Could oxygen therapy help to alleviate symptoms for M.E patients?

ME or Myalgic Encephalopathy is one of a few different names that are given to what is an illness of uncertain cause that affects thousands of people. It is also known as Chronic Fatigue Syndrome (CFS), Post-viral Fatigue Syndrome (PVFS) and Chronic Fatigue Immune Dysfunction Syndrome (CFIDS). All types of people of all ages are affected and for many years much controversy surrounded ME as the whether it was in fact an illness at all. Patients suffer from severe and debilitating fatigue, painful muscles and joints, disturbed sleep, gastric disturbances, poor memory and concentration and the onset is usually linked to a viral infection, operation or an accident, although some suffer a slow steady onset.


In some patients the effects are minimal but for others lives are changed drastically. In the young school-life can be severely disrupted and for older patients employment can become impossible. Social/family life can become restricted and many are housebound or even bed-bound for months or years.

Any vigorous exercise such as running or biking can result in the patient being bed-bound and most patients focus on more mild exercising like walking, swimming, tai chi etc.

A study discovered that patients were getting the blood they needed to the muscles but for some reason they weren’t taking up the oxygen very quickly and it took longer for the oxygen levels to get back to normal after exercise.

It could be that the mitochondria in the cells which use oxygen to produce energy could be damaged. These mitochondria also would normally pump damaging free-radicals out of the cell which could interfere with muscle metabolism and cause pain.

Oxygen uptake into the cells would also normally neutralise lactate build-up created during exercise and in the patients in the study it took longer for the oxygen to neutralise the toxic build-up in the cells after exercise.

Another study found that in ME patients specifically that there was significantly lower blood volumes which could account for lower oxygen levels, on average a 20% reduction, which could be cause by the nervous system. In fact some doctors believe that ME may be caused by low oxygen levels. An additional theory is that the nervous system shuts down blood vessels when an ME patient is at rest and then fails to open them up sufficiently when you become active, which is a bad combination when the patient cannot sleep at night and then cannot fulfil any activities during the day.

If low oxygen levels are a root cause of ME then it is being researched at the moment as to whether increasing oxygen levels ie via home oxygen therapy would help to alleviate the symptoms of this disease. Many patients with other conditions such as COPD and Sleep Apnoea have discovered that by using oxygen for these other conditions it has also alleviated their ME symptoms as well. Some find that a 15minute session twice a day can help to nip the symptoms in the bud, others did not or found that longer or more frequent sessions were needed. Others find it helpful to have oxygen on board the air plane when travelling on holiday as before they had experienced increased symptoms whilst away on previous holidays. Patient’s with Sleep Apnoea have found that oxygen not only helped with their sleep but made them feel more energised and decreased the severity of their fatigue in the mornings and made the syndrome much easier to live with. It seems to vary from patient to patient as to if and how it helps, as for example some COPD patients find that their oxygen tanks and concentrators helped, whereas others found that only by switching machines to a CPAP machine did it help with their ME symptoms.

It seems from the evidence and patient feedback that there is a link and that increasing oxygen intake to increase blood oxygen levels does, in most cases help to alleviate or extinguish ME symptoms. However with the syndrome itself still unexplained and only a few studies having been carried out so far on this topic, much more research is needed to conclusively prove the link. Also as patients sometimes have a mixture of different inter-linking conditions and causes of their ME symptoms, different patients may respond differently so it may be a case of trial and error as to how you can increase your oxygen levels in a way that will work to alleviate your ME symptoms.

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Polycythemia or Erythrocytosis is where there is a high concentration of red blood cells in your blood.  This makes the blood thicker, less viscous and less able to travel through blood vessels and to organs impeding oxygen delivery. This is obviously a huge problem with those who already suffer with conditions like COPD where oxygen delivery is already hindered.

Symptoms of mild cases include:
•    Headaches
•    Blurred vision
•    Red skin
•    Tiredness
•    High blood pressure
•    Dizziness
•    Abdomen discomfort
•    Confusion
•    Nose bleeds and bruising
•    Gout
•    Itchy skin (especially after a bath, as a result of the high levels of white blood cells releasing the chemical histamine)
The slow, sluggish blood flow associated with Polycythemia can also cause blood clots, which can put you at risk of heart attacks, pulmonary embolisms (blockages in a vessel), Deep-Vein Thrombosis (DVT) or Strokes.

