Streeten, D H · The American journal of the medical sciences · 2001 · DOI
This study found that people with ME/CFS have problems with how blood vessels in their feet respond to stress. When standing up, their blood pressure drops abnormally after a delay, and their foot veins don't tighten properly in response to a hormone (norepinephrine) that normally helps maintain blood pressure. This suggests that the nerves controlling blood vessels in the legs may not be working correctly in ME/CFS.
This study provides a potential physiological mechanism for orthostatic intolerance in ME/CFS—a hallmark symptom affecting many patients—by identifying specific abnormalities in blood vessel function and nerve signaling. Understanding this mechanism could lead to targeted treatments, and the reported benefit of MAST compression suggests a testable intervention pathway for symptom management.
This study does not establish that impaired venous innervation is the primary cause of ME/CFS or that it explains all fatigue symptoms in the condition. It demonstrates correlation and association in a small sample but does not prove causation, and findings may not generalize to the broader ME/CFS population or to patients without prominent orthostatic symptoms.
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 (2001). Role of impaired lower-limb venous innervation in the pathogenesis of the chronic fatigue syndrome.. The American journal of the medical sciences. https://doi.org/10.1097/00000441-200103000-00001
BibTeX
@article{mecfsatlas-streeten-2001-role-impaired,
author = {Streeten, D H},
title = {Role of impaired lower-limb venous innervation in the pathogenesis of the chronic fatigue syndrome.},
journal = {The American journal of the medical sciences},
year = {2001},
doi = {10.1097/00000441-200103000-00001},
note = {PubMed: 11269790},
url = {https://www.mecfsatlas.com/evidence/streeten-2001-role-impaired},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/streeten-2001-role-impaired
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