Beneficial effects of intermittent intravenous saline infusion in dysautonomic patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: a case-series. — CFSMEATLAS
Beneficial effects of intermittent intravenous saline infusion in dysautonomic patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: a case-series.
Sjögren, Per, Huhmar, Helena, Bertilson, Bo C et al. · Frontiers in neurology · 2025 · DOI
Quick Summary
This small study tested whether giving patients with ME/CFS regular salt water infusions through an IV could help with symptoms like dizziness and rapid heartbeat when standing up. Twenty-two patients received these infusions every three weeks for 9 weeks, and most reported feeling better, with improvements in symptom scores, quality of life, and ability to work. While the results were encouraging, this was a preliminary study without a control group, so more research is needed to confirm whether this treatment actually works.
Why It Matters
Dysautonomic symptoms like orthostatic intolerance and postural tachycardia are severely disabling in ME/CFS and lack uniformly effective treatments. This study suggests a relatively simple, accessible intervention (IV saline) may alleviate these symptoms and improve quality of life and work capacity, potentially opening a new therapeutic avenue for this population.
Observed Findings
Composite symptom scores improved significantly from 47 ± 13 to lower levels (p < 0.001).
Median POTS score improved from 64 (IQR 16) on a 0-120 scale (p < 0.001).
Quality-of-life measures improved significantly from a median of 25 (IQR 25) on a 0-100 scale (p < 0.001).
Ability-to-work improved from a median of 0 (IQR 26) on a 0-100 scale (p < 0.05).
Patients had low baseline body hydration (mean 48 ± 6%) and high baseline disability.
Inferred Conclusions
Intermittent intravenous saline infusion may reduce dysautonomic symptoms and improve quality of life in ME/CFS patients with hypovolemia and/or dysautonomia.
Volume loading through IV saline appears to enhance work capacity in this population.
This approach warrants further controlled investigation as a potential therapeutic strategy for ME/CFS-related dysautonomia.
Remaining Questions
What is the optimal frequency, volume, and duration of saline infusions for sustained benefit?
How do results compare to a placebo control group or standard care controls?
Which patient subgroups (by dysautonomia severity, hypovolemia markers, or other criteria) respond best to this intervention?
What This Study Does Not Prove
This case-series cannot prove that IV saline infusions cause symptom improvement, as there is no control group and improvements could result from placebo effect, natural fluctuation, or concurrent treatments. The study's small size (n=22) and reliance on self-reported measures also limit generalizability. Long-term efficacy and optimal dosing regimens remain unestablished.
Tags
Symptom:Orthostatic IntoleranceFatigue
Biomarker:Blood Biomarker
Method Flag:PEM Not DefinedNo ControlsSmall SampleExploratory Only