Blood gases test results--for Tim

[Guest guest]

Rich,

Thanks for your response. The answers to your questions are 1) yes, 2)

no, and 3) I don't know.

I was feeling quite bad when the test sample was taken, but not the worst

it's ever been. The numbers I gave are correct; note that even if HCO3

were 26.47, such a result would still be abnormally high. The venous CO2

measurement was part of a standard comprehensive metabolic profile.

Tim

>Tim,

>I've been working on your blood gases results, >and I have some

>questions:

>1. Was this test run at a time when you were >experiencing the

>shortness of breath or suffocation feelings?

>2. Is there any chance that the arterial HCO3 >concentration was

>actually 26.47, instead of 26.7 millimoles per >liter? I think this

>parameter is calculated from the pH and the >PCO2 using the

>--Hasselbalch equation, and I get >26.47 from your pH and PCO2

>values.

>3. Was the venous CO2 value you cited a >measure of the PvCO2 or was

>it the socalled " total CO2, " or the socalled > " CO2 content, " which

>includes HCO3, and is actually about 95% >HCO3?

>Thanks.

>Rich

> Rich, could you take a look at the following arterial blood gas

numbers

> and see if they are consistent with your theory about the cause of

my

> sense of suffocation?

>

> pH was high at 7.494.

> PCO2 was borderline low at 35.5.

> PO2 was high at 107.5.

> HCO3 was high at 26.7.

> BE was high at 3.6.

> COHB was low at 0.4.

> tHB was borderline low at 14.0.

> O2 SAT and MET HB were both normal.

>

> Also, my venous CO2 was high at 32.

>

> Thanks very much.

>

> Tim

________________________________________________________________

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[Guest guest]

Tim,

Thanks for the responses. Sorry for my delay in responding. Life

has been pretty eventful for me during the past few days. I turned

60 about two weeks ago and retired from my 30-year job with the

University of California eight days ago. I moved my office home, but

almost all my stuff is still in boxes. I got a new computer and set

it up with a new e-mail address, with the usual machinations to

change things with the internet groups. Two days ago I had a

colonoscopy, which thankfully showed that my rectal cancer of four

years ago has not returned! My wife and I celebrated our 16th

anniversary yesterday. These have all been wonderful developments,

but I've gotten a little behind on my correspondence!

Concerning your blood gases test results, the high arterial blood pH

and borderline low PaCO2 are consistent with an abnormally low

metabolic rate, resulting in low production of CO2. I think this is

consistent with partial blockades in the intermediary metabolism of

the red, " slow-twitch " skeletal muscle cells. The PaO2 is high.

Without a corresponding measurement of PvO2 in the venous blood, it's

difficult to say for sure what this means. If the PvO2 is also high,

this would say that the reason is that the cells are not using oxygen

at as fast a rate as normal, which would be consistent with the

partial blockades, or that the oxygen is not able to diffuse from the

blood to the cells at as fast a rate as normal because of

hypercoagulation. If the PvO2 is normal or below normal, this would

suggest that either the blood is not moving through the circulation

at as fast a rate as normal, or that the total volume of red blood

cells is below normal. So I'm not sure what to say about this. It

does seem that your lungs are in good shape, though. I'm puzzled to

see that the arterial blood bicarbonate and the venous blood total

CO2 (which is mostly a measure of venous blood bicarbonate) are on

the high side of normal and high, respectively. I would have

expected that the kidneys would have lowered the bicarbonate in order

to try to correct the pH. So I don't understand this. The high base

excess confirms that you have metabolic alkalosis, in other words,

that your bicarbonate level is high. The low COHB says that you are

not suffering from carbon monoxide poisoning, which is good news.

The low normal total hemoglobin concentration suggests borderline

anemia.

As far as the hypothesis I suggested is concerned, I think it could

still be on target, except it's hard to say whether the oxygen

deprivation part is correct without more information. As you know,

your PaO2 came out high, suggesting that there is plenty of oxygen in

the arterial blood, and thus that there should be no oxygen

starvation of the respiratory center, and that my hypothesis is wrong

about this part. However, this could be deceiving if the total blood

cell volume is low, or if the blood is not flowing well through the

respiratory center, or if diffusion of oxygen is hindered by

hypercoagulation. The fact that Dr. Weil's breathing exercise makes

your feeling of suffocation worse suggests that there really is a

shortage of oxygen getting to the respiratory center. It doesn't seem

to be due to low oxygen saturation or low arterial oxygen partial

pressure, but it may still be occurring because of one of these other

factors.

