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Linking findings to symptoms

Just a glance back at the four symptom clusters enu­merated earlier will demonstrate how well Bell's new research findings account for CFIDS/ME abnormalities: blood pooling in the extremities, low body-wide blood volume, and resulting low blood flow to the brain have obvious implications for fatigue, neurology prob­lems, pain, and sensitivities. (Regarding alcohol intol­erance, for example, just imagine a PWC's blood alco­hol level after two drinks if the patient has 50 to 70 percent of normal blood volume! Likewise, the low volume could spur over-sensitivity to drugs, histamine, etc.). Even healthy people, Bell noted, are instructed to lie down after donating blood to the Red Cross, be­cause of the possibility of fainting and lightheadedness resulting from orthostatic hypotension.

Making sense of mish-mosh 

Given that some PWCs seemingly suffer only from low plasma levels and others only from low RBC mass, the mixed treat­ment results at Johns Hopkins begin to make sense: "The only thing that Florinef affects is blood volume," Bell noted. Therefore, the 50 percent of Florinef re­sponders may likely have been those with the lowest blood volumes, not with NMH per se. Bell noted that one of the Johns Hopkins subjects treated with Florinef went from a pre-medication functioning level of 20 to 40 percent, quickly recovered on Florinef, and then stayed at 100 percent for two full years, even af­ter discontinuing the drug. She later experienced a re­lapse, went back on Florinef, and recovered com­pletely in two weeks (she is now, not surprisingly, staying on Florinef!). "Such a rapid recovery is a re­markable finding and clearly not explained by chance but instead by the drug," Bell said.

Bell also spelled out how his findings could explain many of the signs and symptoms that have seemed like a random mish-mosh until now. To name just one: SPECT scans of PWCs frequently show "holes" in the brain; these represent areas of insufficient blood flow. (MRI abnormalities, too, could be the result of low blood volume.)