Blood

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Abnormalities in red blood cell shape, red blood cell deformability, and blood flow have been detected in patients who present with ME/CFS. Treatments that address blood flow issues may lead to improvement in symptoms for some patients.

Abnormalities[edit | edit source]

A high proportion of ME/CFS patients have been shown via a Dual Tag Test to have significantly lower blood volume than healthy controls. [1][2]

Multiple studies have found unusual properties of red blood cells, including issues with deformability. Deformability is the ability of a red blood cell to change shape. This is necessary because some capillaries are narrower than the red blood cells themselves.  If red blood cells are not deformable enough, blood flow slows down.

The shape of red blood cells has been found to be unusual in ME/CFS patients in several studies. This can also slow blood flow, as well as change how molecules dock on the surface of a red blood cell. One study found significantly increased quantities of stomatocytes in the blood of CFS patients. Stomatocytes are red blood cells that have lost their concave shape, usually due to a membrane defect.[3]

Both changes in deformability and changes in shape can be related to the way nutrients are or are not being processed in the body. For example, excess cholesterol can change the shape of red blood cells in some conditions by adhering to the outside of the membrane.[4]

While deformability and unusual red blood cell shape can be indicative of ME/CFS, these abnormalities also occur in other conditions. For example, red blood cell deformability is affected in parasitic infections such as malaria, and metabolic disorders such as diabetes;[5] and unusual red blood cell shape is found in several nutritional deficiencies.[6] While unusual shape and decreased deformability may be said to be signs of illness, they are not characteristic of ME/CFS alone.

Symptoms Resulting from Abnormalities[edit | edit source]

Orthostatic intolerance (OI), or difficulty tolerating changes in position, has been estimated to occur in up to 97% of ME/CFS patients.[7] OI is linked to under-oxygenation of the brain [8] due to a combination of red blood cell abnormalities and low blood volume. It has also been suggested that blood pressure and other circulatory system abnormalities contribute to this under-oxygenation. [9]

Proposed Causes for Blood Abnormalities[edit | edit source]

Abnormality Treatments and Adjustments[edit | edit source]

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. Hurwitz, BE; Coryell, VT; Parker, M; Martin, P; LaPerriere ...., A; Bilsker, MS. "Chronic fatigue syndrome: illness severity, sedentary lifestyle, blood volume and evidence of diminished cardiac function". Clinical Science. 118 (2): 125–135.
  2. Streeten, DHP; Bell, D (1998). "Circulating Blood Volume in Chronic Fatigue Syndrome". Journal of Chronic Fatigue Syndrome. 4: 3–11.
  3. Richards, RS; Wang, L; Jelinek, H (January 2007). "Erythrocyte oxidative damage in chronic fatigue syndrome". Archives of Medical Research. 38 (1): 94–98.
  4. Owen, J.S.; Brown, D.J.; Harry, D.S.; Beaven, G.H.; McIntyre, N ....; Gratzer, W.B. (December 1985). "Erythrocyte echinocytosis in liver disease. Role of abnormal plasma high density lipoproteins". J Clin Invest. 76 (6): 2275–2285.
  5. Tomaiuolo, G. (2014). "Biomechanical properties of red blood cells in health and disease towards microfluidics". Biomicrofluidics. 8 (5).
  6. "Poikilocytosis -- Abnormal RBC shape". Laboratory Info. 2017.
  7. Miwa, K (July 2015). "Cardiac dysfunction and orthostatic intolerance in patients with myalgic encephalomyelitis and a small left ventricle". Heart and Vessels. 30 (4): 484–489.
  8. Citation Needed
  9. Citation Needed