If you want to shed more light on this situation and are able to get

more tests run, a venous blood gases test would be helpful. Of

course, it's best if it were run at the same time as the arterial

blood gases test, but you may not want to go through that again, or

your doctor or insurance company may not agree to repeat it. I think

it would still be informative even if run separately, so long as you

are feeling about the same in terms of the feeling of suffocation as

when the arterial test was run. With a venous blood gases test, we

could see whether your arm muscle cells are using oxygen at normal

rates or not.

Another helpful test would be total red blood cell volume. If this

comes out low, that could explain why there seems to be an oxygen

shortage in the respiratory center, even though the arterial blood

has a high PaO2 and a normal O2 saturation of the hemoglobin. This

test is done in nuclear medicine facilities.

If you want to try doing things to improve this without further

testing, I still think the most sweeping thing would be to get rid of

the partial blockades, which may be due to glutathione depletion. I

also still think that oxygen treatment with a CO2 rebreather mask

could be beneficial to you as an interim measure.

I think this is about all I can suggest with the information I have

at this point.

Rich

> > Rich, could you take a look at the following arterial blood gas

> numbers

> > and see if they are consistent with your theory about the cause

of

> my

> > sense of suffocation?

> >

> > pH was high at 7.494.

> > PCO2 was borderline low at 35.5.

> > PO2 was high at 107.5.

> > HCO3 was high at 26.7.

> > BE was high at 3.6.

> > COHB was low at 0.4.

> > tHB was borderline low at 14.0.

> > O2 SAT and MET HB were both normal.

> >

> > Also, my venous CO2 was high at 32.

> >

> > Thanks very much.

> >

> > Tim

>

> ________________________________________________________________

> GET INTERNET ACCESS FROM JUNO!

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[Guest guest]

Tim,

Thanks for the responses. Sorry for my delay in responding. Life

has been pretty eventful for me during the past few days. I turned

60 about two weeks ago and retired from my 30-year job with the

University of California eight days ago. I moved my office home, but

almost all my stuff is still in boxes. I got a new computer and set

it up with a new e-mail address, with the usual machinations to

change things with the internet groups. Two days ago I had a

colonoscopy, which thankfully showed that my rectal cancer of four

years ago has not returned! My wife and I celebrated our 16th

anniversary yesterday. These have all been wonderful developments,

but I've gotten a little behind on my correspondence!

Concerning your blood gases test results, the high arterial blood pH

and borderline low PaCO2 are consistent with an abnormally low

metabolic rate, resulting in low production of CO2. I think this is

consistent with partial blockades in the intermediary metabolism of

the red, " slow-twitch " skeletal muscle cells. The PaO2 is high.

Without a corresponding measurement of PvO2 in the venous blood, it's

difficult to say for sure what this means. If the PvO2 is also high,

this would say that the reason is that the cells are not using oxygen

at as fast a rate as normal, which would be consistent with the

partial blockades, or that the oxygen is not able to diffuse from the

blood to the cells at as fast a rate as normal because of

hypercoagulation. If the PvO2 is normal or below normal, this would

suggest that either the blood is not moving through the circulation

at as fast a rate as normal, or that the total volume of red blood

cells is below normal. So I'm not sure what to say about this. It

does seem that your lungs are in good shape, though. I'm puzzled to

see that the arterial blood bicarbonate and the venous blood total

CO2 (which is mostly a measure of venous blood bicarbonate) are on

the high side of normal and high, respectively. I would have

expected that the kidneys would have lowered the bicarbonate in order

to try to correct the pH. So I don't understand this. The high base

excess confirms that you have metabolic alkalosis, in other words,

that your bicarbonate level is high. The low COHB says that you are

not suffering from carbon monoxide poisoning, which is good news.

The low normal total hemoglobin concentration suggests borderline

anemia.

As far as the hypothesis I suggested is concerned, I think it could

still be on target, except it's hard to say whether the oxygen

deprivation part is correct without more information. As you know,

your PaO2 came out high, suggesting that there is plenty of oxygen in

the arterial blood, and thus that there should be no oxygen

starvation of the respiratory center, and that my hypothesis is wrong

about this part. However, this could be deceiving if the total blood

cell volume is low, or if the blood is not flowing well through the

respiratory center, or if diffusion of oxygen is hindered by

hypercoagulation. The fact that Dr. Weil's breathing exercise makes

your feeling of suffocation worse suggests that there really is a

shortage of oxygen getting to the respiratory center. It doesn't seem

to be due to low oxygen saturation or low arterial oxygen partial

pressure, but it may still be occurring because of one of these other

factors.

