Feel like Oxygen not getting into my cells/brain/body

[heapsreal]

its not oxygen but maybe oxidization thats killing us, peroxynitrate which is thrown around, but i also think we need to try and improve cerebral circulation. These things can increase nitric oxide that can lead to peroxynitrate. I think we need nitric oxide for brain perfusion but need to stop peroxynitrate with lots of different antioxidants. I would be interested in others opinions.

cheers!!!

 

[mellster]

The theory that the body is reducing oxygen supply for a reason is not that new and it is acknowledged that a lot of illnesses don't thrive that well in an oxygen deprived body. However it could also be that there is no reason for reducing oxygen intake and release but (possibly neurological or hormonal) malfunction and then it is simply a state of disarray with no use. This state can be cause by chronic viral infections. Having experienced airhungryness and the frustration to explain its difference from asthma to doctors I would like to find a good middle ground because it is not a good feeling and leading to fatigue as well.

 

[Boule de feu]

Like you, I feel the oxygen does not reach my brain. This is probably why I always have a major headache.
It feels like I'm not breathing properly and always have my mouth open to do so.
Otherwise, I suffocate. It's like I'm drowning but it's a dry feeling.

A few years ago, I was diagnosed with UARS (upper airway resistance syndrome).
After googling it, I just found out that some patients must struggle so violently to get every breath that the resulting dramatic swings in pressure within their chest can even cause collapse of the left side of their heart!

I never realized how serious this condition is and was not using my CPAP machine every night. I will never miss a night, now. I do feel better during the day when using the CPAP. I'm not struggling as much.

Everyone with M.E. should have a polysomnography done.

 

[Emootje]

There are four basic types of hypoxia:

1. Hypoxic hypoxia occurs when there is a deficiency in oxygen exchange in the lungs.
Some causes include:
? Decreased partial pressure of oxygen available at altitude
? Conditions that block the exchange at the alveolar capillary level (e.g. pneumonia, pulmonary edema, asthma, drowning)

2. Anemic hypoxia occurs when the body cannot transport the available oxygen to the target tissues.
Causes include:
? Anemia from acute or chronic blood loss
? Carbon monoxide poisoning
? Medications such as aspirin, sulfonamides and nitrites
? Methemoglobinemia
? Sickle cell disease

3. Stagnant hypoxia occurs when there is insufficient blood flow.
Causes include:
? Heart failure
? Decreased circulating blood volume
? Excess vasodilatation
? Excess vasoconstriction
? Hyperventilation

4. Histotoxic hypoxia occurs when the bodys tissues are not able to use the oxygen that has been delivered to them.
Causes include:
? Hydrogen sulfide (mitochondrial toxin)
? Cyanide (mitochondrial toxin)
? Alcohol (mitochondrial toxin)
? Narcotics (mitochondrial toxin)
? Pesticides (mitochondrial toxin)
? Peroxynitrite (mitochondrial toxin)
? Antiretroviral drugs (mitochondrial toxin)
? Low CO2, hyperventilation (high oxygen affinity of hemoglobin)
? Carbon monoxide (high oxygen affinity of hemoglobin)
? Hypothermia (high oxygen affinity of hemoglobin)
? Alkalosis (high oxygen affinity of hemoglobin)
? Low phosphate (high oxygen affinity of hemoglobin)

Most important causes of hypoxia in ME/CFS:
? Anemic hypoxia: Low red cell mass
? Stagnant hypoxia: Low blood volume, Excess vasoconstriction (high norepinephrine/endothelin/angiotensin)
? Histotoxic hypoxia :All mitochondrial toxins, High oxygen affinity of hemoglobin*

* Oxygen affinity of hemoglobin (p50) is calculated from venous blood gas values.
Excel program to calculate p50 from venous blood gas values:
http://www.medsci.org/v04p0232.htm

 

[Boule de feu]

There are four basic types of hypoxia:

1. Hypoxic hypoxia occurs when there is a deficiency in oxygen exchange in the lungs.
Some causes include:
? Decreased partial pressure of oxygen available at altitude
? Conditions that block the exchange at the alveolar capillary level (e.g. pneumonia, pulmonary edema, asthma, drowning)

2. Anemic hypoxia occurs when the body cannot transport the available oxygen to the target tissues.
Causes include:
? Anemia from acute or chronic blood loss
? Carbon monoxide poisoning
? Medications such as aspirin, sulfonamides and nitrites
? Methemoglobinemia
? Sickle cell disease

