{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T19:17:24Z","timestamp":1781551044521,"version":"3.54.5"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS) is a debilitating condition with no single, uniformly effective pharmacologic therapy. Dysautonomic features like orthostatic intolerance and postural tachycardia syndrome are common features in ME\/CFS, severely affecting the patient\u2019s quality-of-life. Intermittent saline infusion may reduce symptoms associated with dysautonomia, but this has not been tested scientifically in patients with ME\/CFS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this case-series, 22 patients with ME\/CFS and signs of dysautonomia and\/or hypovolemia were treated every third week over 9\u202fweeks with intravenous saline (9\u202fmg\/mL NaCl), using standard aseptic technique. Symptoms were monitored throughout the treatment regime, and a follow-up evaluation was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At treatment start, patients were predominantly female (95%), at mean age 46\u202f\u00b1\u202f10\u202fyears, and with a mean body hydration percentage of 48\u202f\u00b1\u202f6. Self-reported health status revealed an overall symptom score of 47\u202f\u00b1\u202f13 on a 0\u201396 scale, a median POTS score of 64 (IQR 16) on a 0\u2013120 scale, and poor measures of quality-of-life (median 25 IQR 25, on a 0\u2013100 scale) and ability-to-work (median 0, IQR 26, on a 0\u2013100 scale). Following 9\u202fweeks of intermittent saline infusion (mean volume 1,600\u202f\u00b1\u202f360\u202fmL), self-reported composite symptom score, quality-of-life and POTS-related symptoms improved significantly (all <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), as did ability-to-work (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data derived from a non-controlled case-series indicate health benefits from volume loading with intermittent infusion of saline among patients with ME\/CFS, which may stimulate further studies on various forms of intravenous volume loading to patients with ME\/CFS and dysautonomia.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1601599","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T04:10:25Z","timestamp":1753071025000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Beneficial effects of intermittent intravenous saline infusion in dysautonomic patients with Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome: a case-series"],"prefix":"10.3389","volume":"16","author":[{"given":"Per","family":"Sj\u00f6gren","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Huhmar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo C.","family":"Bertilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Brag\u00e9e","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olli","family":"Polo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/s12967-020-02269-0","article-title":"Systematic review and meta-analysis of the prevalence of chronic fatigue syndrome\/myalgic encephalomyelitis (CFS\/ME)","volume":"18","author":"Lim","year":"2020","journal-title":"J Transl Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"412","DOI":"10.3389\/fped.2018.00412","article-title":"Estimating prevalence, demographics, and costs of ME\/CFS using large scale medical claims data and machine learning","volume":"6","author":"Valdez","year":"2018","journal-title":"Front Pediatr"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2861","DOI":"10.1016\/j.mayocp.2021.07.004","article-title":"Myalgic encephalomyelitis\/chronic fatigue syndrome: essentials of diagnosis and management","volume":"96","author":"Bateman","year":"2021","journal-title":"Mayo Clin Proc"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1111\/j.1365-2796.2011.02428.x","article-title":"Myalgic encephalomyelitis: international consensus criteria","volume":"270","author":"Carruthers","year":"2011","journal-title":"J Intern Med"},{"key":"ref5","volume-title":"Beyond Myalgic encephalomyelitis\/chronic fatigue syndrome: Redefining an illness","year":"2015"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.cnp.2020.01.003","article-title":"Cerebral blood flow is reduced in ME\/CFS during head-up tilt testing even in the absence of hypotension or tachycardia: a quantitative, controlled study using Doppler echography","volume":"5","author":"van Campen","year":"2020","journal-title":"Clin Neurophysiol Pract"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e41","DOI":"10.1016\/j.hrthm.2015.03.029","article-title":"2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope","volume":"12","author":"Sheldon","year":"2015","journal-title":"Heart Rhythm"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"298","DOI":"10.7326\/0003-4819-104-3-298","article-title":"Idiopathic hypovolemia","volume":"104","author":"Fouad","year":"1986","journal-title":"Ann Intern Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2858","DOI":"10.1016\/j.jacc.2010.02.043","article-title":"Cardiac origins of the postural orthostatic tachycardia syndrome","volume":"55","author":"Fu","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1097\/MAJ.0b013e318063c6c0","article-title":"Blood volume perturbations in the postural tachycardia syndrome","volume":"334","author":"Raj","year":"2007","journal-title":"Am J Med Sci"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1016\/0002-9343(82)90559-9","article-title":"Postural tachycardia syndrome. 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