Hypoperfusion in the CFS/ME and Long COVID brain

To me, this keeps getting reported in the literature over the last 30 years, with the latest excitement being this August 2021,

Limbic Perfusion Is Reduced in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

Hypoperfusion or reduced perfusion means simply reduced oxygen gets to the brain. There can be many causes, for example (with convention causes first, then likely ME/CFS/LC causes:

  • Low blood pressure
  • Heart Issues
  • Loss of blood volume
  • Hypercoagulation (thick blood)
  • Sticky blood
  • Inflammation of blood vessels (due to chronic low grade infections — often secondary infections and not primary infections)
  • Issues with hemoglobin (iron) due to things like chemical pollutants, including carbon monoxide

Each one of these impair oxygen to the brain and thus can cause many symptoms: inability to concentrate, memory issues, mood swings / irritability, light intolerance, noise intolerance, and many many more. Hypoperfusion also occurs with many neurological conditions and forms of dementia.

To add a personal note, during one relapse of ME/CFS my SPECT scan showed significant hypoperfusion which the radiologist read as “possible early onset Alzheimer’s disease”(due to my age) – it was not, I fully recovered (as evidence by some 1500 blog posts on this site and it’s sister site, Microbiome Prescription Blog.

ME/CFS Literature

When patients deal with MDs, having a rich collection of studies often persuade them to take something serious instead of dismissing it as something from the internet rumor-mill. So, I have assembled prior studies below. Note that POTS has been a hallmark of ME/CFS and is associated with hypoperfusion.

In 20+ years reading literature on ME/CFS, the following issues (or a combination) appear to be dominant causes:

There are a few subsets, like those that suffered organophosphate pesticides exposure (2003). Prolonged ME/CFS reduces the size of the brain (I suspect due to prolonged oxygen starvation)

COVID Literature

The above was the result of 30+ years of investigations, Long COVID is less than 2 years.

Putting it all together

First, try to get an Appropriate Brain Scan depending on the method of scan, abnormalities would be be found from 14% to 80% of the time. You want the 80% scan — or else you MD will say “it’s in your head” in the alternative meaning 😦 .

Second, it is very unlikely that you can be tested for each and every candidate item above. In some cases, there may not be the expertise available or the testing deemed experimental/for research purposes only — this can be ignored/dismissed by a treating physician (or their supervisor). For myself, I had coagulation testing with Berg (their test suite is available in a few locations). There are almost a dozen makers examined — most MDs and even specialists — will only test for a few.

I have put together a collection of researched pages dealing with various issues:

The secondary infections are harder to deal with — often they can become occult (using Jadin’s term from the Pasteur Institute for Tropical Medicine), that is, they may not be seen in the blood (an oxygen rich environment) but in the tissue (lower oxygen, and even more when they produce metabolites (toxins) to inflame blood vessels (further reducing oxygen) and cause fibrin barriers to block oxygen from red blood cells getting into the tissue. They may also persist in the gut microbiome and never enter the blood system — instead their metabolites enter the blood system.

Personally, I favor the microbiome alteration approach. The goal is to make a hostile environment for these bacteria by starving them of their preferred food and flooding them with what they do not like. I did the Jadin’s antibiotic protocol (multiple rotating specific antibiotics for months) with earlier relapse — but I have been just as successful with microbiome manipulation with later relapses (and an apparent shorter time to recovery).

There is Hope

Given the number of issues, challenges with MDs, etc, I realize that most patients will likely get zero traction from the conventional medical establishment — unfortunately. I view that there is a viable alternative treatment approach because of the availability of direct-to-retail 16s microbiome tests. We know that there are pattern of bacteria shifts seen in CFS/ME and Long COVID. It is likely (at least from personal experience) that correcting these shifts result in reduce symptom severity and number (and even complete elimination). See my personal experience here.

The key is really simple — alter diet and supplements –NOT WITH A FORMA COOKBOOK MODEL from Internet ramblings of others — but explicitly based on your personal microbiome. The suggested changes are generated (for free) by artificial intelligence on Microbiome Prescription using almost 2 million facts harvested from the US National Library of Medicine. The suggestions are unique to you — but should always be reviewed by your medical professional before starting.