Carbon Monoxide toxicity can cause ME/CFS, according to Toxicologist Albert Donnay

[Djehuti]

Occasionally a theory has popped up that (at least some cases of) MECFS (and other chronic syndromes/diseases) could be due to chronically elevated endogenous carbon monoxide (CO) levels (disregarding the triggering mechanism for now). This is the theory of toxicologist Albert Donnay, who first reported back in 2000 that inhaled CO poisoning might be a common cause of CFS, FM, MCS, and GWS. The symptoms of each overlap considerably. But there is a dearth of data on patients’ CO levels, despite it being easily measured. We don’t know if MECFS patients have abnormally high (or low) levels. Both very low and high levels of CO are harmful, and can be fatal if not resolved. While CO poisonings due to inhaled gas are somewhat well known, it’s not as well known that the body both creates, stores in tissues, metabolizes, and exhales CO, maintaining a balance under healthy conditions. Various substances, lifestyle behaviors, and even medical treatments can raise or lower internal levels. But if high levels are not resolved, health issues occur. Could this be what’s occurring in some MECFS patients?

If Mr. Donnay’s intriguing theory is incorrect, then there must be at least one clear difference, such as symptoms, or better yet, an objective test or biomarker, that clearly distinguishes them. It is not a DLCO test, for example, which is low in both groups. So what if anything does distinguish them? Are there studies in which people with ME/CFS consistently get results that are significantly different from the results of people who have high levels of CO and/or endogenous Heme Oxygenase (HO) activity?

We’re hoping that contributions to this thread may shed some light on this.

 

[Wishful]

The symptoms of each overlap considerably.

Depending on how broadly you define the symptoms, you can find "considerable overlap" with probably a very large number of diseases and toxins. I think the title should be: "CO can cause symptoms that are somewhat similar to ME symptoms", which doesn't imply that it might cause ME.

 

[Djehuti]

Thank you for the comment, Wishful.

May I clarify, (and I am not Mr. Donnay, but he is a colleague), that this is a theory by Mr. Donnay, and not a statement of established fact in my opinion. Further, there is considerable other evidence which supports his theory, beyond symptom overlap, but which I left out in this initial post in the interest of brevity. From my background as a patient and researcher/writer, though skeptical, I’ve discussed this with him to the extent that I feel it’s worth exploring (all avenues?). I expect that Mr. Donnay will eventually add to this thread, and challenge this (very knowledgeable) community to ask the probing questions and possibly bring forth information which could disprove the theory. Isn’t that worth it?

 

[Wishful]

I wasn't trying to block discussion. Merely pointing out that similarity of some symptoms is not enough for a claim of cause. Staying up late results in feeling fatigued, but that doesn't mean that staying up late "can cause ME".

 

[Rufous McKinney]

But there is a dearth of data on patients’ CO levels, despite it being easily measured.

really basic things might be exactly what we should be investigating. And rarely are.

Everybody loves the oxygen reading at the end of one's finger. Well, where is this oxygen? Does it even reach a cell?

CO2 might be a factor as well.

 

[junkcrap50]

Interesting about endogenous carbon monoxide. Does that actually happen, to anyone, having high or low levels of endogenous CO? What test(s) reveal it? I doubt any ME/CFS patient has had it done.

There probably is something different with CO in PwME because our cellular metabolism & biochemisty is all messed up. Also our oxygen uptake is low.

You're asking for differences in test results between both groups (CO toxicity & ME/CFS patients), but no one here knows what tests are done on CO toxicity patients or what that patient group (for endogenous CO) is called.

I did find this, increased CO in Long Covid patients: https://pubmed.ncbi.nlm.nih.gov/37890507/

Long-COVID is Associated with Impaired Red Blood Cell Function​

2023 Oct 27 doi: 10.1055/a-2186-8108.
Romy Kronstein-Wiedemann # 1 2 , Kristin Tausche # 3 , Martin Kolditz 3 , Madeleine Teichert 2 , Jessica Thiel 1 , Dirk Koschel 3 4 , Torsten Tonn 1 2 , Stephan R Künzel 1 2

