Circulatory

<p>From: Reviving the Broken Marionette: Treatments for CFS/ME and Fibromyalgia</p>

<p>Almost all theories also connect to poor circulation. Postulated causes include hypovolemia (low blood volume), orthostatic hypotension or other dysautonomic states, hypercoagulation, poor erythrocyte deformability and combinations of these. Reduced circulation to brain and other organs could explain virtually all symptoms. Blood perfusion in the brain, especially in the brainstem, has been shown to be impaired in CFS/ME.8</p>

<p>This was associated with depressed baroreflex transfer indicating baroreceptor attenuation through defective vagal efferent response. Only the sympathetic response remained. Heart rate variability declined progressively from normal healthy control subjects through syncope to POTS to CFS patients. Timed breathing and Valsalva maneuver were most often normal in CFS and POTS patients, although abnormalities in select individuals were found. Heart rate and blood pressure regulation in POTS and CFS patients are similar and indicate attenuated efferent vagal baroreflex associated with increased vasomotor tone. Loss of beat-to-beat heart rate control may contribute to a destabilized blood pressure resulting in orthostatic intolerance. The dysautonomia of orthostatic intolerance in POTS&nbsp;</p>