. Glycopyrrolate (Cuvposa, Robinul, others) can decrease sweating. Side effects can include diarrhea, dry mouth, urinary retention, blurred vision, changes in heart rate, headache, loss of taste and drowsiness. Glycopyrrolate can also increase the risk of heat-related illness, such as heatstroke, from a reduced ability to sweat.

Self care

Alternative medicine

Several alternative medicine treatments might help people with autonomic neuropathy. Talk with your health care provider about any treatments you want to try. This can help make sure that they won't interfere with your medical treatments or be harmful.

Alpha-lipoic acid

Research suggests this antioxidant might improve the measures of autonomic nerve function. More study is needed.


This therapy involves placing thin needles in specific points in the body. It might help treat slow stomach emptying and erectile dysfunction. More studies are needed.

Transcutaneous electrical nerve stimulation

This therapy sends low-energy electrical waves through electrodes placed on the skin. Some studies have found that it might help ease pain associated with diabetic neuropathy.

Coping and support

Living with a chronic condition presents daily challenges. Here are some suggestions to help you cope:

Preparing for your appointment

First, you'll probably see your primary care provider. If you have diabetes, you might see your diabetes doctor (endocrinologist). However, you might be referred to a doctor specializing in nerve disorders (neurologist).

You might see other specialists, depending on the part of your body affected by neuropathy, such as a cardiologist for blood pressure or heart rate problems or a gastroenterologist for digestive difficulties.

Here are some tips to help you prepare for your appointment.

What you can do

Ask if you should do anything before your appointment, such as fasting before certain tests. Make a list of:

Take a friend or family member with you to help you remember the information you receive and to learn how to support you. For example, if you pass out from low blood pressure, people around you need to know what to do.

Questions to ask your health care provider about autonomic neuropathy include:

Don't hesitate to ask other questions.

What to expect from your doctor

Your health care provider is likely to ask you questions, such as:

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