3. Stagnant hypoxia occurs when there is insufficient blood flow.
Causes include:
? Heart failure
? Decreased circulating blood volume
? Excess vasodilatation
? Excess vasoconstriction
? Hyperventilation

4. Histotoxic hypoxia occurs when the bodys tissues are not able to use the oxygen that has been delivered to them.
Causes include:
? Hydrogen sulfide (mitochondrial toxin)
? Cyanide (mitochondrial toxin)
? Alcohol (mitochondrial toxin)
? Narcotics (mitochondrial toxin)
? Pesticides (mitochondrial toxin)
? Peroxynitrite (mitochondrial toxin)
? Antiretroviral drugs (mitochondrial toxin)
? Low CO2, hyperventilation (high oxygen affinity of hemoglobin)
? Carbon monoxide (high oxygen affinity of hemoglobin)
? Hypothermia (high oxygen affinity of hemoglobin)
? Alkalosis (high oxygen affinity of hemoglobin)
? Low phosphate (high oxygen affinity of hemoglobin)

Most important causes of hypoxia in ME/CFS:
? Anemic hypoxia: Low red cell mass
? Stagnant hypoxia: Low blood volume, Excess vasoconstriction (high norepinephrine/endothelin/angiotensin)
? Histotoxic hypoxia :All mitochondrial toxins, High oxygen affinity of hemoglobin*

* Oxygen affinity of hemoglobin (p50) is calculated from venous blood gas values.
Excel program to calculate p50 from venous blood gas values:
http://www.medsci.org/v04p0232.htm

Thank you. This is so interesting! =-)
I have anemia from chronic blood loss.
So, it is another part of the ME puzzle... solved! (Well, almost.)

 

[richvank]

Hi, all.

I would like to contribute my views on what is going on with oxygen, CO2, and breathing in ME/CFS.

As I see it, the fundamental issue here is that the mitochondria in cells particularly of the tissues that are most depleted in glutathione are dysfunctional. A major fraction of the total cell mass is in the skeletal muscles, and they are glutathione-depleted. One result is that these tissues do not utilize oxygen at as high as normal a rate, and they also do not produce carbon dioxide at as high as normal a rate.

The blood, of course, circulates to all the tissues, including those with serious mito dysfunction and those that are still operating more normally. The latter include the vital organs, which have complete transsulfuration pathways, and are thus able to make cysteine from methionine, while cells such as those in the skeletal muscles cannot. So when cysteine is in short supply, the vital organs are able to make cysteine to replenish their glutathione and continue to function to preserve life, while the skeletal muscles and some other types of tissues become dysfunctional.

Here's the key point: The respiratory center in the brainstem controls the rate and depth of breathing by sending signals to the muscles involved in breathing. The respiratory center performs this regulation by monitoring the level of CO2 and the pH in the blood it receives. It pays attention to oxygen only when it becomes very low, and hits a trip point, which produces gasping. The CO2 level and pH of the blood represents an average of the effects of the mitochondria throughout the body, but they are dominated by the effects of the skeletal muscles, because of their large fraction of total cellular mass. So the respiratory center sees a low CO2 level in the averaged blood it receives, and it therefore slows and shallows the breathing, trying to raise the CO2 level. However, because the mitochondria are dysfunctional and can't produce CO2 very well, this doesn't work as well as normal, and that's why the rate and depth of breathing remain low.

Unfortunately, other tissues that still have a normal oxygen demand, and which must share the same blood supply, may find that they are not able to get enough oxygen, because the shallowing and slowing of the breathing will also mean that the oxygen intake by the lungs into the blood will be lower than normal. This gives rise to the feeling of "air hunger" or "shortness of breath." In response, people take conscious control of their breathing and raise its rate and depth.

When a person in this condition falls asleep, their normal ability to take conscious control of their breathing ("remind themself to breathe") is not present. Therefore, they can develop sleep apnea (not obstructive sleep apnea, but a central version, due to this confused signal getting to the respiratory center) and can awaken gasping periodically, as their oxygen level repeatedly drops down to the emergency trip point. This is just one more thing contributing to sleep problems in this disorder, added to things like abnormalities in cortisol, blood sugar level, melatonin, and others (all of which also stem from the same root vicious circle mechanism, in my view).

Dr. Cheney's observation that the oxygen saturatioin level of the blood in ME/CFS does not drop as rapidly as normal on breath holding is a consequence of a lower rate of whole-body oxygen utilization because of the mito dysfunction in muscle cells and some other types of cells.