If you want to shed more light on this situation and are able to get

more tests run, a venous blood gases test would be helpful. Of

course, it's best if it were run at the same time as the arterial

blood gases test, but you may not want to go through that again, or

your doctor or insurance company may not agree to repeat it. I think

it would still be informative even if run separately, so long as you

are feeling about the same in terms of the feeling of suffocation as

when the arterial test was run. With a venous blood gases test, we

could see whether your arm muscle cells are using oxygen at normal

rates or not.

Another helpful test would be total red blood cell volume. If this

comes out low, that could explain why there seems to be an oxygen

shortage in the respiratory center, even though the arterial blood

has a high PaO2 and a normal O2 saturation of the hemoglobin. This

test is done in nuclear medicine facilities.

If you want to try doing things to improve this without further

testing, I still think the most sweeping thing would be to get rid of

the partial blockades, which may be due to glutathione depletion. I

also still think that oxygen treatment with a CO2 rebreather mask

could be beneficial to you as an interim measure.

I think this is about all I can suggest with the information I have

at this point.

Rich

> > Rich, could you take a look at the following arterial blood gas

> numbers

> > and see if they are consistent with your theory about the cause

of

> my

> > sense of suffocation?

> >

> > pH was high at 7.494.

> > PCO2 was borderline low at 35.5.

> > PO2 was high at 107.5.

> > HCO3 was high at 26.7.

> > BE was high at 3.6.

> > COHB was low at 0.4.

> > tHB was borderline low at 14.0.

> > O2 SAT and MET HB were both normal.

> >

> > Also, my venous CO2 was high at 32.

> >

> > Thanks very much.

> >

> > Tim

>

> ________________________________________________________________

> GET INTERNET ACCESS FROM JUNO!

> Juno offers FREE or PREMIUM Internet access for less!

> Join Juno today! For your FREE software, visit:

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[Guest guest]

Pardon me for jumping into this thread but please allow me to throw

some speculation into the blood gas issues.

One thing that causes oxygen molecules to be released from

hemoglobin is low pH. As the blood flowing through the capillaries

in the tissue encounters areas of lowered pH, possibly due to

carbonic acid, the oxygen is released from hemoglobin and diffuses

into the cell. The hemoglobin then picks up carbon dioxide for

transport to the lungs to release and exchange for more oxygen.

carbonic acid is formed by combining the H2O and CO2, the two

byproducts of oxygen dependent energy manufacture in the

mitochondria. The enzyme that performs the combining of H2O and CO2

is zinc dependent.

What if carbonic acid is not being produced and therefore CO2 and

H2O are being retained in the cell. Lack of carbonic acid and the

pH stays elevated so the release of oxygen from hemogobin is not

triggered.

Another possibility is that muscle constriction due to reduced

cellular magnesium and calcium could impair capillary blood flow

through the tissue and the blood is shunted via other pathways. Or

a hypercoagulated state of the blood impedes capillary blood flow.

The kidneys fail to adjust blood pH because the body is attempting

to correct the acidic condition that exists within the cell.

Without oxygen the cell is having to produce more ATP via the

anaerobic pathway of glycolysis. This process further acidifies the

internal cell environment by building up pyruvic acid. Another

enzyme fails to convert pyruvic acid to lactic acid. (This process

is functioning in PWCFIDS.)

Low blood co2 levels tell the respiratory centers in the brain that

it needs to build this up so in its attempt to do so breathing rate

and depth is decreased. Low blood CO2 levels also effect acid

production in the stomach. Acid that is necessary to ionize a

number of minerals from the food: calcium, magnesium, zinc, iron,

vit B12 and folic acid,... etc so that the body can absorb them.

Some things to think about.

All the best,

Jim

Fibromyalgia: A Hypothesis of Etiology

http://www.xmission.com/~total/temple/index.html

> > > Rich, could you take a look at the following arterial blood

gas

> > numbers

> > > and see if they are consistent with your theory about the

cause

> of

> > my

> > > sense of suffocation?

> > >

> > > pH was high at 7.494.

> > > PCO2 was borderline low at 35.5.

> > > PO2 was high at 107.5.

> > > HCO3 was high at 26.7.

> > > BE was high at 3.6.

> > > COHB was low at 0.4.

