AN ESTIMATED 15 to 20 million people in the United States over age 40 have some type of peripheral neuropathy. In many, the impairment is predominantly in small nerve fibers, and the clinical presentation consists of pain, burning, tingling, and numbness in a length-dependent or stocking-glove distribution. Autonomic neuropathy  or small fiber neuropathy is  caused by damage to the smallest nerves that  supply sensory feelings, help regulate  your heart rate, blood pressure, perspiration and digestion, among other functions. Neuropathy means  damage to your nerves. Autonomic small fiber neuropathy is  are often due to diabetes, autoimmune diseases, infections or toxic conditions. Your nerves transmit messages between your brain and your  organs. Damage to your autonomic nerves results in faulty communication with your brain and the affected  parts of the body .Your nerves are composed of many types of fibers and the smallest fiber is affected by this neuropathy so it is called small fiber neuropathy. The condition is fully and easily reversible.

Signs and symptoms are variable on which nerves are affected but can range from dizziness to trouble with digestion and urination to sexual difficulties. Treatment involves addressing the underlying cause, if possible, and managing the signs and symptoms.

Signs and symptoms of autonomic neuropathy depend on which parts of your autonomic nervous system are most affected. They may include:

• A drop in blood pressure on standing (orthostatic hypotension), which can cause dizziness and fainting
• Trouble with urination, including diminished sensation, overflow incontinence and inability to empty your bladder completely, which can lead to urinary tract infections
• Male impotence or weak erectile function.
• Numbness in toes very common and may be the earliest and only symptom,  feet or genitals, abdomen. Tendency to trip easily. Burning sensation on skin. Difficulty in judging accelerator position while driving.
• Trouble focusing eyes.
• Vaginal dryness and difficulties with arousal and orgasm in women
• Difficulty digesting food (gastroparesis), which can cause diarrhea, constipation, abdominal bloating, nausea, vomiting, heartburn, feeling full after eating little and loss of appetite
• Cardiovascular problems, such as heart rate abnormalities
• Heat intolerance, especially during exercise, and usually decreased sweating or increase sweating.
• Sluggish pupil reaction to light and dark
• Exercise intolerance, which causes your heart rate to remain unchanged instead of increasing and decreasing in response to your activity level
• Lack of the usual warning signs of low blood sugar (hypoglycemia), which include shakiness, sweating and palpitation

1. Urinary incontinence
2. Urinary tract infection (UTI)
3. Erectile dysfunction
4. Erectile dysfunction in diabetes: Keys to prevention
5. Vaginal dryness
6. Diabetic gastroparesis
7. Constipation
8. Diarrhea
9. Cardiovascular disease 101: Know your heart and blood vessels
10. Numbness feeling in toes, fingers or abdomen. Burning  and pain.
11. Hypoglycemia
     

    Causes Make sure you do not have celiac disease

    Your nervous system is made up of two parts. The core is your central nervous system — your brain and spinal cord. The rest of your nervous system, branching off from your spinal cord to the rest of your body, is your peripheral nervous system.

    Part of the peripheral nervous system involves nerves that you consciously control — such as nerves you use to move your voluntary muscles. Part is your autonomous nervous system — the nerves that regulate the part of your nervous system that you can't control, such as your heart rate, blood pressure and digestion.

    Damage to your peripheral nerves is called peripheral neuropathy. Autonomic neuropathy is a type of peripheral neuropathy in which the very small nerves are damaged.

    A number of conditions can lead to damage of the autonomic nerves. The most common cause is diabetes. About half of the people who have diabetes eventually develop some type of neuropathy.

    Other causes may include:

    • Alcoholism, a chronic, progressive disease that can lead to nerve damage
    • Poor diet White rice, white flour, white sugar no fatty acids in diet.
    • Infection from virus, mycoplasma type bacteria.
    • Abnormal protein buildup in organs (amyloidosis), which affects the organs and the nervous system
    • Autoimmune diseases, in which your immune system attacks and damages parts of your body, including your nerves
    • Some tumors, which can press on nerves and cause direct or remote damage (paraneoplastic syndrome)
    • Multiple system atrophy, a degenerative disorder that destroys the nervous system
    • Surgical or traumatic injury to nerves, injury can be from a car accident.
    • Other chronic illnesses such as Parkinson's disease and HIV/AIDS
    • Celiac disease more info

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