His observation of oxygen toxicity is a consequence of the fact that if more oxygen is supplied to mitochondria that are dysfunctional, more of it is converted to superoxide ions, rather than to water molecules, as is normal. This exacerbates the state of oxidative stress that is already present, and that's why it feels "toxic."

There have been at least four studies reporting hypocapnia (low carbon dioxide partial pressure in exhaled gas) in ME/CFS. This has been attributed (I believe wrongly) to hyperventilation. In fact, it is due to mito dysfunction, and PWMEs/PWCs in fact mostly have HYPOventilation. The one study that actually measured ventilation rate in ME/CFS did not find hyperventilation.

I believe that all of this fits together, and it all comes back down to the vicious circle mechanism described by the GD-MCB hypothesis. This vicious circle mechanism is responsible for the mito dysfunction, and that's what brings on all the rest of what I have discussed here. This vicious circle also explains the other abnormalities in ME/CFS in straightforward detail, taking account of known biochemistry and physiology.

Best regards,

Rich

 

[mellster]

Rich - excellent summarization, thanks! Fits with my experience of no hyperventilation, but rather hypoventilation. So would you conclude that steroid asthma inhalers are not the appropriate treatment for air-hunger?

 

[Emootje]

Same here, no hyperventilation, but rather hypoventilation.

My capillary blood gas measurements:
pH = 7,46 [7.37-7.45]
CO2 = 42 [35 -45 mmHg]
pO2 = 77 [70 - 100 mmHg]
HCO3 = 28,9 [22 - 28 mmol/l]
spO2 = 0.96 [0.96 -1.00]

New theory:
PWC seem to have low blood volume. Low blood volume stimulates the sympathetic tone and the renin angiotensin aldosterone system.
Stimulated aldosterone makes the blood more alkaline (contraction alkalosis) resulting in hypoventilation and low oxygen levels.

 

[mellster]

Interesting theory - but that would mean that you have a very simple treatment option, breathe consciously more and faster, no? Might be worth a try..

 

[Emootje]

Thanks Mellster!
I already tried many breathing techniques: hyperventilation, breathing in a bag and slow deep breathing.
Only the last one gave me a benefit probably due to the norepinephrine lowering effects of deep breathing and not because of the CO2 changes.

 

[mellster]

Thanks, good info. I tried a couple as well - it's not easy to get rid of that feeling, but it seems to be confirm the theory as I never have it when I exercise, only when at rest although it's getting better. I think we simply forget to often the conscious breathing and it is some CNS mediated mild hypoventilation in the background. It definitely also helps to keep sinuses and lungs clear as much as possible. I also would have that feeling often when waking at night, since I started LDN my sleep and breathing during sleep has improved quite a bit, but I also make sure there is no sinus congestion at all before I go to bed. Also occasionally I find the breathe easy nasal strips very helpful to improve airflow through the nose. cheers

 

[SickOfSickness]

Yes, even though a pulse oximeter would usually show me at 99% or 100%.

I think mine has a big tie to allergies and sensitivities. Chemicals, foods, pollens, mold, dust mites, and other stuff. That is just my gut feeling on why.

I wish I could afford the O2 tank set up, or preferrably concentrator, because the tank seems like I would need more energy just to use it.

 

[FunkOdyssey]

It would be interesting to see how anyone with these symptoms responds to piracetam which is documented to improve functionality and damage caused by hypoxic conditions.

 

[Emootje]

Piracetam sounds like a very good idea, there are even some studies showing it is effective against breath holding spells in children.
http://www.ncbi.nlm.nih.gov/pubmed/9492090
http://www.ncbi.nlm.nih.gov/pubmed/18724570

Another treatment I'm thinking about is Buffered Ammonium Chloride, it makes the blood more acidic which stimulate ventilation.
Antagonizing of the aldosterone receptor activity may also work. (spironolactone, ACE and AII inhibitors, no fludrocortisone, no corticosteroid, no liquorice)
Just some idea's.....

 

[mellster]

I started piracetam but have it at work and forget to take it - argh!! Need to order another batch at home. This feeling of air hunger is one of the less painful but more frustrating continuous symptoms. I realized that it is more present after exercise, like the next day and paradoxically it gets better when exerting again lie walking etc. It it also more present in the morning than at other times and usually clears up mostly around noon though it's always slightly present. Maybe it has to do with not getting enough oxygen while sleeping or with a long startup time in the morning. I feel good when waking up at night and not depleted, it's after I get up when I notice it. So puzzling. FWIW I started nebulizing glutathione and hope it will help.