> > > tHB was borderline low at 14.0.

> > > O2 SAT and MET HB were both normal.

> > >

> > > Also, my venous CO2 was high at 32.

> > >

> > > Thanks very much.

> > >

> > > Tim

> >

> > ________________________________________________________________

> > GET INTERNET ACCESS FROM JUNO!

> > Juno offers FREE or PREMIUM Internet access for less!

> > Join Juno today! For your FREE software, visit:

> > http://dl.www.juno.com/get/web/.

[Guest guest]

I admit I didn't follow all this. However, in the Cheney tape he talks

about poor oxygen transport that is in 92% of PWC's. If you expire air out

of your lungs and hold your breath, your body should pull oxygen out of your

blood. You can measure this with a pulse ox thing on your fingertip. In

70% of PWC's, they do not pull oxygen out of the blood. The oxygen is

there, but it doesn't transfer into tissues. This of course can cause

fatigue, pain, growth of microorganisms that like low-oxygen environments.

Sorry if I am wrong and this isn't related, but it seemed related.

Thanks,

Doris

----- Original Message -----

From: " rvankonynen " <richvank@...>

>

> As far as the hypothesis I suggested is concerned, I think it could

> still be on target, except it's hard to say whether the oxygen

> deprivation part is correct without more information. As you know,

> your PaO2 came out high, suggesting that there is plenty of oxygen in

> the arterial blood, and thus that there should be no oxygen

> starvation of the respiratory center, and that my hypothesis is wrong

> about this part. However, this could be deceiving if the total blood

> cell volume is low, or if the blood is not flowing well through the

> respiratory center, or if diffusion of oxygen is hindered by

> hypercoagulation. The fact that Dr. Weil's breathing exercise makes

> your feeling of suffocation worse suggests that there really is a

> shortage of oxygen getting to the respiratory center. It doesn't seem

> to be due to low oxygen saturation or low arterial oxygen partial

> pressure, but it may still be occurring because of one of these other

> factors.

[Guest guest]

Jim,

Thanks for your comments.

Concerning the possibility of the zinc-dependent enzyme carbonic

anhydrase B being inhibited, so that the rate of synthesis of

carbonic acid is decreased, if this were the case I would expect to

see an elevation in PaCO2, but in Tim's case the opposite is observed.

You mentioned " muscular constriction due to reduced cellular

magnesium and calcium. " I think that reduced cellular calcium would

relax the muscles rather than constrict them, because calcium is

known to be used as the signal to contract muscle fibers. I do think

there is good evidence that magnesium is depleted in many PWCs.

You suggest that the kidneys do not adjust the blood pH because " the

body is attempting to correct the acidic condition within the cell. "

Which cell are you referring to? Do you mean the red, " slow-twitch "

skeletal muscle cells? If so, how do the kidneys sense that these

cells are acidic? If the kidneys are to respond to a condition, they

have to be able to get a signal that tells them that the condition

exists. I don't think it's sufficient to invoke " the body " in an

anthropomorphic way, as though it mysteriously " knows " things

and " corrects " things, without having some basis for the mechanism in

known physiology. As far as I know, the kidneys adjust the chemistry

of the blood in order to keep its various components within certain

ranges, but they don't respond to intracellular conditions in other

tissues. As far as I know, the control of pH within the individual

cells is done by ion pumps in the cell membranes.

I do agree that a primary lack of oxygen for the skeletal muscle

cells is a factor in some PWCs, and that there are digestive problems

in many PWCs as well. However, it looks to me as though there are

quite a few subsets within the CFS population, and it's necessary to

take a look at each individual case to determine which subset it

falls into. I'm glad to hear that you have had success in helping

eight people. I suspect that as you consider more cases, you will

find that they don't all respond in the same way to your program,

because different mechanisms are at work in different PWCs.

Nevertheless, if you've found ways to help at least some, that's a

big step forward.

Rich

> > > > Rich, could you take a look at the following arterial blood

> gas

> > > numbers

> > > > and see if they are consistent with your theory about the

> cause

> > of

> > > my

> > > > sense of suffocation?

> > > >

> > > > pH was high at 7.494.

> > > > PCO2 was borderline low at 35.5.

> > > > PO2 was high at 107.5.

> > > > HCO3 was high at 26.7.

> > > > BE was high at 3.6.

> > > > COHB was low at 0.4.

> > > > tHB was borderline low at 14.0.

> > > > O2 SAT and MET HB were both normal.

