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If we have low blood volume where does it go?

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
Any chance are bodies aren't peeing it out but using it in the inflammation process ?

Anyone else get swelling or drainage regularly ? Could this could be a mast cell problem ? Don't most of us have allergies ?

Some of it will go into swellings via the lymphatic system, which often gets blocked with us - hence some of the swelling. It will eventually drain back into the bloodstream, then we will lose too much as 'usual'. I understand that manual drainage results in a lot of urination, which would make sense as it will be adding a lot of fluid back into the blood in a short time.
 
Messages
2,565
Location
US
Most of us have low blood volume. Once we have low blood volume, if we get IV fluids, our blood volume is increased, however the effect is temporary. We will lose that extra fluid in 1 or 2 weeks.

Based on reading that, I came up with a reason for the low blood volume. When we have the initial trigger, our bodies are under such stress that it needs to conserve energy. It is busy fighting the infections and starts producing less and less RBC, WBC, and platelets. The volume of blood decreases so that we have the same concentration of RBC, WBC, and platelets.

That explanation may be too simplistic. Perhaps we have a reason for not producing as many RBC, WBC, and platelets.

In reading about platelet production, I see that causes of less production can include: If you have autoimmune diseases, chicken pox, cancers, or bacteria in the blood. Another reason is not enough available folate or B12, and many of us have a genetic defect related to folate. Ibuprofen and asprin can reduce production. Platelets can get trapped in the spleen too.

I believe our blood volume lowers over the months after infection, or when our body starts losing the battle against the invaders that keep coming.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Up until this year no phlebotomist ever had trouble finding my veins. Now they can't, despite being assured they were experts. The last one gave up and took blood from a vein in my hand.
 

PNR2008

Senior Member
Messages
613
Location
OH USA
My veins have been hiding for years but now it seems that the one in my hands are used more often.
 

SOC

Senior Member
Messages
7,849
I would say drink tons of isotonic or hypertonic fluids rather than water. If you are low in electrolytes - as we tend to be because we lose these in urine as well as fluid - drinking a hypotonic fluid like water will exacerbate the deficiency by diluting your blood further.

Our cardiologist said the same thing when he put us on Florinef for low blood volume -- do NOT increase fluids with just water, you'll make your situation worse. Drink electrolyte fluids -- as MeSci says, isotonic or hypertonic.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
Our cardiologist said the same thing when he put us on Florinef for low blood volume -- do NOT increase fluids with just water, you'll make your situation worse. Drink electrolyte fluids -- as MeSci says, isotonic or hypertonic.

I drink fruit juice rather than water. You can find out the nutritional compositions of juices (and other foods) here.
 

xchocoholic

Senior Member
Messages
2,947
Location
Florida
Even if fluids do re-enter our bodies post inflammation their composition is different. I'm drawing a blank on what chemicals our bodies use in the inflammation process. All I can remember is that nsaids target these.

The fact that we urinate most post lymphatic massage would indicate our bodies see this fluid as toxic.

fwiw, everytime I get a kidney stone or infection, my body goes into overtime trying to pee it out. Sometimes it's so bad that I can't leave the toilet without going again. The spasms make me lose bladder control.

When I first came down with me/cfs in 1990 one of my symptoms was bladder spasms. Not fun.

Great discussion. tc ... x
 

allyb

Senior Member
Messages
127
Location
yorkshire/lancashire border, England
If we have very low blood volume, when we have a blood tests.......would this alter the results of the tests?

I have noticed that my, sodium and bicarbonate are all higher than they should be and potassium is at higest end of normal
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
If we have very low blood volume, when we have a blood tests.......would this alter the results of the tests?

I have noticed that my, sodium and bicarbonate are all higher than they should be and potassium is at higest end of normal

That's interesting - my sodium and bicarb are low when I'm most ill, and never high. My potassium is normal or high, but the high reading was from a serum (plasma) test which can give falsely high readings due to minerals leaking out of red blood cells into the serum.

Maybe you tend to have a predominantly water diuresis rather than an osmotic diuresis. In water diuresis urine tends to be pale, whereas in osmotic diuresis it is darker. You can check how concentrated it is with a wine hydrometer, and with a formula you can convert it to osmolality, which is the concentration measure used more often in medicine. If you lose mostly water it will concentrate your blood more.
 
Messages
15,786
Every urine sample during the past few years since I got sick has had traces of blood in it. So it would seem I'm consistently losing some that way.
 

beaker

ME/cfs 1986
Messages
773
Location
USA
Our cardiologist said the same thing when he put us on Florinef for low blood volume -- do NOT increase fluids with just water, you'll make your situation worse. Drink electrolyte fluids -- as MeSci says, isotonic or hypertonic.
I was originally addressing "what kind of salt" question when I said drink lots of water. That's with salt tablets.
And prescription K++ . I forgot that they had me on that too.
That was Rowe's florinef protocol at the time.

It didn't work anyways.
 

SOC

Senior Member
Messages
7,849
I was originally addressing "what kind of salt" question when I said drink lots of water. That's with salt tablets.
And prescription K++ . I forgot that they had me on that too.
That was Rowe's florinef protocol at the time.

