The World of Osler's Web

The World of Osler's Web

The Problem

part two, volume is vital

Hillary Johnson's avatar
Hillary Johnson
Aug 03, 2025
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Part 2. The Problem

For at least thirty-five years, scientists and clinicians have struggled to understand the relationship between hypovolemia and any number of vascular, cardiac and neurological abnormalities common to myalgic encephalomyelitis.

When I searched PubMed combining the terms ‘myalgic encephalomyelitis’ and ‘low blood volume,’ I stopped counting after finding 143 papers on the subject. But there are more. When I searched Google Scholar, I abandoned the task at 413 papers on page 45 of 21,700 results.

Here are links to just five of those papers at the top of the PubMed list (as I write this):

Re: Blood volume correlates with orthostatic hypotension; Cerebral blood volume reduction; Blood volume and cardiac function; Cardiovascular and haematological pathology; Blood volume and its relation to peak (O)2 consumption.

Significant findings have been made but a consensus has yet to form, or to become integrated into the otherwise subjective diagnostic criteria for the disease.

As long ago as the 1980s, in response to an outbreak of the disease in Dunedin, New Zealand—locals dubbed it ‘Poor man’s AIDS’ because research funds were unavailable— an electron microscopy expert, Les Simpson came up with a hypothesis.

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