October is Dysautonomia Awareness Month
October is Dysautonomia Awareness Month - and an opportunity to improve understanding of disorders affecting the autonomic nervous system.
The autonomic nervous system helps regulate functions such as heart rate, blood pressure, temperature, digestion and responses to changes in posture. Dysautonomia is an umbrella term rather than a single diagnosis, and can include conditions such as POTS, orthostatic hypotension, neurally mediated syncope and autonomic neuropathies.
Symptoms can include light-headedness, palpitations, fainting or near-fainting, fatigue, exercise intolerance, cognitive symptoms, temperature intolerance and gastrointestinal symptoms.
Many other conditions can cause similar symptoms, so appropriate medical assessment remains important.
At Coelevate, our role is not to diagnose every cause of dysautonomia. Instead, when the history suggests orthostatic intolerance or associated balance and functional problems, we can gather clinically useful information and help guide rehabilitation or referral.
Depending on the presentation, assessment may include:
NASA Lean testing - repeated heart-rate and blood-pressure measurements during a standardised postural challenge to look for an abnormal orthostatic response.[1]
BTrackS balance testing - objective measurement of postural sway where dizziness or instability is part of the presentation.[2]
Vestibular, oculomotor and proprioceptive assessment when symptoms suggest these systems may also be contributing to dizziness or instability
Functional measures to understand how symptoms affect standing, walking, exercise tolerance and participation
Rehabilitation is then individualised. It may include carefully graded movement, balance or vestibular work and other prescribed strategies within the patient's tolerance. We do not assume that every patient with dizziness has dysautonomia, or that every patient with dysautonomia needs the same rehabilitation.
The aim is simple: ask the right clinical question, measure what is relevant, and use the findings to decide what happens next - including medical referral or co-management where indicated.
Sources
1. Lee J, Vernon SD, Jeys P, et al. Hemodynamics during the 10-minute NASA Lean Test: evidence of circulatory decompensation in a subset of ME/CFS patients. J Transl Med. 2020;18:314. PMCID: PMC7429890.
2. Goble DJ, Baweja HS, Haworth JL. The Balance Tracking System (BTrackS) for Postural Control Assessment/Training - a Decade of Research. Med Devices (Auckl). 2025;18:579-593. doi:10.2147/MDER.S560337.
3. Quodling N, Hoffman N, Carrick FR, Jemni M. A Review of Movement and Functional Impairments in Fibromyalgia: Implications for Targeted Treatment. J Pain Res. 2025;18:5587-5597. doi:10.2147/JPR.S543775. PMID: 41169901. (Relevant to functional limitation, dizziness/balance and exercise-capacity assessment in fibromyalgia.)
