Treating Low Blood Volume in CFS

The low blood volume finding in chronic fatigue syndrome has been consistently replicated; there is no doubt that low blood volume is common in this disorder. Since low blood volume can cause, among other things, reduced blood flows to the brain (cognitive difficulties), problems standing (orthostatic intolerance), increased heart rate and reduced heart functioning it generated some interest in the research community.

In August 2009 Dr. Teitelbaum released his treatment recommendations for low blood volume. Dr. Teitelbaum is a well known ME/CFS physician associated with the Fibro Fatigue Centers. His protocols are generally very supplement rich and often focus on hormones.

Dr. Teitelbaum’s Treatment Recommendations For Low Blood Volume

  1. Hydrate yourself by drinking lot of water. Check your hydration levels by checking your mouth and lips to see if they’re dry.
  2. Use salt liberally – keep all that water your drinking around eating a lot of salt. Eat salty foods. (V-8 juices have a good blend of salt and other electrolytes. )
  3. Improve adrenal support by taking (yes) one of the doctors Adrenal Supplements.
  4. If your doctor can supply them try saline IV’s. (Dr. Bell has reported that several of his patients respond very well to plain saline IV’s). Dr. Teitelbaum recommends Meyer’s cocktails if you can get them.
  5. Even if your blood tests (ferritin) are only modestly low (or below 50) take iron (1-2 tablets 29 mg. w/vit.C)
  6. Take testosterone and thyroid even if your test levels are normal.
  7. Improve heart functioning by taking mitochondrial enhancing supplements such as: D-Ribose: 5 gm (I scoop) two times a day for three weeks, twice a day thereafter/ acetyl L carnitine (500 mgs, two times a day), coenzyme Q. 10 (200 milligrams a day, Dr. Teitelbaum’s Energy Revitalization Formula.

Give the program 6 to 12 weeks to take effect. For Dr. Teitelbaum’s complete article click here.

leokitten May 8, 2014 at 3:07 pm

Honestly this treatment protocol and much of what I see from CFS “expert” physicians are just blind empirical treatments that might help around the edges but could also cause unintended negative consequences (like taking hormones when you might not need them???) and most importantly fail to find and correct the underlying problem. That’s why if you take the treatment you only improve somewhat and if you stop you immediately revert back. Pointless.

Your CFS doctor should be a little smarter and if you have symptoms of hypovolemia try and determine the underlying cause. Unfortunately there is no fairly straightforward lab test that can be done via major labs like Labcorp or Quest to determine your blood volume. The test for blood volume is a more complicated nuclear medicine test that requires special equipment, see

Your CFS doctor should be asking you more questions about your symptoms like e.g. are you urinating a lot? Is your blood pressure high or low? Your doctor should do all the lab tests they easily do to determine what could be the underlying cause of low blood volume:

24-hr urine cortisol
24-hr urine aldosterone
24-hr urine osmolality
24-hr urine catecholamines
24-hr urine metanephrines
Antidiuretic hormone (ADH) profile
Angiotensin II
Renin activity

The 24-hr urine collections will show you and your doctor how much urine you produce each day. With all of this information then you can make a more informed decision as to the best treatment approach.

I have ME/CFS with all of the classic symptoms. The reason I feel I needed to write this comment is because I had very clear signs and symptoms of low blood volume and if I had followed Dr. Teitelbaum’s treatment protocol above I would have gotten worse and created new problems. After doing the above tests I was able to determine exactly what was causing my low blood volume and to only treat that.

Mary Jo August 17, 2014 at 4:40 pm

Like Vicky, I was wondering if the tests you mentioned found out the cause of your low blood volume? Did you feel faint when you were standing or sitting for a long time?

vicky June 11, 2014 at 1:28 am

Did you find out what was causing your symptoms from those tests? I too am undergoing some investigations with a cardiac specialist as i have puched for investigatiosn into low blood volume. I have been down the adrenal route and was also sceptical, but still suffering. What diagnosis did they come up with for you?

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