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Have dysautonomia and autoimmune disease. Feeling cold and skin color changes. Having shooting pain under finger nails. Help?

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Internal Medicine Specialist
Practicing since : 2005
Answered : 507 Questions
Hi! I have dysautonomia and possible autimmune disease (High XXXXXXX 1:160) but no antibodies showing
I keep getting a few things that bother me . . .my feet keep feeling really cold; no skin color changes just cold, and sometimes I get pin prick feelings in them......

also I keep getting random throbbing shooting pain under random fingernails - usually in the hands.. under random fingernails . its not consistant. it lasts for a second than goes away.

are these concerning?

I am on nadolol for POTS - now I know that could possible cause cold tingly feet...but what about the shooting pain under nails

can I have something serious that could kill me like vasculitis?
im very new to both P.O.T.S and autoimmune what can I do to help ? I am on Plaquenil and Nadolol; again no antibodies showing for the autoimmune disease
I do not have raynauds.
Posted Sat, 3 Aug 2013 in General Health
Answered by Dr. Omer 28 minutes later

As you have said that you were diagnosed with POTS ( postural orthostatic tachcardia syndrome) , with poistive XXXXXXX 1:160 , taking nadalol + hydroxychloroquinine

Yes, in dysautonomia , sensory peripheral neuropathy usually co-exists.And you are right this is not RAYNAUDS phenomenon.

Your autonomic system controls the dilatation on skin vessels to maintain body temperature , but in dysautonomia vessels of skin change on their on with no reugulation , so you feel cold , and sometime heat.

Peripheral sensory neuropathy usually co-exists with dysautonomia especially in hands and feet , your sensory system send wrong signals of throbbing pain and and pin -pricking sensation.

POTS is common in your age group , but prognosis depends on person to person.Your doctor has given you excellent combination of DMARDS like hydroxycholoroquinine and nodalol to have a good and slow heart rate.

As your XXXXXXX is high your dysautonomia+peripheral sensory neuropathy could be because of SLE , Sjogrens , WEgners etc. Treatment is usually for all those diseases include DMARDS( disease modifying drugs).

The prognosis of dysautonomia which is secondary cause meaning positive XXXXXXX is good , almost these people live a normal life span with medications.

Just keep a good follow up with your doctore , get nerve conduction test for sensory neuropathy as well.

Hope this helps.

Take care.
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