If we have low blood volume where does it go?

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Perhaps, we can conclude that reduced plasma and blood volumes are features of POTS, but not of ME/CFS in general. This appears consistent with the conclusion reached by van Campen (2019) that blood volume is significantly reduced in ME/CFS patients with orthostatic intolerance.
WIth regard to measuring cardiac output , ejection fraction etc , rather than volume directly, I think that Paul Cheney said you need to measure cardiac output while upright and it changes dramatically. He found that cardiac output in me/cfs patients was nearly as low as people in cardiogwnic shock when upright.

There may be cfs patients who do not have orthostatic intolerance, but in my mind it’s an important feature of the disease and should be part of criteria.

So Fukuda criteria may be capturing patients that are either not cfs patients or just atypical. There’s also a dynamic aspect to this illness. People may get progressively worse and meet different criteria. So maybe the Fukuda patients—I’m not saying they aren’t “real cfs” patients but maybe early on , .or partially recovered?
 

Inara

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ans in fact I wonder if what people call “hyperadrenergic pots” is an adaptive response to hypovolemia where the body tries to conserve volume and push blood where it needs
Yes. I think it's an "emergency program". But what's different that this program is started, and not another one?
 

bombsh3ll

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Yes. I think it's an "emergency program". But what's different that this program is started, and not another one?
It's not actually different to what one would expect, it corresponds to stage 2 of the 4 typically recognized stages of hypovolaemic shock - BP and HR increase due to sympathetic activation as the body tries to compensate for hypovolaemia.

The difference lies in that "shock" is usually seen as an acute event, from which one either recovers (with or without treatment, as if the blood loss/diarrhoea or whatever cause stops, & their fluid regulating hormones kick in the blood volume is restored), or the hypovolaemia worsens & they die.

The traditional school of thought in medicine doesn't seem to recognize that people can remain miserably existing in chronic stage 2 shock, with say 10-20% of their expected blood volume missing, able to retain just enough fluid & sodium not to die, but not enough to live any quality of life either.

Dr Bell was spot on, & yet his research is paid no attention.

B xxx
 

Jackdaw

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I wee like a horse so I guess that is why low blood volume occurs. 1.2 litres in one wee is my PB. :)

I drink salt water which helps a bit and am hopefully starting Florinef soon. I am hoping that helps.
 

bombsh3ll

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I wee like a horse so I guess that is why low blood volume occurs. 1.2 litres in one wee is my PB. :)
Same here, but I've been like that all my life even prior to illness. When I did a 24hr urine collection I looked at the 3.5 litre container, & said this will be full in an afternoon, where am I supposed to put the rest of it?! I had to get 3 containers.

I drink salt water which helps a bit and am hopefully starting Florinef soon
Good luck with the Florinef! Unfortunately I wasn't able to tolerate it but it works miracles for some people.

B xxx