Mon–Fri 8AM–5PM · Telehealth Available
VerityMD Neurology accepts new patient referrals by fax: (916) 244-3875
TM Flow Testing for Autonomic Dysfunction, Small Fiber Neuropathy, Dizziness, Neuropathy Symptoms, and Circulation Concerns
The autonomic nervous system controls automatic body functions such as heart rate, blood pressure regulation, sweating, circulation, digestion, and the body’s response to standing.
Small fiber nerves help control pain, temperature sensation, sweating, and autonomic function. VerityMD Neurology offers autonomic nervous system and small fiber neuropathy testing using TM Flow technology when clinically appropriate.
Symptoms We Evaluate
Burning pain in the feet or hands
Tingling, numbness, or temperature sensitivity
Pain with normal touch
Dizziness when standing
Lightheadedness, near-fainting, or fainting
Brain fog with standing
Sweating changes
Cold hands or feet or color changes
Diabetic neuropathy symptoms
Neuropathy symptoms with normal EMG/NCV testing
Conditions We Help Evaluate or Manage
Small fiber neuropathy risk
Autonomic neuropathy
Diabetic autonomic neuropathy
Cardiac autonomic neuropathy risk
Orthostatic intolerance
Sudomotor dysfunction
Peripheral circulation concerns
Peripheral artery disease risk markers
Endothelial or cardiometabolic risk markers
Services and How They Help
TM Flow Autonomic Nervous System Testing
TM Flow can evaluate selected markers of autonomic nervous system function including heart rate variability and cardiovascular autonomic responses.
How this helps:
Evaluates autonomic regulation
Helps assess dizziness with standing
Provides objective data for hydration, compression, medication review, and treatment planning
Small Fiber Neuropathy and Sudomotor Testing
Sudomotor testing evaluates sweat gland function as a marker of small fiber autonomic nerve involvement.
How this helps:
Assesses small fiber/autonomic nerve involvement
Helps evaluate burning or painful neuropathy symptoms
May be useful when EMG/NCV is normal but symptoms persist
Peripheral Vascular and Circulation Assessment
TM Flow may include peripheral vascular markers relevant to circulation concerns in hands and feet.
How this helps:
Assesses vascular risk patterns
Supports evaluation in diabetes or vascular risk factors
Connects neuropathy and circulation concerns
Cardiac Autonomic Neuropathy Risk Assessment
Cardiac autonomic neuropathy can affect heart rate and blood pressure regulation, especially in diabetes and metabolic disease.
How this helps:
Evaluates heart rate variability and cardiovascular autonomic responses
May explain dizziness, exercise intolerance, or abnormal heart rate responses
Supports risk-factor counseling
EMG/NCV Testing When Large Fiber Neuropathy Is Also Suspected
Some patients need both TM Flow/sudomotor testing and EMG/NCV because small fiber and large fiber neuropathy can overlap.
How this helps:
Evaluates large fiber neuropathy, radiculopathy, or entrapment neuropathy
Complements small fiber testing
Supports more complete diagnosis
When Autonomic & Small Fiber Neuropathy Testing May Be Helpful
Dizziness or brain fog when standing
Near-fainting episodes
Sweating changes
Burning foot pain
Diabetes or prediabetes with neuropathy symptoms
Small fiber symptoms with normal EMG/NCV
Parkinson’s disease with dizziness, blood pressure changes, constipation, or falls
What to Bring or Have the Referring Office Send
Referral from PCP, specialist, or referring provider
Medication list, including over-the-counter medications and supplements
Relevant office notes, hospital records, imaging reports, labs, and prior neurological testing if available
Blood pressure readings if available
Diabetes history and most recent A1c if available
Prior EMG/NCV or autonomic testing if available
Cardiology records if dizziness or fainting has been evaluated
Important Note
This page is for patient education and does not replace individualized medical advice. Testing and treatment decisions should be based on the patient’s history, examination, records, medications, insurance requirements, and clinical judgment.
Emergency Symptoms
Call 911 or go to the nearest emergency department for:
Sudden weakness, facial droop, trouble speaking, or new vision loss
Severe sudden headache or rapidly worsening neurological symptoms
Loss of consciousness, seizure, chest pain, or severe shortness of breath
New inability to walk or sudden severe dizziness with stroke-like symptoms
New Patient Referrals
VerityMD Neurology accepts new patient referrals by fax from the patient’s primary care physician, specialist, or referring provider’s office. To ensure accurate triage, insurance verification, and appropriate scheduling, referrals should be sent directly from the referring provider’s office.
Patients who would like to be seen at VerityMD Neurology should contact their PCP, specialist, or referring provider and ask them to fax a neurology referral with relevant clinical notes, insurance information, medication list, imaging reports, lab results, and prior neurology records if available.
We accept the following insurance
Client Stories
What Our Patients Say
My husband and I are very impressed with the care and professionalism of Dr. Mittal and his staff. Dr. Mittal took time to listen to us - to ask us questions - and to clearly explain the diagnosis and his treatment recommendations. We feel very fortunate - and relieved - to have this neurologist as a member of our care team.
Dr. Manoj Mittal thoroughly understands the complexities of my condition (involving my brain, neck, and nerves) and developed a comprehensive action plan. During my follow-up visit, he carefully assessed my progress to ensure I was staying on track. I had been neglecting a few aspects of my treatment, but he guided me back on course. My treatment involves a team of specialists, multiple surgeries, and personal effort, and I’m truly satisfied with the plan. For the first time in nearly a decade, I feel genuinely hopeful. Thank you, Dr. Manoj Mittal. A+
I was concerned about issues and I called their office. My appointment was not until January and after hearing my concerns, the staff had me scheduled on a Monday, which happens to be two days from when I called voicing my concerns. Nice job.
Dr. Manoj Mittal is an excellent neurologist. He listens carefully, explains everything clearly, and truly cares about his patients. My mom is under his care, and we are very grateful for his expertise and compassion. Highly recommend!
Saw Dr. Mittal and during the first visit he was able to order a few tests that helped diagnose my issue. During the appointment he spent a good amount of time with me and made me feel heard. He was then able to see me again on short notice to help direct me towards next steps, I am very grateful to him.
My 1st appointment with Dr. Mittal, was such a pleasure & surprise. The staff & Dr. Mittal were kind & not in such a hurry. The Dr. took a half hour with me, thoroughly explaining his thoughts & what was to come. Impressed is not a strong enough adjective! Thank you for being a true Doctor who cares.
VerityMD Neurology offers expert neurological care for Sacramento, Carmichael, Folsom, and surrounding communities under the guidance of board-certified neurologist Dr. Manoj Mittal.
Quick Links
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Contact
Phone: (916) 500-4989
Fax Referral: (916) 244-3875
Office Hours
Mon-Fri: 8:00 AM–12:00 PM and 1:00 PM–5:00 PM
Closed for lunch: 12:00 PM–1:00 PM
Sat–Sun: Closed
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