School of Medicine and Health Sciences Poster Presentations

The Use of Lifestyle Modification to Manage Dysautonomia: A Case Series

Document Type

Poster

Abstract Category

Clinical Specialties

Keywords

Dysautonomia, lifestyle modification, anti-inflammatory, Elhers Danlos Syndrome, autonomic nervous system

Publication Date

Spring 5-1-2019

Abstract

Background: Dysautonomia is not a single disease process, but rather a constellation of symptoms that together represent dysfunction of the autonomic nervous system. Certain connective tissue disorders, such as Ehlers Danlos Syndrome hypermobility type (EDs-ht), are known to be associated with various forms of dysautonomia, most commonly Postural Orthostatic Tachycardia Syndrome (POTs) and Mast Cell Activation Syndrome (MCAS), and is disproportionately found in female patients. Currently, treatment for individuals with dysautonomia is limited and mainly consists of symptomatic management through the use of off-label medications, as the etiologies of dysautonomia are poorly understood. One of proposed pathophysiologic mechanisms driving autonomic dysfunction is increased levels of systemic inflammation and neuroinflammation. Reducing systemic inflammation in patients presenting with dysautonomic processes may prove helpful in reducing symptoms and improving quality of life, and can be achieved through lifestyle modification to an “anti-inflammatory lifestyle.” This lifestyle includes eating an anti-inflammatory diet, engaging in physical activity and limiting sedentary time, optimizing sleep quality and quantity, and practicing stress management, including through mind-body interventions. Objective: To assess the effectiveness of lifestyle modification to decrease number of symptoms, symptom severity, and to improve quality of life for a cohort of patients who presented with a combination of POTs and MCAS in the setting of EDs-ht. Design: A retrospective chart review was performed for 4 adult female patients, treated for dysautonomia in a lifestyle medicine practice. Data was collected regarding relevant diagnoses, symptoms, medications, side effects, lifestyle modification counseling, and outcomes. Results: Using individualized anti-inflammatory lifestyle modification counseling for patients with underlying dysautonomia, we found that 3 out of the 4 patients (75%) reported decreased number of symptoms, increased symptom control, as well as improved quality of life. No worsening of symptoms was reported. Conclusion: Individualized anti-inflammatory lifestyle modification counseling show promise as a tool for the management of patients that present with dysautonomia in the setting of EDs-ht. Decreasing systemic inflammation through lifestyle modification maybe a useful and safe means to both decrease the number and severity of symptoms in these patients and improve their quality of life, and further research into this subject is warranted.

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Presented at Research Days 2019.

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The Use of Lifestyle Modification to Manage Dysautonomia: A Case Series

Background: Dysautonomia is not a single disease process, but rather a constellation of symptoms that together represent dysfunction of the autonomic nervous system. Certain connective tissue disorders, such as Ehlers Danlos Syndrome hypermobility type (EDs-ht), are known to be associated with various forms of dysautonomia, most commonly Postural Orthostatic Tachycardia Syndrome (POTs) and Mast Cell Activation Syndrome (MCAS), and is disproportionately found in female patients. Currently, treatment for individuals with dysautonomia is limited and mainly consists of symptomatic management through the use of off-label medications, as the etiologies of dysautonomia are poorly understood. One of proposed pathophysiologic mechanisms driving autonomic dysfunction is increased levels of systemic inflammation and neuroinflammation. Reducing systemic inflammation in patients presenting with dysautonomic processes may prove helpful in reducing symptoms and improving quality of life, and can be achieved through lifestyle modification to an “anti-inflammatory lifestyle.” This lifestyle includes eating an anti-inflammatory diet, engaging in physical activity and limiting sedentary time, optimizing sleep quality and quantity, and practicing stress management, including through mind-body interventions. Objective: To assess the effectiveness of lifestyle modification to decrease number of symptoms, symptom severity, and to improve quality of life for a cohort of patients who presented with a combination of POTs and MCAS in the setting of EDs-ht. Design: A retrospective chart review was performed for 4 adult female patients, treated for dysautonomia in a lifestyle medicine practice. Data was collected regarding relevant diagnoses, symptoms, medications, side effects, lifestyle modification counseling, and outcomes. Results: Using individualized anti-inflammatory lifestyle modification counseling for patients with underlying dysautonomia, we found that 3 out of the 4 patients (75%) reported decreased number of symptoms, increased symptom control, as well as improved quality of life. No worsening of symptoms was reported. Conclusion: Individualized anti-inflammatory lifestyle modification counseling show promise as a tool for the management of patients that present with dysautonomia in the setting of EDs-ht. Decreasing systemic inflammation through lifestyle modification maybe a useful and safe means to both decrease the number and severity of symptoms in these patients and improve their quality of life, and further research into this subject is warranted.