> > > >

> > > > Also, my venous CO2 was high at 32.

> > > >

> > > > Thanks very much.

> > > >

> > > > Tim

> > >

> > > ________________________________________________________________

> > > GET INTERNET ACCESS FROM JUNO!

> > > Juno offers FREE or PREMIUM Internet access for less!

> > > Join Juno today! For your FREE software, visit:

> > > http://dl.www.juno.com/get/web/.

[Guest guest]

Doris,

Yes, this is very much related. I think that it's a very significant

observation that so many PWCs transport oxygen out of their blood at

a much slower rate than normal, healthy people, and using a pulse

oximeter while holding the breath is a very clever way to observe

this.

The question is, " Why do so many PWCs use blood oxygen at a much

slower rate than normals? " We know it isn't a problem with the lungs

in these particular people, since the pulse oximeter measurement is

made on oxygen already attached to hemoglobin. It may be that

hypercoagulation, leading to the deposition of fibrin molecules in

the capillaries, which blocks oxygen diffusion to the cells, is

responsible in some PWCs. But I suspect that in the main subset the

problem is that the red, " slow-twitch " muscle cells have partial

blockades in their intermediary metabolism, often in the Krebs

cycles, and that these partial blockades decrease their rate of

metabolism and thus their demand for oxygen. So long as their

cytochrome oxidase molecules already have oxygen molecules bound to

them, which aren't being converted to water molecules at a normal

rate, the cells can't take more oxygen. As a result, the partial

pressure of oxygen remains high in the venous blood, and there is no

driving force to remove oxygen from the hemoglobin. It's a

backlogged condition. The problem is not in oxygen transport per se,

but in oxygen utilization by the cells. It's like you can lead a

cell to oxygen, but you can't make it drink. This hypothesis is

consistent with several other observations, including the elevated

citric acid in the urine of many PWCs, suggesting a Krebs cycle

partial blockade downstream of citric acid, and the observation that

simply pumping in more oxygen, using normobaric or hyperbaric oxygen,

doesn't significantly help many PWCs.

Rich

> I admit I didn't follow all this. However, in the Cheney tape he

talks

> about poor oxygen transport that is in 92% of PWC's. If you expire

air out

> of your lungs and hold your breath, your body should pull oxygen

out of your

> blood. You can measure this with a pulse ox thing on your

fingertip. In

> 70% of PWC's, they do not pull oxygen out of the blood. The oxygen

is

> there, but it doesn't transfer into tissues. This of course can

cause

> fatigue, pain, growth of microorganisms that like low-oxygen

environments.

>

> Sorry if I am wrong and this isn't related, but it seemed related.

> Thanks,

> Doris

> ----- Original Message -----

> From: " rvankonynen " <richvank@a...>

> >

> > As far as the hypothesis I suggested is concerned, I think it

could

> > still be on target, except it's hard to say whether the oxygen

> > deprivation part is correct without more information. As you

know,

> > your PaO2 came out high, suggesting that there is plenty of

oxygen in

> > the arterial blood, and thus that there should be no oxygen

> > starvation of the respiratory center, and that my hypothesis is

wrong

> > about this part. However, this could be deceiving if the total

blood

> > cell volume is low, or if the blood is not flowing well through

the

> > respiratory center, or if diffusion of oxygen is hindered by

> > hypercoagulation. The fact that Dr. Weil's breathing exercise

makes

> > your feeling of suffocation worse suggests that there really is a

> > shortage of oxygen getting to the respiratory center. It doesn't

seem

> > to be due to low oxygen saturation or low arterial oxygen partial

> > pressure, but it may still be occurring because of one of these

other

> > factors.

[Guest guest]

The PaCO2 would be directly related to oxygen received by the cell.

Since CO2 is a byproduct of the aerobic krebs cycle, without oxygen

diffusing into the cell, CO2 production would be diminished.

I agree with you regarding the effect of reduced calcium. I read an

abstract suggesting that reduced cellular calcium was suspected to be

responsible for muscular constriction. Calcium and Magnesium are

both low so threw them both into a blanket statement.

The kidneys adjusting blood for cellular acidity was what Cheney had

said in his video. There is much that is still not known about how

the body works. In some speculation you just have to say this

happens, and this happens and then a miracle takes place here and

this is what we end up with as a result. If all the physiology of

the body were known these conditions would not be so confusing.