Signs of this include:
•    Pain, swelling, redness and tenderness in your legs
•    a heavy ache in the affected area
•    Warm skin in the area
•    Breathlessness
•    Chest/upper back pain
•    Coughing up blood
•    Feeling dizzy or light-headed
•    Fainting

Apparent Polycythemia is where your red cell count is normal but the concentration of red blood cells is higher due to a lack of plasma in the blood making it thicker. Usually caused by being overweight, smoking, excessive drinking or from certain medications like diuretics.  It can be improved if the underlying condition is treated.

Absolute Polycythemia is where your body is actually producing too many red blood cells. Primary Polycythemia is where your bone marrow is producing too many due to a genetic defect in the JAK2 gene and is known as Polycythemia Vera (PV).  Secondary Polycythemia is where too many red blood cells are produced but is caused by an underlying condition.
Secondary Polycythemia can be caused by kidney disease or tumours but also by COPD and Sleep apnoea which can cause an increase in Erythropoietin to be produced by the kidneys which stimulates the bone marrow to produce more red blood cells.  This is a reaction to there not being enough oxygen reaching the kidneys.
The treatment aims to prevent symptoms and complications such as blood clots from occurring and to treat any underlying causes so will vary slightly from patient to patient.
Venesection is the quickest and simplest way of reducing the number of red blood cells.  It involves removing about one pint of blood at a time, in a similar way to giving a blood donation. The frequency could be anywhere from one a week to once every 6-8 weeks depending on cause and severity.
Medications such as interferon to reduce red blood cell production and those to prevent blood clots such as aspirin may be administered. Or any medication that treats the underlying cause may be given.

The outlook depends upon the underlying cause but most cases are mild and easily managed, although PV can be more serious.
If you have Polycythemia, it is important to take any medication you are prescribed and keep an eye out for signs of possible blood clots to help reduce your risk of serious complications.
Continuous low-flow oxygen therapy can also help to relieve Polycythemia. As increased oxygen supply to the kidneys will reduce the amount of erythropoietin they release and therefore prevent an increase of red blood cell production in the bone marrow and also helps to relieve associating symptoms.


Vitamin A could cure emphysema


New research has revealed that Retinoic acid, a derivative of vitamin A that is found in eggs, milk and vegetables could hold the key to reverse lung damage caused by the disease Emphysema. Emphysema involves the gradual destruction of the small, air sacs (alveoli) located at the tip of the smallest air passages (bronchioles). Over time the walls of the air sacs are destroyed resulting in “holes” leaving fewer and larger air sacs, which diminish the gas exchanged in the lungs and decreases the amount of oxygen in the bloodstream. Emphysema is one of the most common respiratory diseases in Britain and causes progressive damage to the lungs, which can eventually kill and there is currently no cure. Symptoms include breathlessness but sufferers can be left gasping for breath and reliant on oxygen.

It usually affects older people and is generally the result of long-term damage to the lungs caused by smoking or exposure to other harmful substances.

Retinoic acid is already being used to treat acne but research on mice has found that it helps to repair damaged lung tissue by allowing the alveoli to grow back again until they reach normal levels and trials have already started on humans.

Just 12 days of daily injections of the compound ATRA enabled the mice to grow healthy new alveoi .

It appears that COPD sufferers may have a deficiency of Vitamin A and an increase of Vitamin A will aid in repairing the damage that the deficiency caused. Other research has shown that cigarette smoking (the leading cause of developing COPD) had a direct impact on lowering Vitamin A uptake in the body, caused by a common carcinogen found in cigarettes called benzopyren. It appears that a vitamin A deficiency may be the culprit behind emphysema and cigarettes could merely be the vehicle.

