Autonomic hyperactivity symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differentiating Hypoglycemia from other diseases that cause autonomic hyperactivity symptoms:

Disease	Clinical Manifestation					Investigations
	Symptoms				Signs
	Palpitations	Fever	Sweating	Headache
Hypoglycemia	+	-	+	+	Tachycardia Blurred vision Pallor Tremors Seizures/ Coma	Plasma glucose <70 mg/dL Serum Insulin level Serum Proinsulin Serum C-Peptide
Anxiety disorders	+	-	+	+	Patient looks irritable Rapid pulse and may be irregular	Psychiatry evaluation
Pheochromocytoma	+	+	+	+	Tachycardia Strong rapid pulse High pulse pressure	Plasma fractionated metanephrines, 24-hour urinary fractionated metanephrines, catecholamines. Computed tomography: Radiological evaluation should follow lab tests to locate site of the tumorr.
Arrhythmia	+	-	-	-	Irregular pulse	ECG changes according to the cause
Hyperthyroidism	+	+	+	+	Hyperactive deep tendon reflexes Thyromegaly Exophthalmus	Level of thyroid-stimulating hormone (TSH) Levels of T4 and/or T3 in the blood Antibodies such as anti-TSH-receptor antibodies in Graves' disease