For many of us living with autoimmune conditions, the road to diagnosis is long, winding, and often littered with dismissals. But what if some of the “weird” symptoms we’ve been told to ignore—like dizziness, fainting, or heart rate swings—were actually early clues?
A recent case series published in Immunologic Research (Sept 2025) sheds light on a lesser-known but deeply impactful connection: dysautonomia as an early presentation of primary Sjögren’s disease (pSjD). In this study, six patients—mostly women—experienced autonomic nervous system dysfunction years before their Sjögren’s diagnosis. Their symptoms included orthostatic hypotension, syncope, and other forms of autonomic instability, often mistaken for anxiety, dehydration, or “just stress.”
What’s striking is that in five out of six cases, dysautonomia preceded the diagnosis of Sjögren’s by 2 to 10 years. That’s a decade of unexplained symptoms, medical gaslighting, and missed opportunities for early intervention. And while treatment with immunosuppressants like hydroxychloroquine and rituximab led to partial improvement in most patients, only one experienced full remission of dysautonomia symptoms.
This research matters. It validates what many of us have felt but struggled to name: that autonomic dysfunction can be part of the autoimmune picture, not just a side note. It also reminds us that early neurological symptoms deserve attention, especially in women, whose pain and fainting are too often dismissed.
If you’ve been living with unexplained dizziness, heart rate fluctuations, or fainting spells—and you’ve been told it’s “just anxiety”—this study might help you feel seen. Dysautonomia could be part of your autoimmune story.
What is Dysautonomia?
Dysautonomia refers to a group of conditions that affect the autonomic nervous system—the part of the body that controls involuntary functions like heart rate, blood pressure, digestion, and temperature regulation. When this system malfunctions, it can lead to symptoms that feel random, overwhelming, and hard to explain.
For people with Sjögren’s disease, dysautonomia may show up as:
Orthostatic hypotension (feeling faint or dizzy when standing)
Syncope (actual fainting episodes)
Heart rate fluctuations
Digestive issues
Temperature sensitivity
Fatigue that feels “wired but tired”
These symptoms often precede a formal diagnosis of Sjögren’s by years, making them easy to dismiss or mislabel as anxiety, dehydration, or stress. But dysautonomia is a real neurological manifestation—and in autoimmune conditions like Sjögren’s, it deserves recognition and treatment.
FAQs About Dysautonomia
Q: Is dysautonomia a disease or a symptom? A: It can be both. Dysautonomia is an umbrella term for autonomic dysfunction. In some cases, it’s a standalone condition (like POTS), but in autoimmune diseases like Sjögren’s, it’s often a symptom of broader immune system disruption.
Q: What does it feel like to live with dysautonomia? A: Many describe it as unpredictable and exhausting. You might feel dizzy when standing, experience heart palpitations, have trouble regulating body temperature, or feel like your body is “short-circuiting” without warning.
Q: Can dysautonomia be treated? A: Yes—though treatment varies. Options include medications to stabilize blood pressure and heart rate, lifestyle changes (like increased salt and fluid intake), and immunosuppressants if it’s linked to autoimmune disease. Some people also benefit from physical therapy or compression garments.
Q: How is dysautonomia diagnosed? A: Diagnosis often involves autonomic testing, such as tilt-table tests, heart rate variability monitoring, and symptom scoring tools like COMPASS-31 or CASS. Unfortunately, many people face delays in diagnosis due to lack of awareness.
Q: Is dysautonomia common in Sjögren’s? A: It’s not the most common symptom, but it’s increasingly recognized. Studies like the 2025 case series show that dysautonomia may be more prevalent than previously thought—and often appears before other hallmark symptoms like dry eyes or mouth.
RECENT RESEARCH into Dysautonomia & a Sjögren’s Diagnosis
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