Question and Answer Forum

What is your opinion about the use of IV saline in CFS?

By David S. Bell, MD, FAAP

Published in Lyndonville News, March 1999

Question: I am an 18-year-old and have had CFS for three years. What is your opinion about having normal saline infusion?

Answer: Normal saline infusion is intravenous (IV) fluid that is frequently given to people when they are dehydrated. It is a treatment that carries very little risk and essentially is just a salt solution that is infused into the vein. The reason that we have started using normal saline infusion is because of the observation that it sometimes makes people feel better. Unfortunately, the results from using saline infusion are a little disappointing but it remains the treatment of choice for about 10 of our patients. It appears that the results are most gratifying for those who have a baseline activity of around 3-5 hours daily. Even those persons with CFS with less activity have seen some benefit from the saline but it has not lasted very long.

The problem with normal saline infusion is that the response typically lasts only 12-24 hours. Most persons will say that they are tired immediately after the infusion, but 4-6 hours later feel quite well and will be able to do activity they normally could not do. However, within 12-24 hours this energy seems to wear off and they return to their previous state. The saline infusion seems to be of value for those persons who are having an acute relapse. At the present time, we have seen no complications with this treatment. Our practice is to infuse with one liter of normal saline once weekly usually done in the home through a home nursing service. Of the patients who are using the IV saline, we have documented that their blood pressure falls in a pattern called orthostatic hypotension or delayed orthostatic hypotension and this condition standardly can be treated with saline infusion. Insurance may cover the cost. Even if insurance does not cover it, the expense for a liter of saline and the tubing is generally quite reasonable, about $10. However, there is usually an additional cost for the placement of the needle and the monitoring.

My disappointment with this mode of treatment is that it seems to be a short-lived response lasting only about twelve hours. There seems to be no cumulative effects so that people are not recovering over time. They keep getting the same effect after each infusion, but are not getting better as I had hoped would be the case. Some persons also seem to have decreased response over time and, if that occurs, I would suggest stopping and trying it at a later time.

Thank you for your interest.

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