A question was asked on Facebook which I recall some studies report hypo-perfusion (too low oxygen levels) at the pain points. This aspect was first suggested/found by David Berg back in 1999 [see this post for more details]. The old studies:
- Chronic fatigue syndrome and/or fibromyalgia as a variation of antiphospholipid antibody syndrome: an explanatory model and approach to laboratory diagnosis, Dave Berg, 1999.
- The pain of fibromyalgia syndrome is due to muscle hypoperfusion induced by regional vasomotor dysregulation [2007]
I was delighted to see many more studies.
Some terms that are connected to coagulation: fibrinogen (Major component of clots). Cerebral blood flow is the amount of oxygen reaching the brain, with coagulation this decreases [the brain becomes starved for oxygen].Prothrombotic is another name for Hypercoagulable state (A.K.A. Thick Blood)
Elevated platelet and RBC counts, PDW values, and fibrinogen levels as well as decreased prothrombin time are all indicative of a prothrombotic state in FM patients, which may be enhanced by an increased inflammatory tone.
Are Patients With Fibromyalgia in a Prothrombotic State? [2019]
- ” Clear significant differences between FM … FM had associations with specific plasma proteins involved in blood coagulation, metabolic, inflammation and immunity processes.” [2020]
- “we noted several proteins involved in coagulation and inflammation pathways with distinct expression patterns in patients with FM.” [2020]
- “This study suggests that different plasma protein patterns are associated with different pain intensity and psychological distress in CWP. Proteins belonging to the coagulation cascade and immunity processes showed strong associations to each clinical outcome” [2018]
- “The interplay of the complement and coagulation cascades contributes to the inflammatory process, while the activation of Liver-X Receptor/Retinoid-X Receptor and Farnesoid-X Receptor/Retinoid-X Receptor could attempt to alleviate it. Finally, we have identified two proteins, haptoglobin and fibrinogen, as potential biomarker-candidates of FM for future studies.” [2018]
- “Significant correlations were found between thalamic Cerebral blood flow [rCBF] values and pain belief values.” [2011]
- “These results show that brain perfusion abnormalities in patients with fibromyalgia are correlated with the clinical severity of the disease.” [2008]
- “in hyperalgesic FM patients, we found significant hyperperfusion in regions of the brain known to be involved in the sensory dimension of pain processing and significant hypoperfusion in areas assumed to be associated with the affective-attentional dimension. ” [2006]
- Decreased muscle blood flow in fibromyalgia patients during standardised muscle exercise: a contrast media enhanced colour Doppler study [2006] “that muscle ischemia(an inadequate blood supply to an organ or part of the body) can contribute to pain in FM,”
- Intramuscular hypoperfusion, adrenergic receptors, and chronic muscle pain [2002] “a prominent and consistent feature for regional myofascial pain and to a lesser degree for fibromyalgia was intramuscular hypoperfusion”
- Tissue oxygen measurement and 31P magnetic resonance spectroscopy in patients with muscle tension and fibromyalgia [1997] – “hypoxia” — low oxygen levels
Bottom Line
This area tends to fall into a medical no-physician land. Clinical MDs are rarely familiar with coagulation and if pressed, will pass patients to what they deem to be an appropriate specialist – a hematologist. A hematologist will ask “show me the strokes, the venous clots etc” and then excuse himself from involvement. The issue is that of low grade, clinically significant, low level coagulation often known as “micro-clots” in recent Long COVID literature.
Coagulation disorders are complex. Some have well established treatments, some do not.
Some additional notes:
CFS Remission 
