• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To become a member, simply click the Register button at the top right.

ANSAR test - yes or no?

SDSue

Southeast
Messages
1,066
The cardiologist I'm scheduled to see for dysautonomia / POTS wants to do this test. What I wouldn't give for a knowledgeable, local POTs doctor.

I see some old posts about the ANSAR, but no real information.

Anyone had the ANSAR?
 

Gingergrrl

Senior Member
Messages
16,171
@SDSue Can you tell us what the ANSAR test involves? I just googled it but can't figure out what it actually is! I have never heard of it before. My cardio who is "supposed" to be an autonomic specialist has never mentioned this test to me. I would love to hear more!
 

halcyon

Senior Member
Messages
2,482
This was the most detailed thing I could find:

The ANX 3.0 tests are two independent clinical tests (or studies) designed to determine the ability of both branches of the autonomic nervous system (ANS) to respond to and relax from a challenge. The two branches that make up the ANS are the sympathetic and parasympathetic (SNS and PSNS, respectively). The challenges are:

1) deep breathing to challenge the PSNS,
2) valsalva to challenge the SNS, and
3) standing from a seated position to challenge both systems. (A tilt challenge may also be performed.)
Source

It doesn't sound too crazy, but I'm not sure about some of the claims made about the test:

ANSAR testing can detect many conditions in the early stages, when treatment can be most effective. Cardiovascular disease, diabetes, Parkinson’s disease, multiple sclerosis, chronic fatigue syndrome and high blood pressure are just some of the conditions that can be identified and measured with the ANSAR test.
Source
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
1) deep breathing to challenge the PSNS,
2) valsalva to challenge the SNS, and
3) standing from a seated position to challenge both systems. (A tilt challenge may also be performed.)
It doesn't sound too crazy, but I'm not sure about some of the claims made about the test:
All that was part of my TTT, but...I do doubt the claims too.

Sushi
 

Gingergrrl

Senior Member
Messages
16,171
Thanks @halcyon @SDSue @Sushi but I am still unclear how the data from this test would change someone's treatment? My TTT was crap and did not include anything mentioned here so I definitely did not have an ANSAR test. I am wondering what it would change for me as it mentioned things like beta blockers & Midodrine (which I already take), compression stockings (which I already wear on most days), etc. It also seems to mention hypertension throughout the description whereas I have hypotension. But I would do this test in a heartbeat (no pun intended) if it would get me more effective treatment!
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
I am still unclear how the data from this test would change someone's treatment?
Discovering whether the sympathetic or parasympathetic is dominant and whether they are "taking care of appropriate functions" or whether they have their jobs mixed up, is very helpful in prescribing medications.

Sushi
 

Gingergrrl

Senior Member
Messages
16,171
Discovering whether the sympathetic or parasympathetic is dominant and whether they are "taking care of appropriate functions" or whether they have their jobs mixed up, is very helpful in prescribing medications.

@Sushi I'm sure mine are all messed up and nothing is doing it's job appropriately. How would I find someone who does this ANSAR test who actually knows the level of detail that you are mentioning? There does not seem to be any cardios in my city who know about this stuff and I have now seen three since 2012.
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
@Sushi I'm sure mine are all messed up and nothing is doing it's job appropriately. How would I find someone who does this ANSAR test who actually knows the level of detail that you are mentioning? There does not seem to be any cardios in my city who know about this stuff and I have now seen three since 2012.
If you can find a doc who does a TTT according the the guidelines of dysautonomia specialists, they would include all those sub-tests. My TTT had 7 sections and tested all those things plus some others like an audio stress test. I know specialists like this are hard to find but that would be the kind of thing to look for.

Sushi
 

WillowJ

คภภเє ɠรค๓թєl
Messages
4,940
Location
WA, USA
Is it maybe a little simplistic to think of the out-of-balance CNS as being either sympathetic-dominated OR parasympathetic-dominated?

Just like we no longer think of the immune system as only either upregulated OR downregulated; it might be some of both.

Control systems of the body are enormously complex.

I have had zero testing for dysautonomia, but I spent the last year getting tested for diseases I don't have. I'm worn out. I have florinef and not sure how much value more kinds of dysautonomia treatment would add (especially as it's hard for me to use anything that changes blood vessel or heart rate, between the ME and other conditions)?

edit: above para is my story--not wanting to discourage anyone else, just wanting to know how much value testing adds, and sharing that I didn't get any testing, either (but nonetheless got treatment or partial treatment, not sure which!)
 
Last edited:

Gingergrrl

Senior Member
Messages
16,171
@Sushi I don't think there are any specialists like that anywhere near me (unless they are in the witness protection program.)