All the best,

Jim

> > > > > Rich, could you take a look at the following arterial blood

> > gas

> > > > numbers

> > > > > and see if they are consistent with your theory about the

> > cause

> > > of

> > > > my

> > > > > sense of suffocation?

> > > > >

> > > > > pH was high at 7.494.

> > > > > PCO2 was borderline low at 35.5.

> > > > > PO2 was high at 107.5.

> > > > > HCO3 was high at 26.7.

> > > > > BE was high at 3.6.

> > > > > COHB was low at 0.4.

> > > > > tHB was borderline low at 14.0.

> > > > > O2 SAT and MET HB were both normal.

> > > > >

> > > > > Also, my venous CO2 was high at 32.

> > > > >

> > > > > Thanks very much.

> > > > >

> > > > > Tim

> > > >

> > > >

________________________________________________________________

> > > > GET INTERNET ACCESS FROM JUNO!

> > > > Juno offers FREE or PREMIUM Internet access for less!

> > > > Join Juno today! For your FREE software, visit:

> > > > http://dl.www.juno.com/get/web/.

[Guest guest]

Rich,

Please explain why you believe hyperbaric oxygen doesn't help PWCs.

As a PWC finding hyperbaric very helpful and trying to understand why

in 20 years no one recommended I try it, I have not found where it

has been systematically tried. This despite general agreement that

insufficient O2 transport/uptake is a serious problem in most PWC

(92% per Cheney).

Cheney used to suggest breathing unpressurized O2, and now recommends

Weil's breathing exercise. Both induce a small amount of O2 into

hemoglobin, tissues, and other body fluids relative to O2 under

hyperbaric pressure.

In the absence of CFS research funding, we can't know if CFS hypoxia

relates to your Krebs blockade hypothesis or according to

observations of deformed RBCs, low blood volume, hypercoagulation,

and inflexible RBCs unable to fit into small capilaries in PWC.

But recent discussions where participants reported sensitivity to

altitude changes and breathing exercise effects at least suggest that

some of us (maybe only the hypercoagulated) may benefit from

hyperbarics as I do. The largest informal tally I found from the UK

showed 83% of PWCs reported some improvement.

Regards,

> > I admit I didn't follow all this. However, in the Cheney tape he

> talks

> > about poor oxygen transport that is in 92% of PWC's. If you

expire

> air out

> > of your lungs and hold your breath, your body should pull oxygen

> out of your

> > blood. You can measure this with a pulse ox thing on your

> fingertip. In

> > 70% of PWC's, they do not pull oxygen out of the blood. The

oxygen

> is

> > there, but it doesn't transfer into tissues. This of course can

> cause

> > fatigue, pain, growth of microorganisms that like low-oxygen

> environments.

> >

> > Sorry if I am wrong and this isn't related, but it seemed related.

> > Thanks,

> > Doris

> > ----- Original Message -----

> > From: " rvankonynen " <richvank@a...>

> > >

> > > As far as the hypothesis I suggested is concerned, I think it

> could

> > > still be on target, except it's hard to say whether the oxygen

> > > deprivation part is correct without more information. As you

> know,

> > > your PaO2 came out high, suggesting that there is plenty of

> oxygen in

> > > the arterial blood, and thus that there should be no oxygen

> > > starvation of the respiratory center, and that my hypothesis is

> wrong

> > > about this part. However, this could be deceiving if the total

> blood

> > > cell volume is low, or if the blood is not flowing well through

> the

> > > respiratory center, or if diffusion of oxygen is hindered by

> > > hypercoagulation. The fact that Dr. Weil's breathing exercise

> makes

> > > your feeling of suffocation worse suggests that there really is

a

> > > shortage of oxygen getting to the respiratory center. It

doesn't

> seem

> > > to be due to low oxygen saturation or low arterial oxygen

partial

> > > pressure, but it may still be occurring because of one of these

> other

> > > factors.

[Guest guest]

,

Thanks for your comments and for the data.

I'm not saying that hyperbaric oxygen doesn't help some PWCs, though

I'm surprised at the figure of 83% that you mentioned. Over the

course of time in reading posts, I have read several from people who

said hyperbaric oxygen didn't help them, including at least one

person from the U.K., but I certainly don't have good statistics on

that. I think that Dr. Garth Nicolson is doing this in southern

California, but I haven't heard how the results have been coming out.

My general hypothesis for CFS is that in all cases there is a partial

blockade somewhere in the intermediary metabolism, and particularly

in the Krebs cycle or the respiratory chain. This includes the

bottom of the respiratory chain, where oxygen comes into the

picture.

