I have abandoned the possibility of Postural Orthostatic Tachycardia Syndrome (POTS). I’m not going to persuade its investigation anymore.
Although having said that, I still have the symptoms. Possible reason for it is hypocapnia or “low CO2 level in blood”, and the condition is called Chronic Hyperventilation Syndrome (CHVS).
Dr TL explained the CHVS to me in April 2008 . I understood the mechanism of the problem. However, I had (and still have) difficulty adopting it because of “hyperventilation” in its name. Because my hypocapnia is not caused by hyperventilation, I cannot have the mental connection with the name Chronic Hyperventilation Syndrome.
Since the original introduction to CHVS, problems in my lungs were identified and being treated. Therefore, I assume that my hypocapnia is caused by underlining medical condition, which is lung problem (possibly interrelating with ME/CFS).
So, I may refer the condition in my blog simply “Chronic Hypocapnia”.
Hypocapnia can cause cerebral vasoconstriction that resulting in cerebral hypoxia or reduced oxygen supply to the brain. This explains the same symptoms as POTS.
I found a website that explains Chronic Hyperventilation Syndrome in easy-to-understand way. (Please click on the link and have a look. Its symptom list is very similar to ME/CFS, if not the same.) This also explains why I feel being suffocated while my blood oxygen salutation is sufficient.
Chronic Hyperventilation Syndrome constantly and slowly depletes your blood of carbon dioxide. With too little carbon dioxide in the blood, receptors that should be bonding with CO2 end up bonding with oxygen instead. Ironically, your blood ends up having too little free oxygen available to your body’s systems and organs. As a result, all of your body’s systems receive too little oxygen. That means your brain, your stomach, your muscles … they’re all getting slightly deprived of oxygen. As a result, you start having seemily unrelated symptoms in all these different areas of the body.
At the back of my mind, I recall there is a theory about ME/CFS being oxidation problem… I’m not going into the detail for now.
Since CO2 increases the acidity in the blood, a low CO2 level leads to increased alkalinity in the blood. This, in turn, leads to the constriction of blood vessels that supply blood to the brain. Moreover, transport of essential electrolytes for the functioning of the nervous system is also reduced.
Deviations in the amount of carbon dioxide in blood can lead to dizziness, respiratory and cardiac arrest and even death.
I’m satisfied with the theories why I have symptoms.
However, as expected, solution for the Chronic Hypocapnia from physical condition is not so simple. (I noticed treatments for Hyperventilation Syndrome from panic/anxiety.) I was advised to breathe into paper bag… So far, I haven’t noticed relief from this method.
When I tried it at hospital transit centre, nurse misunderstood it as I’m having a panic attack… (It is not really a modest method to try in public because it looks like attention seeking act.) She checked oxygen level, and of course, it was normal. She really should have checked CO2 level, as the problem is not oxygen level, but ample oxygen is not utilised to function the body system due to hypocapnia.
I shall try it again at bed time and see if I feel any improvement in my condition.
One of the most obvious causes of low CO2 is caused by chronic hyperventilation syndrome. "CVHS is a diagnosis begging for recognition", according to Dr. Lumb, the researcher who has based most of his life's work on researching this condition. It is easily treated using breath re-training techniques - and the most popular and widely known of these is the Buteyko Method. There is no medicine that helps it, so it is best to get onto a program with a BIBH trained Buteyko practitioner as soon as possible. Chronic HVS has all the symptoms you listed, and the reason for the the hypocapnia is that more CO2 is lost than is made - and if chronic this usually due to through hyperventilation. You state that you don't hyperventilate, but healthy adults breathe twelve times per minute at rest with no sighs, yawns, or distincive apnoeas, and take around 0.4l of air in with every breath. CVHS could be better described as hidden hyperventilation, because while you wouldn't notice an extra breath or two per minute, this significantly increases the volume of air breathed over time. 12 x 0.4= 4.8l p/min, but if you were taking a barely noticable extra two breaths per minute at say 15 breaths, that volume increases to 6l p/min. The difference in volume over a 24 hr period is 1728 litres of air. Over a week, you would have breathed enough extra air to fill a swimming pool, and this is at the expense of your overall health, because we should be breathing to meet the needs of metabolism. A good indicator of CHVS is snoring, yawning often, mouth breathing, sighing often and the need to take a deep breath - which is often not possible in individuals with low CO2. It isn't noticeable, but it has a serious implication for health and for stress levels, which sky-rocket when there is a reduction of oxygen delivery. What is actually happening on a physiological level is a well known medical fact: CO2 is a catalyst for oxygen delivery, and without it, the oxy-haemoglobin bond strengthens. This is called the Bohr Effect and is taught in first year medicine. The problem with CHVS (from a medical perspective) is that there is no MEDICINE to treat it - which is why you may draw a blank with your GP. Paper bag breathing won't help and it is not recommended in any way as a treatment for a chronic condition - but rather as an intervention during an acute attack - and only if there is no underlying cardiac problem - which there often is when people have respiratory disorders. CO2 is not a waste gas, it is a vital component of breathing gases. in all things, as always, balance is key. If the respiratory gases are unbalanced, you will have problems.