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I like Dr Bell - I think he and Streeten were the first to find low blood volume and orthostatic intolerance in CFS. He was however, totally convinced by the XMRV fiasco recently and there are many other theories (probably with better evidence) that explain idiopathic hypovolumia in POTS and its association perhaps with elevated ang II or perhaps abnormal kidney dopamine activity. Orthostatic increases in dopamine in the periphery work on d1 receptors in the kidney which have been recently found to also be involved in plasma volume regulation.

I would think that many patients with CFS/POTS where low blood volume is a feature have such poor quality of life as a consequence of that fact that they would be willing to do anything to resolve it. if the patient wanted to get a blood transfusion to improve their CFS and was willing to sign consent then it seems like a contradition in the hippocratic oath to deny them that.

Florinef corrects low blood volume as does licorice extract through aldosterone pathways. But saline is amazing, although shortlived.

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