De Lorenzo, F, Hargreaves, J, Kakkar, V V · Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 1997 · DOI
Some ME/CFS patients experience dizziness or fainting when standing up, a condition called orthostatic hypotension. This study tested whether salt supplements could help 22 ME/CFS patients with this symptom. After 8 weeks, salt helped 11 patients feel better, but 10 patients' symptoms returned—and those 10 had lower levels of a hormone called renin that helps regulate blood pressure.
Orthostatic symptoms are common and disabling in ME/CFS. This study suggests that sodium chloride may help some patients but not others, and identifies a potential biomarker (low renin activity) that could predict treatment response and point toward distinct disease mechanisms within the ME/CFS population.
This study does not prove that renin deficiency causes orthostatic hypotension in ME/CFS, only that an association exists in non-responders. The findings are correlational and come from a single center with modest sample size; results require replication before clinical practice changes. The study also does not establish whether low renin is a primary cause or a secondary consequence of ME/CFS pathology.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
De Lorenzo, F, Hargreaves, J, & Kakkar, V V (1997). Pathogenesis and management of delayed orthostatic hypotension in patients with chronic fatigue syndrome.. Clinical autonomic research : official journal of the Clinical Autonomic Research Society. https://doi.org/10.1007/BF02267980
BibTeX
@article{mecfsatlas-de-lorenzo-1997-pathogenesis-management,
author = {De Lorenzo, F and Hargreaves, J and Kakkar, V V},
title = {Pathogenesis and management of delayed orthostatic hypotension in patients with chronic fatigue syndrome.},
journal = {Clinical autonomic research : official journal of the Clinical Autonomic Research Society},
year = {1997},
doi = {10.1007/BF02267980},
note = {PubMed: 9292244},
url = {https://www.mecfsatlas.com/evidence/de-lorenzo-1997-pathogenesis-management},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/de-lorenzo-1997-pathogenesis-management
Contribute
Private, reviewed by a human. Not a public comment thread.