 

[rydra_wong]

When I was a teen I told my mother I felt like I was breathing but the oxygen wasn't going anywhere. She told me to lie down and gave me an orange juice and a vitamin E. So I was healthy and oxygen starved! But mine was/is classic anemia due to fibroid tumors which I had taken out 3 times but kept growing back. I would feel like I was looking at the world from the bottom of a deep black well. When I got feelings of floating I could not sleep and felt I would die if I did not fix it right away. I quickly learned to consume iron in mass quantities. The shocking thing has been that after my hysterectomy I still have been anemic at least 3 times! I get short of breath and everything seems heavy -- even things that are not heavy such as my purse! It have had to switch back to a multi with iron since my blood test showed it was really iron I was short of.

 

[rydra_wong]

The theory that the body is reducing oxygen supply for a reason is not that new and it is acknowledged that a lot of illnesses don't thrive that well in an oxygen deprived body. However it could also be that there is no reason for reducing oxygen intake and release but (possibly neurological or hormonal) malfunction and then it is simply a state of disarray with no use. This state can be cause by chronic viral infections. Having experienced airhungryness and the frustration to explain its difference from asthma to doctors I would like to find a good middle ground because it is not a good feeling and leading to fatigue as well.

Wow, I really don't understand this. But I dont know who Cheney is either. I thought ME shortness of breath was the same as B12 deficiency shortness of breath which is caused by anemia since you need B12 to make blood cells. Anemia causes air hunger...truly. Is each of you sure you are not anemic? Because your hemoglobin can be fine but if your ferritin is below 70 you are anemic. Mine has never been as high as 70 in my life but after a hysterectomy it dropped low enough to cause gasping for air a number of times (i can't remember how low, but below 20 anyway) and my hemoglobin was normal. (When I was younger my hemoglobin was also quite low). When it happened the first time post hysterectomy I looked up anemia and quite a few deficiencies can cause it including B12, P5P, and copper (not just iron). You could do a google search for deficiencies causing anemia then get a hair analysis to find out if you have any of those deficiencies.

 

[Valentijn]

My iron levels are, to quote "great!" But we tend to have low circulating blood volume in ME/CFS, meaning our red blood cells can probably hold oxygen just fine, but our circulatory system has trouble delivering it to our brains at an appropriate rate.

This probably causes the sensation of oxygen deprivation, in addition to light-headedness. I've noticed that if I lie down when feeling very light-headed, my breathing changes for while, becoming deeper and more rapid, maybe to increase oxygen uptake while I'm in a position to benefit from it?

 

[rydra_wong]

ok I am only learning, but doesn't low blood volume mean you are dehydrated or something? Can't you drink fluids to raise the blood volume? (or are you talking about MCV? in which case it is a form of anemia?). I still have a feeling we are not communicating because I think differently than you. If I had low blood volume (how is this diagnosed anyway?) I think I would be reaching for alkaline minerals and water. If my oxygen is not going anywhere I look up 'deficiencies that cause anemia' and take those things (in the active forms). If something doesn't work that studies or logic say are supposed to work I work on my digestion - taking cider vinegar in water or HCL tablets as necessary. I have been self-medicating my whole life so it is possible I am unconsciously doing something that might help you. I did think M.E. was the result of a genetic problem that was not circumvented but now I am beginning to think it is that plus some viral or pathogen component to set it off. (I never met anyone with worse genetics than me and I am still functionining so it has to be something more).

P.S. This website is very different from Fredd's website of people with B12 deficiencies. It looks like I'm not in Kansas any more.

 

[Valentijn]

ok I am only learning, but doesn't low blood volume mean you are dehydrated or something? Can't you drink fluids to raise the blood volume?

It's probably due to low production of Anti-Diuretic Hormone, which requires cysteine. A cysteine deficiency is a likely cause or side-effect of many cases of ME/CFS. Without enough ADH, the body dumps more fluids than it should.

Although fluids, potassium, and sodium might help to keep the problem from becoming horrific, they don't solve the problem. Transfusions or IV fluids can also be helpful, but the body only holds onto the "extra" fluids for a short time (days?) before ADH levels signal the body to dump them.

This is why supplementing cysteine in various forms might help, since it allows more ADH to be formed. N-acetyl cysteine (NAC) is the one I take that seems to have helped.