Beta-carotene is a pigment found in plants that helps produce the vivid colours of certain fruits and vegetables, such as cantaloupe and carrots. When ingested, beta- carotene is converted by the body into vitamin A (retinol), which can then be used by the body or it can simply act as an antioxidant scavenging free radicals, a reason why Vitamin A may also have anti-cancer properties.

Until the affects of this synthetic compound has been thoroughly tested, the best way to safely increase vitamin A/Beta-Carotene Levels is with your diet. Experts warn that large oral doses of synthetic stand-alone supplemental vitamin A can be dangerous, as it is a fat soluble vitamin and stored in the liver and large doses can damage the liver. The best way to ensure adequate levels of beta carotene or vitamin A is via your diet and not through pills. It has even been shown that if smokers, former-smokers or those exposed to asbestos take artificial beta-carotene supplements it can increase the lung cancer risk and affect the heart, therefore natural intake is a lot safer at the moment.

Here are the ten foods rich in levels of Beta-carotene. As Beta-carotene is a fat soluble vitamin, eating the following foods with a fat like olive oil or nuts can help absorption:


  • Sweet potato
  • Carrots
  • Dark green leafy vegetables
  • Cos
  • Canteloupe Melon
  • Butternut Squash
  • Red peppers
  • Broccoli
  • Peas
  • Dried Apricots


In addition vitamin A deficiency can make iron deficiency more severe, reducing even further the amount of oxygen being taken up by the body. Therefore increasing your vitamin A levels also increases your body’s ability to take up oxygen, vitally important for those suffering with a lung disease who may require supplemental oxygen to help ease their breathing and increase oxygen levels.

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ieCrowd has recently announced that they have achieved a huge milestone by designing an advanced supplemental oxygen delivery device called Smart Oxygen. It is designed to be used by patients suffering with diseases such as COPD. The device has the ability to automatically adjust to the patient’s oxygen needs, even if they are constantly changing, through analysing the level of activity.


It has been confirmed by the FDA that the Smart Oxygen device has been submitted for approval by the FDA as it would need several bench and laboratory performance tests before it can be approved for commercial marketing. It is expected that if the device passes all testing criteria then it could be available in the early part of 2016.

The device can adjust automatically on a breath-by-breath basis. It uses an algorithm which is patent-pending, to allow it to deliver a specific dose of oxygen in response to the respiratory pattern that the patient is exhibiting. If the device is enabled to respond to a patient’s changing metabolic activities and oxygen requirements then the patient will receive the specific and appropriate amount of oxygen when they are carrying out activities that require short bursts of increased oxygen consumption, such as climbing the stairs, walking or exercising. This then maintains satisfactory blood oxygen levels without the need to manually adjust the oxygen flow rate (which patients are not recommended to do themselves anyway). This results in a more dynamic lifestyle with increased mobility, better exercise performance and improved quality of life.

Keeping active and maintaining an exercise routine is crucial for COPD patients however many find it difficult as they get out of breath so easily whereas this device would adjust and increase their oxygen flow rate if necessary and only when the body required it to allow them to exercise and perform daily tasks much more easily and ultimately improve their fitness levels and their medical condition.

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Vitamin D and COPD

We obtain 80% of our Vitamin D from sunlight but the rest we obtain through our diet such as from fish, egg yolks and in fortified dairy and grain products. Vitamin D is essential for strong bones, because it helps the body use calcium from the diet, but increasingly, research is revealing the importance of vitamin D in protecting against a host of health problems.

Low blood levels of the vitamin have been associated with the following:

  • Increased risk of death from cardiovascular disease
  • Cognitive impairment in older adults
  • Severe asthma in children
  • Cancer

Research suggests that vitamin D could play a role in the prevention and treatment of a number of different conditions, including type 1 and type 2 diabetes, hypertension, glucose intolerance, COPD and multiple sclerosis.

Vitamin D protects against COPD flare-ups by protecting the body against infections, which can trigger COPD attacks and also reducing levels of compounds that destroy lung tissue.

The most well-known benefit of Vitamin D is its role in ensuring strong bones and teeth by facilitating calcium uptake in the body. COPD patients have an increased risk of developing osteoporosis, which is an indicator of vitamin D deficiency. This evidence alone is strongly indicative of the importance of maintaining good levels of vitamin D in a COPD patient’s diet.

