“You guys are about a litre short in blood volume, ok? If I’m sitting at five litres, you’re sitting at four. So, you’re really, really sensitive to blood volume changes. If you’re a little dry, you crash. ” Dr. Nancy Klimas

The low blood volume finding in chronic fatigue syndrome has been consistently replicated; there is no doubt that low blood volume is common in this disorder. Low blood volume can cause, among other things, reduced blood flows to the brain (cognitive difficulties), problems standing (orthostatic intolerance), increased heart rates and reduced heart functioning.

While not the entire answer to chronic fatigue syndrome, increasing blood volume can be quite helpful.

Blogs

• Maggies ‘Panic’ – Check out Dr. Bell’s story of an ME/CFS patient who’s panic attacks turned out to be a result of her bodies attempt to deal with low blood volume.  ‘Maggie’ improved tremendously using salt and Florinef and for two days she was back to her old self but then mysteriously relapsed.
• The Blood Volume Paradox in Chronic Fatigue Syndrome and POTS  – a recent study examines why blood volume is low and suggests that desmopressin, an analogue of vasopressin, may be helpful
• The Blood (Volume) Will Out: Is Ischemia A Key in Both POTS and Chronic Fatigue Syndrome?
• Regular Use of Saline May Reduce Symptoms, Boost Energy in POTS (and ME/CFS?) – saline is a blood volume enhancer and is often used to ameliorate crashes.
• NIH Funds Chronic Fatigue Sydrome (ME/CFS) Grant to Increase Blood Volume – Marvin Medow begins a study examing how effective oral rehydration solution is in increasing blood volume. He believes this cheap and easy to make solution may be more effective than saline.
• Measuring Blood Volume the Daxor Way – check out the best way to assess your blood volume
• See much more on low blood volume including how to diagnose and treat it, and how to make ORS in ourOrthostatic Intolerance Resources section

Non-Drug Approaches

Elevating Your Head While Sleeping

In what’s surely the easiest practice simply elevate the head of the bed six inches by putting some risers under the bed legs at the head of the bed (or by using a body-length wedge shaped cushion. NASA uses this approach to recondition its astronauts after spaceflights.  One person (see comments below) found a dramatic improvement in his sleep after doing this for a week.

Salt

“The reduction in salt, which is a good idea for most people, may push orthostatic intolerant people into having symptoms of OT” Dr. Peter Rowe

Many people with chronic fatigue syndrome crave salt.  Increasing your salt (with your doctor’s permission) and fluid intake can increase your blood volume increasing blood flows to your heart and brain, enabling you to stand more easily and think more clearly.

Increasing salt intake will only work, though, if you increase your fluid intake as well for (see below). Increasing salt intake should be done slowly and is often achieved simply by eating saltier foods. Some ME/CFS and POTS patients who already had low salt intake have had dramatic improvements by increasing their salt intake. Do not increase your salt intake, however, if you have high blood pressure.

• Dig Deeper: Some great tips on increasing salt intake from POTSRecovery
• Dig Deeper: Martha Kilcoyne received dramatic benefits from increasing her salt intake.

Be consistent! – Dr. Rowe suggests that patients who make a serious (i.e. consistent) effort at increasing their fluid intake will benefit the most. He recommends drinking a glass of liquid every two hours with a goal of drinking at least two liters of water a day (approximately half a gallon).  If you’re trying to increase both blood volume and salt tomato juice is an excellent choice.