Kell, Douglas B, Pretorius, Etheresia, Zhao, Huihui · Pharmaceuticals (Basel, Switzerland) · 2025 · DOI
This study proposes that tiny blood clots called fibrinaloid microclots may be the physical basis behind a traditional Chinese medicine concept called 'blood stasis,' which describes sluggish blood flow. The authors suggest that these microclots block small blood vessels and reduce oxygen delivery to tissues, and that certain Chinese herbal remedies—particularly a formula called Xue Fu Zhu Yu—may help by reducing microclot formation. If correct, this could open new treatment avenues for ME/CFS, long COVID, and other chronic inflammatory conditions.
ME/CFS patients often experience reduced oxygen delivery and perfusion-related symptoms; a mechanistic framework linking microclots to disease pathology could validate both tissue hypoxia observations and interest in anticoagulatory or fibrinolytic interventions. For researchers, bridging TCM concepts with microclot biology offers a testable hypothesis and points toward potentially novel, low-toxicity botanical treatments that warrant rigorous clinical investigation.
This review does not prove that microclots cause ME/CFS or that blood stasis is the primary driver of disease; it proposes a mechanistic hypothesis. The study does not include clinical trial data demonstrating that Xue Fu Zhu Yu or its components are effective in ME/CFS patients, nor does it provide direct experimental evidence that the herbal formula reduces microclot burden in vivo. Correlation between microclot presence and disease does not establish causation.
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 →
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