Diaphoresis


What is Diaphoresis?

Diaphoresis or excessive sweating related to an underlying condition is one of the most disconcerting signs that patients can experience. One usually experiences normal sweating when exercising, performing laborious tasks, exposed to hot weather, subjected to stressful, anxious events or having a sauna bath.

But in times when the person has uncontrollable sweating for no particular reason, it’s time to have a look and consult a medical professional.First, let’s look at the body organ responsible for producing the sweat.

The skin is responsible for producing sweat and oil in order to cool the body as well as keep the skin water-proof. This fulfills a lot of functions such as maintain core body temperature in fluctuation in hot or cold weather and protecting the sterile, underlying structures from potentially invasive and destructive bacteria.

However, the skin may also produce excessive sweat due to underlying causes that may give clues to an unknown, underlying disease.


Diaphoresis

What are Sweat Glands?

Sweat glands are long, spiral, tubular glands distributed all over the body, except on the red margins of the nail beds, glans penis and the clitoris. The sweat glands extend through the full thickness of the dermis, and their extremities may lie in the superficial fascia. They deeply penetrate into the dermis.

Sweat is composed of mostly water, urea, sodium, potassium, chloride and lactate. By itself, sweat is odorless, but when it mixes with oil from sebaceous glands and bacteria that produce substrates, it acquires the distinctive, pungent, repulsive smell known as body odor.

The sweat gland responds to various stimuli but virtually controlled by the autonomic nervous system via its sympathetic arm. When stimulated, the brain sends neurotransmitters that cause the sweat to be secreted by the cells.

What is the Autonomic Nervous System?

The autonomic nervous system is responsible for stimulating the sweat glands in response to any environmental stimuli or underlying diseases in the body. We take a look at the autonomic system and its two branches, the sympathetic and parasympathetic nervous system.

Diaphoresis Causes

There are many abnormal causes of diaphoresis. One benign cause is idiopathic palmar hyperhidrosis wherein the body simply just sweats more than it needs to maintain normal thermoregulation.

There is no underlying disease or condition that may explain this, the person just has genes that make the sweat glands more active than usual.

In essential hyperhidrosis, over activity of the sympathetic nervous system is suspected. In some cases, increased body fat can be a cause for people to sweat excessively, the body has more surface area and heat generation and in order to keep cool, the body must sweat more than a person of a more ideal body mass index.

In the next few paragraphs, we will discuss the more serious causes of diaphoresis. Insulin use in Diabetes Mellitus is one cause, low blood sugar sends signals to the brain that blood sugar levels are low and the body’s sympathetic response is activated in an effort to improve delivery of unusable glucose to the body’s cells which also activates the sweating in the glands.

However, the skin is cold and clammy because the energy production is low and the body can’t maintain heat.

Another cause is Hyperthyroidism; in this case there is an overproduction of the thyroid hormones T3 and T4 which stimulate the body’s cells for metabolism. In this scenario, all of the body’s cells from the brain down to the foot are stimulated and have increased utilization of glucose.

This leads to an excess of ATP production which may not also affect the sympathetic nervous system such as the adrenals releasing catecholamines, epinephrine and norepinephrine.

Another probable cause for excessive sweating is an underlying heart condition. In Acute Coronary Syndrome or simply a condition where your heart does not get enough oxygen, can cause the person to experience short episodes of heavy sweating.

This is very common disorder in the developed world exists because of many risk factors such as sedentary lifestyle, fast food and smoking.

As the heart receives less oxygen due to increased exertional effort, cold exposure or simply being blocked by a thromboembolus, the heart experiences a sharp, brief, stabbing pain followed by a rapid stimulation of the autonomic nervous system that causes excessive diaphoresis.

Secondary Excessive Diaphoresis

Diaphoresis is known as the “silent handicap”. If people continue to experience it, this could lead to a decreased quality of life from a social and psychological perspective. For benign cases such as idiopathic hyperhidrosis, essential hyperhidrosis and obesity, patients may use a lot of antiperspirant, lose weight and bring towels or handkerchiefs to wipe away excess sweat.

In cases of hot environment, a cool glass of water will do the trick. For a patient that finds increased diaphoresis in anxiety-provoking effects, the patient can imbibe an anticholinergic just before these events like a giving a speech or a performance before a large crowd.

In cases which have causes determined to be underlying medical condition, the patient may need to consult a healthcare professional who will ask about the nature of the excessive sweating, make a correct diagnosis, run some tests and prescribe the appropriate treatment.

In cases of diabetes, the physician may prescribe sugar when you have excessive sweating to improve blood sugar levels. In cases of Hyperthyroidism, the patient may be given beta-blockers which will decrease the stimulation of the thyroid cells producing excess thyroid hormone.

Conclusion

Sweat is a natural function of the body in response to various stimuli in the environment and it has a protective function. It can also be a result of conditions inside the body that may need medical attention.

Whatever the reason is for the excessive sweating, we should make sure that a good medical professional is capable of ruling out diseases and ensuring that the sweating is a normal process.

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