[Thought experiment] In a random cohort of 100 ME/CFS patients (recent diagnosis via CCC), what can you know about them with 90%+ certainty?

[butter.]

Yes this is very much in the space we are looking. Urine output, urea cycle (nitrogen metabolism), hormone production, blood flow, energy metabolism. That's where we think the answer lies and nearly all our projects are looking at these in different ways.

This little trial came out a while ago:
https://www.sciencedirect.com/science/article/pii/S0914508716301204

I should add that part of the saline trial we are doing a 24 hour urine collection following each infusion. We want to capture what the urine output looks like as well as it's speed. We don't do a typical 24 hour urine capture, we developed a new form the buckets each urine stop separately.

Very interesting study, I thought I would mention that measures to increase volume (saline, desmo,fludro,..) worked well for me in the earlier phase of my illness but stopped working after a while. Recently I started a retrial of desmopressin and was quite surprised when it made me feel MUCH worse. What was really surprisig though was that it led to an elevated NTproNB, which is a biomarker for heart failure. This biomarker works essentially by indirectly (an overly 'stretched' heart muscle will lead to its expression) measuring fluid overload!

The whole blood volume issue is a bit of an enigma as you know, the best 'simple' explanation from a mere structural perspective, that could be a common/shared phenotype in IACCs, I believe is that there is 1. not enough capacity to hold the necessary blood volume, i.e. a literal lack of blood vessels (especially microvascular) unable to meet metabolic demand and/or 2. a stagnation/sagging of blood in the venous compartment that could be partially overcome by more volume. In a sense, ADH could be low because blood vessels are overly 'stretched' in some compartments but not others leading to a kind of paradoxical situation (from a central command perspective) of too much AND too little volume. Afaik nobody has looked at the issue from this perspective; maybe for good reasons.

I think it could be interesting to consider because such a scenario would ultimately lead to hypoxia, and what we see metabolically looks a bit like hypoxia?