Within this general hypothesis, there are several subsets. I agree

that there are some subsets in which the basic problem is that oxygen

is not getting to the enzyme cytochrome oxidase in the cells.

Hypercoagulation could be one reason. Insufficient lung function

because of earlier serious lung disease may be another. Chronic

carbon monoxide poisoning may be another. Poor circulation may be

another. There may be others. I think these subsets will indeed be

helped by hyperbaric oxygen.

However, I think there are other subsets in which the basic problem

is not that oxygen is not getting to the cells. In these people, the

partial blockade is within the cells themselves. It looks to me as

though the main subset has a partial blockade at aconitase in the

Krebs cycle. The evidence for this is high citric acid in the urine,

and low alpha ketoglutaratic acid (also known as 2-oxo-glutaric

acid). They also have low reduced glutathione, as evidenced by a

liver detox test or an analysis of red blood cells. In this subset,

I don't think that hyperbaric oxygen will do much good. I'm willing

to be corrected if this isn't found to be true.

I don't know which subset you would fit into. Have you had a urine

organic acids test or a detoxification panel? Have you had arterial

or venous blood gases tests? Have you had an ISAC panel? How do you

respond to going to higher elevation or airplane trips? How do you

respond to Dr. Weil's breathing technique? Have you had any serious

lung disease in the past? Have you had a pulse oximeter test? How

do you feel if you breathe into a paper back for four minutes, better

or worse? Are your hands and feet usually cold? Have you had a

sedimentation rate measurement run on your blood that came out 5 mm

per hour or less? Is there a chance that you are exposed to carbon

monoxide on a continuing basis, as from a leaky heating system? Any

data along these lines would help to determine your subset.

In any case, I'm glad you have found something that helps, and again,

I'm not saying it wouldn't help other PWCs, just that it won't help

all of them, and perhaps not even the majority. Can you recall where

that figure of 83% came from, and how many cases were counted?

Rich

> Rich,

>

> Please explain why you believe hyperbaric oxygen doesn't help

PWCs.

> As a PWC finding hyperbaric very helpful and trying to understand

why

> in 20 years no one recommended I try it, I have not found where it

> has been systematically tried. This despite general agreement that

> insufficient O2 transport/uptake is a serious problem in most PWC

> (92% per Cheney).

>

> Cheney used to suggest breathing unpressurized O2, and now

recommends

> Weil's breathing exercise. Both induce a small amount of O2 into

> hemoglobin, tissues, and other body fluids relative to O2 under

> hyperbaric pressure.

>

> In the absence of CFS research funding, we can't know if CFS

hypoxia

> relates to your Krebs blockade hypothesis or according to

> observations of deformed RBCs, low blood volume, hypercoagulation,

> and inflexible RBCs unable to fit into small capilaries in PWC.

>

> But recent discussions where participants reported sensitivity to

> altitude changes and breathing exercise effects at least suggest

that

> some of us (maybe only the hypercoagulated) may benefit from

> hyperbarics as I do. The largest informal tally I found from the

UK

> showed 83% of PWCs reported some improvement.

>

> Regards,

>

[Guest guest]

Duncan,

Have you treated any PWCs whose symptoms got worse under ozone

therapy? My concern about it is that if someone is in a state of

oxidative stress and is glutathione-depleted, I'm not sure that their

body will respond by elevating the glutathione and other

antioxidants. The problem may be that their antioxidant system is

already stretched to the limit, and they don't have any reserve to

call up when they get ozone, which worsens the state of oxidative

stress. I'm willing to be corrected if this doesn't match your

experience.

Rich

> Chronic fatigue and myalgia are often treated successfully with

ozone,

> mainly as a program of steam saunas. Here are reasons why it

produces

> results:

>

> 1) Partial pressure of oxygen is increased

>

> 2) Oxidation of toxins

>

> 3) Oxidation of infections

>

> 4) Induced glutathione and other antioxidant elevation as a

response to the

> brief oxidative stress.

>

> <<Rich, Please explain why you believe hyperbaric oxygen doesn't

help PWCs.

> As a PWC finding hyperbaric very helpful and trying to understand

why

> in 20 years no one recommended I try it, I have not found where it

> has been systematically tried. This despite general agreement that

> insufficient O2 transport/uptake is a serious problem in most PWC

> (92% per Cheney).>>

>

> Duncan Crow (ozone therapist in Canada)

> 250-748-6967

[Guest guest]

Rich,

The link showing 83% PWC improved using hyperbarics was:

http://www.drys00384.pwp.blueyonder.co.uk/hbot.htm

This UK author shares my view that hyperbarics should be

systematically assessed for treatment of CFS.