COVID-19 disease, caused by the severe acute respiratory syndrome virus 2 (SARS-CoV-2), induces a broad spectrum of clinical symptoms ranging from asymptomatic cases to fatal outcomes. About 10-35% of all COVID-19 patients, even those with mild COVID-19 symptoms, continue to show symptoms, i. e., fatigue, shortness of breath, cough, and cognitive dysfunction, after initial recovery. Previously, we and others identified red blood cell precursors as a direct target of SARS-CoV-2 and suggested that SARS-CoV-2 induces dysregulation in hemoglobin- and iron-metabolism contributing to the severe systemic course of COVID-19. Here, we put particular emphasis on differences in parameters of clinical blood gas analysis and hematological parameters of more than 20 healthy and Long-COVID patients, respectively. Long-COVID patients showed impaired oxygen binding to hemoglobin with concomitant increase in carbon monoxide binding. Hand in hand with decreased plasma iron concentration and transferrin saturation, mean corpuscular hemoglobin was elevated in Long-COVID patients compared to healthy donors suggesting a potential compensatory mechanism. Although blood pH was within the physiological range in both groups, base excess- and bicarbonate values were significantly lower in Long-COVID patients. Furthermore, Long-COVID patients displayed reduced lymphocyte levels. The clinical relevance of these findings, e. g., as a cause of chronic immunodeficiency, remains to be investigated in future studies. In conclusion, our data suggest impaired erythrocyte functionality in Long-COVID patients, leading to diminished oxygen supply. This in turn could be an explanation for the CFS, dyspnea and anemia. Further investigations are necessary to identify the underlying pathomechanisms.

 

[Djehuti]

Yes, it does happen to people, endogenous CO poisoning.

I have a CO gas-detector wristband (about $200), and can now monitor my levels, which track well with body temperature. It (exhaled CO) spiked a few days before the last time I had Covid. But we would need a group of people or clinic to start sampling some patients, as so far there’s no data.

Mr. Donnay had raised a red flag about those risks mentioned in Long-Covid paper, but it took a long time before it became recognized more widely.

So back to the theory and are there differences, I’m under the impression that vomiting is a key symptom difference, well known in CO poisoning, but not so much in MECFS per symptoms surveys. But I don’t know this for sure and wonder what is known.

 

[Alvin2]

I don't think this is it. Its not impossible but its seems like a strained theory.

That said one could measure its levels in the blood, presumably a delicate but not impossible thing to do. It does has a higher affinity than oxygen for hemoglobin.
Next where in the body is it coming from? I have never heard of the body producing it, that said i am not an expert on all things CO.
Finally i would experimentally treat it with hyperbaric oxygen and see if patients dramatically improve. If they do then you have a strong bit of evidence there. Several forum members have tried it and if it were magic we would know of that by now. IIRC some have had some marginal improvement.

 

[Rufous McKinney]

vomiting is a key symptom difference,

maybe our ambient nausea is influenced by CO levels....part of the Sickness Behavior suite is this anorexic thing; food is off-putting.

 

[Rufous McKinney]

What is the role of CO2? as opposed to CO? Both might be happening.

 

[perchance dreamer]

Gas ovens and ranges can emit carbon monoxide as well as other harmful pollutants. According to this article, they leak methane even when they are not on. It's just in the past year that I've read of these harmful effects.

https://www.health.harvard.edu/blog...e-pollution-that-may-harm-health-202209072811

There are ways to mitigate the harm of gas stoves such as opening the windows a little while cooking, using the vent hood, and placing an air purifier in the kitchen. I'm sure legions of people have lived healthy lives with gas appliances.

Still, when our duel-fuel oven gave out recently (gas range and electric oven), we got an induction oven. I love it!!! It's safer and more energy efficient than gas, and I think it's a dream to cook with. We did have to buy several new pieces of cookware, though. In order for a pot or pan to work with induction, a magnet must be able to adhere to the bottom. Most of our existing cookware is fine for induction.

I'm old enough to remember in the U.S. when gas companies pushed the idea that gas is cleaner than electric. I believed that until I started reading about the safety concerns around gas appliances. This research is not new. It's just that in the U.S. the information has just recently started to appear in the press.

