Autonomic Nervous System Issue

[taxdoc]

I was diagnosed with CFS over 16 years ago.  Since then I have been diagnosed with CIDP (being treated with IVIG) and diastolic heart failure.  I have low cardiac output (3.0) with no physical cause.  I have hypertension and a fast heart rate (average over 105) and the only thing that brings it down is Clonidine.  However, whenever I exercise my blood pressure and heart rate go sky high and stay high for up to 2-3 days despite taking various medications.  I have had my thyroid checked and it is fine.  My heart is in good shape based on a CT scan and I have no blockages.  My cardiologist believes I have a problem with my autonomic nervous system, but has no idea as to what the problem is.  He also believes that I have restrictive cardiomyopathy, but there is a disagreement with my other docs on this issue.

My infectious disease doc took various biopsies of my stomach (he believes that CFIDS is caused by an entrovirus) and found that I have Coxsackie B5 and some type of other RNA virus.

I am extremely fatigued and I really don't know where to turn at this point.  Should I go and have my autonomic nervous system tested and if so any suggestions where?

Thanks,

David

[Abhijeet Deshmukh, MD]

Hello David.

If the fatigue is your main concern at this point of time, have you undergone the graded exercise therapy ? Also, antidepressant medications are shown to be effective. You may also try Atomoxetine, which is an autonomic nervous system stimulant.

Clonidine, on the other hand is an inhibitor of epinephrine/nor-epinephrine release. Hence we have two classes of drugs which work on the autonomic nervous system and might be helpful for CFS. You need not do any test for autonomic nervous system.

Regards