More salt in diet could help chronic fatigue

CELIA HALL

Medical Editor

More salt in the diet together with heart drugs may be the answer for thousands of patients who suffer from chronic fatigue syndrome, according to new research from the United States.

Doctors at Johns Hopkins University Medical School in Baltimore believe they have found a link between chronic fatigue syndrome (CFS) - also known as myalgic encephalo-myelitis (ME) - and a form of low blood pressure.

Professor Hugh Calkins, director of electrophysiology in the school's cardiology division, said yesterday that if their ideas prove to be true then many CFS patients who put themselves on restricted "healthy" low- salt diets may be doing themselves more harm than good.

The latest study from the Johns Hopkins researchers involved 23 CFS patients and will be published later this year. However, the European newspaper said in a report yesterday that 19 of the patients treated with increased salt and drugs, 15 improved, and 9 recovered completely.

Professor Calkins said that although their sample was small, the link was sufficiently interesting to mount a full, scientifically controlled trial, which is was now being set up.

The association has been made between neurally mediated hypotension (NMH) and CFS because of the similarity of the symptoms that follow fainting episodes. After faints the NMH patients often complain of abdominal discomfort and aching muscles.

The theory is that if patients suffer episodes of low blood pressure several times a day or a week this could be sufficient to render them constantly fatigued. The link was made in an earlier study reported in the Lancet in March, which described seven adolescents who fainted after exercise.

They were treated with more salt in the diet and heart drugs and four out of seven got better. All had suffered light-headedness and fatigue after exertion, most also had nausea, headaches, abdominal pain and problems concentrating. Four were already diagnosed as having CFS. The drugs were used to steady the heart rate which works harder during episodes to increase the blood circulation.

They were given a tilt test used to diagnose NMH, in which patients are put on an upright tilt table for up to 30 minutes. This can induce fainting or lightheadedness in affected people.