 

[Rufous McKinney]

I'm old enough to remember in the U.S. when gas companies pushed the idea that gas is cleaner than electric

I'm old enough to remember the All Electric Home: with a special metal sign informing you of that, bolted onto the house by the front door.

placing an air purifier in the kitchen.

I don't think that would reduce risks from gas stoves; altho maybe it might filter some of the particulates formed by gas going.

I could really notice alot more "dust" when my gas furnace pilot light is on and I"m using the furnace.

 

[Rufous McKinney]

I now live without furnaces, or heaters. Or air conditioners.

I can open windows, and I can turn on a fan, or I can dig out a sweater.

 

[Wishful]

In order for a pot or pan to work with induction, a magnet must be able to adhere to the bottom.

There are some stainless steel alloys that a magnet won't stick to, but should work well with induction. Induction heating doesn't work on low electrical resistance materials, such as copper or aluminum. Stainless steel is a poor conductor, both of electricity and heat, and the latter is why better stainless steel pots have aluminum or copper bases.

 

[Wishful]

it might filter some of the particulates formed by gas going.

Natural gas flames don't produce much particulates unless they are really badly adjusted (yellow flame).

I could really notice alot more "dust" when my gas furnace pilot light is on and I"m using the furnace.

Well, the furnace blows dusty air around, even if the pilot light and burner are off.

I now live without furnaces, or heaters.

I don't have any indoor burning appliances, but tending my outdoor boiler and cooking on a twig stove (outdoors) results in lots of smoke inhalation.

 

[Djehuti]

I don't think this is it. Its not impossible but its seems like a strained theory.

That said one could measure its levels in the blood, presumably a delicate but not impossible thing to do. It does has a higher affinity than oxygen for hemoglobin.
Next where in the body is it coming from? I have never heard of the body producing it, that said i am not an expert on all things CO.
Finally i would experimentally treat it with hyperbaric oxygen and see if patients dramatically improve. If they do then you have a strong bit of evidence there. Several forum members have tried it and if it were magic we would know of that by now. IIRC some have had some marginal improvement.

Levels can be easily checked with the RKI gas watch (and others), by breathing into the sensor, and Mr. Donnay has a way to differentiate between lung, venous, arterial, and (all other) tissue levels. CO is released when heme proteins break down, such as when a women menstruates. If they build up faster than your body can metabolize and get rid of it, you start to feel bad, and normally, your body temperature goes up too. But my CO levels don't seem to build up (or stay up), and I'm usually cold. Perhaps that's what differentiates at least many MECFS patients from "typical" CO poisoning cases?
@Alvin2 , I personally am skeptical but think it should be disproven/proven either way to move things forward,

Is anyone able to comment on how common vomiting is for MECFS patients not due to a co-morbid condition?

 

[Djehuti]

Gas ovens and ranges can emit carbon monoxide as well as other harmful pollutants. According to this article, they leak methane even when they are not on. It's just in the past year that I've read of these harmful effects.

https://www.health.harvard.edu/blog...e-pollution-that-may-harm-health-202209072811

There are ways to mitigate the harm of gas stoves such as opening the windows a little while cooking, using the vent hood, and placing an air purifier in the kitchen. I'm sure legions of people have lived healthy lives with gas appliances.

Still, when our duel-fuel oven gave out recently (gas range and electric oven), we got an induction oven. I love it!!! It's safer and more energy efficient than gas, and I think it's a dream to cook with. We did have to buy several new pieces of cookware, though. In order for a pot or pan to work with induction, a magnet must be able to adhere to the bottom. Most of our existing cookware is fine for induction.

I'm old enough to remember in the U.S. when gas companies pushed the idea that gas is cleaner than electric. I believed that until I started reading about the safety concerns around gas appliances. This research is not new. It's just that in the U.S. the information has just recently started to appear in the press.

Not only that, @perchance dreamer , but I've been advised that at least in America the consumer CO detectors do not actually display levels higher than 0 ppm until around 30 ppm, AND then there's a time delay, and I suspect that the EPA limit is less than 30 for chronic exposure.
I've been looking into indoor air quality detectors that measure VOCs, etc., related to this.

 

[Alvin2]

@Alvin2 , I personally am skeptical but think it should be disproven/proven either way to move things forward,

I'm happy to see it tested as long as its not taking money from legitimate research.