@WillowJ I totally understand and am close to giving up on all further testing myself. I think Atenolol and Midodrine (both super low doses) are the best combo that I am going to find. The only two things I am still curious about testing are growth hormone and mold (b/c of my living situation) but then I think I am done.

But @SDSue if you do the ANSAR test I want to hear all about it!
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
s it maybe a little simplistic to think of the out-of-balance CNS as being either sympathetic-dominated OR parasympathetic-dominated?
Agreed. It is usually not that simple. My test showed that both the parasymp and the symp were too revved up and sort of competing, but, overall there was more parasympathethic activity.

Control systems of the body are enormously complex.
For sure!

Sushi
 

WillowJ

คภภเє ɠรค๓թєl
Messages
4,940
Location
WA, USA

SDSue

Southeast
Messages
1,066
@Sushi I'm sure mine are all messed up and nothing is doing it's job appropriately. How would I find someone who does this ANSAR test who actually knows the level of detail that you are mentioning? There does not seem to be any cardios in my city who know about this stuff and I have now seen three since 2012.
Perhaps you could contact the ANSAR company and ask who has their equipment. It's been around for at least 10 years. :)
 

Ruthie24

Senior Member
Messages
219
Location
New Mexico, USA
I think it may be more popular on the east coast, or at least that's what I've heard. I believe Dr Pocinki uses it but I haven't found anyone out on this side of the country that has one. I've seen some presentations that Dr P did on the EDS site where he referenced the ANSAR findings of various patients.
 

SDSue

Southeast
Messages
1,066
I think it may be more popular on the east coast, or at least that's what I've heard. I believe Dr Pocinki uses it but I haven't found anyone out on this side of the country that has one. I've seen some presentations that Dr P did on the EDS site where he referenced the ANSAR findings of various patients.
Do you recall being impressed with what he said, or was it just fluff? Did he really learn anything interesting or is this just another fancy machine that can be billed but doesn't make a difference in treatment? Thanks.
 

Ruthie24

Senior Member
Messages
219
Location
New Mexico, USA
It was after watching that video that I thought maybe it wasn't all just a snow job (the ANSAR test). I seem to remember him using the graphs from it to demonstrate how someone with dysautonomia differed from normals even when just sitting still or when going from sitting to standing. It was interesting info, but not exactly sure how much it would influence treatment per se.

He showed how a patient, even feeling not symptomatic, had dramatically different results on the test than a normal would. Showed how their autonomic system would react when they did either deep breathing or sit-to-stand. For dysautonomia patients they had a constant state of over-reacting by first one branch(sympathetic) and then the other (parasympathetic) of the ANS. This would keep going for quite a long time as each branch tried to normalize what the other one had done.

Actually, I think he did show how that test changed in the patient after treatment was started. It still wasn't a normal tracing but did have a better response. So, maybe it changes how he approaches treatment in his practice. I suppose this test is like most others: in the right hands it can be beneficial but if someone just does it and doesn't know how to interpret what they see, it's just another test they can bill.

Keep us posted on what you decide, please?
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
I suppose this test is like most others: in the right hands it can be beneficial but if someone just does it and doesn't know how to interpret what they see, it's just another test they can bill.
That makes sense to me too. Problem is the dearth of docs who have the knowledge to interpret it...unless that lab gives very good guidelines.

Sushi
 

SDSue

Southeast
Messages
1,066
It was after watching that video that I thought maybe it wasn't all just a snow job (the ANSAR test). I seem to remember him using the graphs from it to demonstrate how someone with dysautonomia differed from normals even when just sitting still or when going from sitting to standing. It was interesting info, but not exactly sure how much it would influence treatment per se.

He showed how a patient, even feeling not symptomatic, had dramatically different results on the test than a normal would. Showed how their autonomic system would react when they did either deep breathing or sit-to-stand. For dysautonomia patients they had a constant state of over-reacting by first one branch(sympathetic) and then the other (parasympathetic) of the ANS. This would keep going for quite a long time as each branch tried to normalize what the other one had done.

Actually, I think he did show how that test changed in the patient after treatment was started. It still wasn't a normal tracing but did have a better response. So, maybe it changes how he approaches treatment in his practice. I suppose this test is like most others: in the right hands it can be beneficial but if someone just does it and doesn't know how to interpret what they see, it's just another test they can bill.

Keep us posted on what you decide, please?
Thanks so much! I am weighing my options right now, as I'm close to getting IV saline approved. I'm thinking it might be worthwhile to get a baseline prior to and after saline. (for insurance purposes)

I will keep you posted, but it looks as if I may subject myself to yet another test. Not sure when, though.