Studies in America show that there is a strong relationship between the levels of Vitamin D and forced lung capacity. Lower vitamin d levels result in worsened ability to exhale air from the lungs. Also studies in the Netherlands show that former smokers with low vitamin D levels had more severe COPD.

A study in 2011 showed that COPD patients taking vitamin D could breathe easier and muscle strength improved resulting in patients being able to exercise more than those who were taking a placebo. Other studies show that those patients with low vitamin D levels have an increased risk in falls, slower walking speeds, poorer balance and decreased muscle strength. Also their COPD symptoms such as coughing and shortness of breath grew worse.

Studies show that COPD patients often have low levels of Vitamin D. This may be due to genetics, which can predispose someone to naturally have lower levels. Also those with COPD often stay indoors a lot more and therefore it may be due to reduced exposure to sunlight.

Although there is little evidence that low Vitamin D levels may directly result in developing COPD, this possibility cannot be ruled out.

The advice for COPD patients is to ensure they have their Vitamin D levels monitored and to take supplements of both vitamin D and Calcium to ensure healthy levels are maintained. This topic again highlights the huge importance of ensuring COPD patients have a balanced and nutritional diet as well as ensuring they get outdoors and keep active to aid in preventing flare-ups and improving their medical condition as well as improving quality and duration of life,


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The link between diabetes and COPD

Chronic Obstructive Pulmonary disease and Diabetes Mellitus are both common and under-diagnosed diseases. COPD is considered as a risk factor for Type 2 Diabetes due to inflammation, oxidative stress, insulin resistance and weight gain. On the other hand Diabetes may act as an independent factor as it negatively impacts upon pulmonary structure and function. It also results in an increased risk of infection and worsened COPD outcomes. Recognising the inter-relations between these two diseases can help to improve the outcome and medical control for both conditions.


Patients with COPD have an increased risk of developing Diabetes. Not only directly but indirectly as COPD patients often suffer from other medical conditions like elevated blood pressure and high cholesterol levels, which are linked to diabetes. The combination of these medical problems is often referred to as ‘metabolic syndrome’.

The specific pathology as to why COPD patients are at a high risk of developing diabetes is unclear, but it is thought that it is due to inflammation associated with lung disease and the use of corticosteroids.

Elevated levels of glucose are associated with abnormal lung function. Those with type 1 diabetes experience a 20% decline in lung function and it may contribute to worsening symptoms in COPD patients.

Diabetes can affect the lungs in different ways. It has been associated with decreased lung volume, reduced lung expiration volumes and reduction in the ability of the lung tissue to diffuse oxygen. It is thought that glucose affects the diaphragm, breathing muscles and nerves in the lungs.

Diabetes is also associated with abnormal brain control of breathing pattern and can cause sleep-breathing disorders. Studies show that COPD patients with diabetes have an accelerated decline in lung function compared to those without diabetes and uncontrolled diabetes in COPD patients result in increased exacerbations, more frequent and longer hospitals stays and risk of death.

The adverse affects of diabetes on lung function appears to be stronger among people who smoke tobacco, and this group of people also have the highest risk of developing COPD.

Both conditions have also been linked to a phenomenon called oxidative stress, in which highly energized compounds called reactive oxygen species, which react strongly with other molecules, damage tissue. In the case of COPD, oxidative stress injures the airway and promotes inflammation in the lungs, and oxidative stress has been implicated as an underlying cause of the insulin resistance seen in Type 2 diabetes.

Both conditions can occur independently of each other but can also occur due to the presence of the other one. Both diseases also have a negative impact upon the state of the other. COPD will cause worsening of Diabetes and vice-versa. Therefore adequate diabetic control is key for patients with COPD to prevent worsening of their condition, as there is no cure for COPD and prevention is critical.

Due to the huge overlap between these conditions if you have been diagnosed with either condition you should ask your GP to check for the other. If you have diabetes and have a history of smoking you are at a high risk for developing COPD and like-wise if you have COPD make sure you are checked for diabetes especially if you have a family history of diabetes.


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