After a reread, a more correct statement would be that out of 336 PWC

tested in 2 groups, between 70-83% reported some improvement, while a

small number (2 of 36 in one reported sample) got worse.

The most common improvement was reduced fatigue which is consistent

with my experience. I fit into your hypercoagulated (2 positives on

Hemex ISAC panel) category, with some sensitivity to altitude. So

you are correct to predict that I would benefit from hyperbaric O2.

Specifically I have 2 main groups of symptoms. The symptom group

thankfully relieved by hyperbarics has been:

1) Subjective 95% reduction of low grade infections I almost always

had: sore throat, swollen neck lymph nodes, dermatitis, unidentified

stomach bug. Now I just feel the edge of these when tired.

2) Major increase in general energy level and in also terms of a

feeling of reserve strength in muscles that I had almost forgotten

about.

3) Relief of FM type symptoms: sore/stiff neck, general body and

muscle soreness.

My other symptoms relate to adrenal insufficiency per 24 hour

cortisol testing. These include extreme intolerance to exercise,

cold all over (not just extremities as in Reynauds), excessive day

and night sweats, delayed sleep, and fatigue if I push the above

limitations. These have not yet improved significantly with

hyperbarics.

But hyperbarics remains incomparably better than the literally dozens

of remedies I have tried over 20+ years. I feel that knocking out

half the symptoms gives me a much better foundation to go after the

rest.

I like your O2 transport or partial Krebs blockade model. It it is

consistent with how different PWC are in what ails and helps them.

It also suggests that it is easy to predict who will benefit from

hyperbaric O2, making it a potentially very useful treatment.

Beyond the model I feel the issue to understand in terms of the PWC

community is:

(1) What portion of PWC are in the group with O2 transport defects

rather than a Krebs blockade?

(2) Is hyperbaric a viable treatment relative to other options for O2

transport improvement?

On the first question, my impression from Hemex/Dave Berg is that a

majority of chronic fatigue cases suffer hypercoagulation. I can't

quote a percent, and I would welcome any information or correction of

this assumption.

On the second question the standard treatment for hypercoagulation is

heparin, usually by injection. Like most medications there are

potential side effects: osteoperosis, hair loss, and bleeding.

The beauty of hyperbarics by contrast is that it is not invasive and

vitually without side effect. While forcing oxygen to the cells for

aerobic ATP production, it also tends to kill off anerobic baterica,

mycoplasmasm, even Lyme Disease, improve white cell production, and

clear the mind. It does not create a serious herx reaction.

Moreover, successful outcome does not depend on isolating exact

pathogens as with many protocols. And it is good for you to the

point where athletes are using it to improve performance.

Nevertheless hyperbaric O2 is almost untried for CFS. I was the

first CFS customer at the local HBOT center (there was 1 successful

outcome FM before me). If you grant that hyperbarics should help the

group with poor O2 transport then I am one person closer to getting

this potentially vital point across.

Regards,

> > Rich,

> >

> > Please explain why you believe hyperbaric oxygen doesn't help

> PWCs.

> > As a PWC finding hyperbaric very helpful and trying to understand

> why

> > in 20 years no one recommended I try it, I have not found where

it

> > has been systematically tried. This despite general agreement

that

> > insufficient O2 transport/uptake is a serious problem in most PWC

> > (92% per Cheney).

> >

> > Cheney used to suggest breathing unpressurized O2, and now

> recommends

> > Weil's breathing exercise. Both induce a small amount of O2 into

> > hemoglobin, tissues, and other body fluids relative to O2 under

> > hyperbaric pressure.

> >

> > In the absence of CFS research funding, we can't know if CFS

> hypoxia

> > relates to your Krebs blockade hypothesis or according to

> > observations of deformed RBCs, low blood volume,

hypercoagulation,

> > and inflexible RBCs unable to fit into small capilaries in PWC.

> >

> > But recent discussions where participants reported sensitivity to

> > altitude changes and breathing exercise effects at least suggest

> that

> > some of us (maybe only the hypercoagulated) may benefit from

> > hyperbarics as I do. The largest informal tally I found from the

> UK

> > showed 83% of PWCs reported some improvement.

> >

> > Regards,

> >