Garner, Richard, Baraniuk, James N · Journal of translational medicine · 2019 · DOI
This study looked at dizziness and lightheadedness symptoms in ME/CFS patients when lying down versus standing up. Researchers found that these symptoms were very common in ME/CFS (occurring in 72% of patients when standing) and that they often happened even while lying down—something doctors don't usually check for. Importantly, these symptoms weren't simply caused by a rapid heart rate, suggesting a different mechanism is at play in ME/CFS.
Orthostatic intolerance significantly impacts quality of life in ME/CFS patients but is often underrecognized. This study reveals that OI symptoms in ME/CFS may operate through mechanisms beyond heart rate acceleration, potentially opening new avenues for diagnosis and treatment. Identifying that recumbent symptoms are common challenges clinicians to reassess how they evaluate and manage OI in this population.
This study does not establish causation or the underlying physiological mechanisms driving OI symptoms in ME/CFS. It does not prove that non-tachycardia mechanisms are the primary driver of symptoms, only that tachycardia alone does not account for reported symptoms. As a cross-sectional study, it cannot determine whether OI develops as a consequence of ME/CFS or is an independent comorbidity.
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
Garner, Richard & Baraniuk, James N (2019). Orthostatic intolerance in chronic fatigue syndrome.. Journal of translational medicine. https://doi.org/10.1186/s12967-019-1935-y
BibTeX
@article{mecfsatlas-garner-2019-orthostatic-intolerance,
author = {Garner, Richard and Baraniuk, James N},
title = {Orthostatic intolerance in chronic fatigue syndrome.},
journal = {Journal of translational medicine},
year = {2019},
doi = {10.1186/s12967-019-1935-y},
note = {PubMed: 31159884},
url = {https://www.mecfsatlas.com/evidence/garner-2019-orthostatic-intolerance},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/garner-2019-orthostatic-intolerance
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