“Cardio-autonomic neuropathy and small fiber neuropathy diagnosis cannot be made with routine laboratory tests and clinical examination alone. Both conditions can lead to a change in management depending on what symptoms the patient has and what diagnosis is concluded. For example, patients with cardiovagal impairment can be advised to use compression stockings, or fludrocortisone for more severe cases, and or midodrine can be used. A skin biopsy can be avoided for patients with a small fiber neuropathy diagnosis with this test. Autonomic system testing is considered investigational in situations when criteria are not met. These situations include (but are not limited to) the evaluation of conditions like Chronic fatigue syndrome, fibromyalgia, sleep apnea, hypertension, etc.

I do believe this combination test provides patients useful information and guidance to the overall improvement of their health.” - Dr. Samah Mohiuddin.