Question and Answer Forum

Is there a relationship between CFS and carbon monoxide?

By David S. Bell, MD, FAAP

Published in Lyndonville News, January 2001

Question:

Has any research been done concerning CFS and carbon monoxide relationships? We have natural gas heat and the pilot light is left on all year, hot or cold weather? I've heard a little discussion about a possible relationship between even minute carbon monoxide levels and CFS.

Thanks, Lester

Answer:

The concern about carbon monoxide is an interesting question. The symptoms of chronic, low level carbon monoxide poisoning are very similar to those of CFS, and for this reason I have chosen to review an interesting paper on CO in the Journal Club section. It is also said that there are prominent neurocognitive deficits and high intensity lesions on brain MRI in CO poisoning, again similar to CFS.

When I was young and foolish, a few years ago, I used to believe that it was easy to distinguish CO poisoning from CFS. There exists a blood test to measure CO, the carboxyhemoglobin, and CO testers for faulty furnaces are inexpensive and easy to install. Unfortunately the blood test is useless if the exposure happened a while ago, and I have heard that the cellar testers are not very reliable. CO poisoning should not occur in the summertime, and only in houses that are very tight with poor furnaces. Anyone concerned about CO poisoning should have the air in their house checked by a true expert, perhaps from your heating company.

The symptoms from CO poisoning are presumably due to the inability of oxygen to get to the tissues of the brain. CO sticks to hemoglobin (the oxygen carrying molecule in blood) tighter than oxygen does. Thus when blood circulates in the brain, oxygen does not get to the cells. The striking similarity in symptoms suggests that the primary defect in CFS may be the inability of brain cells to either receive or utilize oxygen. Thus it is theoretically possible that and condition which impairs the overall ability to get oxygen to the brain cells could cause CFS. This may be the fundamental defect of the illness.

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