Streeten, D H, Thomas, D, Bell, D S · The American journal of the medical sciences · 2000 · DOI
This study found that many ME/CFS patients experience a sudden drop in blood pressure and abnormal heart rate acceleration when standing up, along with symptoms like dizziness. The researchers discovered that low red blood cell volume was present in most patients tested, and that wearing inflatable compression pants could quickly reverse these standing problems. This suggests that problems with blood pooling in the legs when upright may contribute to ME/CFS symptoms.
This study provides objective physiological evidence for a treatable mechanism in ME/CFS—orthostatic dysregulation linked to reduced blood volume—that could explain why patients experience worsening symptoms with prolonged standing. The finding that symptoms are correctable with external compression suggests potential non-pharmacological interventions and supports the biological basis of ME/CFS.
This study does not prove that orthostatic hypotension or reduced erythrocyte volume causes ME/CFS in all patients, only that it is frequently present in moderate-to-severe cases. It does not establish whether these findings are primary pathophysiological drivers or secondary consequences of deconditioning or disease. The small sample size (n=15) limits generalizability to the broader ME/CFS population.
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
Streeten, D H, Thomas, D, & Bell, D S (2000). The roles of orthostatic hypotension, orthostatic tachycardia, and subnormal erythrocyte volume in the pathogenesis of the chronic fatigue syndrome.. The American journal of the medical sciences. https://doi.org/10.1097/00000441-200007000-00001
BibTeX
@article{mecfsatlas-streeten-2000-roles-orthostatic,
author = {Streeten, D H and Thomas, D and Bell, D S},
title = {The roles of orthostatic hypotension, orthostatic tachycardia, and subnormal erythrocyte volume in the pathogenesis of the chronic fatigue syndrome.},
journal = {The American journal of the medical sciences},
year = {2000},
doi = {10.1097/00000441-200007000-00001},
note = {PubMed: 10910366},
url = {https://www.mecfsatlas.com/evidence/streeten-2000-roles-orthostatic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/streeten-2000-roles-orthostatic
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