It didn't work anyways.
My daughter was given prescription K+ the first time she was on Florinef through her me/cfs specialist. Our cardio didn't give us the K+ though. After 6 months on Florinef, both of us are developing low potassium even with electrolyte drink that includes potassium, so we may need the prescription K+.

Sorry to hear it didn't work for you. Florinef has helped us a lot. Isn't that just the way with this illness? What works great for some people does nothing for others. It makes it really hard to try to figure out any protocol to improve our condition. :ill:
 

xchocoholic

Senior Member
Messages
2,947
Location
Florida
Every urine sample during the past few years since I got sick has had traces of blood in it. So it would seem I'm consistently losing some that way.

me too. Do you get stones ? I was thinking this could be from constantly passing little stones. I've seen a lot of blood in my urine when trying to pass bigger ones. They're sharp and tearing the urinary tract walls thus causing blood.
 

end

Messages
263
My body apparently increases BP to compensate for lack of blood volume.

My 24hour urinary excretion shows - Sodium +++ While Sodium blood work is normal

OI - Slow K didnt help, while Florinef helped but caused dangerously high BP that had me visit the ER at doctors orders.

I realy dont know why or how blood volume is connected to our illness

My blood tests are similar to what alex relays above
 

end

Messages
263
Up until this year no phlebotomist ever had trouble finding my veins. Now they can't, despite being assured they were experts. The last one gave up and took blood from a vein in my hand.

Hand and lastly via "prick and squeeze" for an LFT
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
My body apparently increases BP to compensate for lack of blood volume.

My 24hour urinary excretion shows - Sodium +++ While Sodium blood work is normal

OI - Slow K didnt help, while Florinef helped but caused dangerously high BP that had me visit the ER at doctors orders.

I realy dont know why or how blood volume is connected to our illness

My blood tests are similar to what alex relays above

That's interesting. I have had high blood pressure for years (it developed a few years after I developed ME) so I was cautious about increasing salt intake following my two episodes of near-life-threatening hyponatraemia, but it didn't seem to increase my bp at all. Maybe that's because I excrete so much of it. The doctors didn't think to compare my blood sodium with my urine sodium until I insisted, but even then they didn't do all the tests that are needed to calculate fractional excretion of sodium (FES). However, my urine sodium was quite high whilst my blood sodium was below normal, suggesting to me that my body has trouble holding on to sodium. It seems to be worst after over-exertion, which I theorise is due to the sodium being excreted with the excess lactate produced by the exertion. This is referred to on page 6 of this paper on d-lactic acidosis. The paper says:

Second, metabolic acidosis may be present without a rise in the plasma anion gap. In this latter setting, either the D-lactate anion was retained in the lumen of the GI tract (with the H being absorbed or titrated by bicarbonate in the lumen of the GI tract), or it was excreted in the urine, but in either case, the cation lost with it was Na+ and/or K+ ion [671 (not a H+ or NH4+ ion, lower right portion of Fig. 6).
This latter type of metabolic acidosis is akin to the over-production of hippuric acid in glue sniffers [68]. Since D-lactate anions are reabsorbed by the kidney much less readily than is L-lactate [54, 69, 70], as time progresses, the anion gap may decline without resulting in a rise in the plasma bicarbonate concentration-that is, D-Iactate is excreted as its Na+ or K+ salt (Fig. 6). Hence there are a number of mechanisms that may contribute to the presentation whereby the rise in the plasma anion gap might not match the fall in the plasma bicarbonate concentration. Not only might this lead to a diagnostic problem, it has implications for therapy because, once the organic anions are excreted as their Na+ or K+ salts, these anions are no longer available for metabolism to regenerate bicarbonate, and the patient might have developed a deficit of Na+ and/or K+.

Basically this suggests strongly to me that overexertion in ME, which leads to excessive amounts of lactate, could lead to deficiency in sodium or potassium.

I hope there are no errors in the above as copied over - it failed to copy the plus signs from the pdf and I had to add them in.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
That's a rather fitting conclusion MeSci! -have recently run out of my hydroxocobalamin and metafolin which are severely affecting cognitive function and make it difficult to interpret said paper

My blood S-Lactate is also High, would be interesting to know if you have had yours measured?

I would also bring across the point of your elevated BP as a probable reaction by the body to low blood volume?

No, I haven't had my blood lactate measured. It's just too frustrating trying to get anything from the NHS. My bicarbonate was very low when I was very ill with hyponatraemia, which is consistent with acidosis. Was 'S-lactate' a typo? If you mean d-lactate, have you seen these threads on d-lactic acidosis in ME/CFS?

http://forums.phoenixrising.me/inde...-the-same-symptoms-as-d-lactic-acidosis.8159/

http://forums.phoenixrising.me/index.php?threads/d-lactic-acidosis-in-cfs.6782/

I don't know whether high bp could be a response to low blood volume. When I developed high bp I did a load of reading up on possible causes (my GP just said it usually had no cause!!!). Can't remember what I found.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
I don't know whether high bp could be a response to low blood volume. When I developed high bp I did a load of reading up on possible causes (my GP just said it usually had no cause!!!). Can't remember what I found.

Finally got my brain in gear and thought - surely blood pressure is partly determined by blood volume, so can't be increased as a result of low volume. So I did a search and this page looks useful.

My own bp fluctuates wildly from one minute to the next, which can't be due to changes in volume - must be neurological, I think.