Research shows that there is abnormal red blood cell structure in most ME patients. This may cause insufficent blood and oxygen flow to the joints, muscles, organs, glands and mitochondria, resulting in chronic exhaustion, weakness and confusion (mental fog). The effect of this on the glands may be a contributing factor to the abnormal HPA axis found in ME. Insufficient oxygen can also cause a rapid build-up of lactic acid during and after exercise, thus leading to severe pains and extreme weakness and exhaustion after exercise.

• L. O. Simpson, 'The Role of Nondisocytic Erythrocytes in the Pathogenesis of Myalgic Encephalomyelitis / Chronic Fatigue Syndrome', The Clinical and Scientific Basis of ME/ CFS [Ottawa, Ontario: The Nightingale Research Foundation, 1992], p. 597

• Abnormally shaped RBC's in CFIDS patients. Dr. Leslie Simpson PhD. Journal of Rheology
  Several research papers about the role of abnormal RBC's in CFS have been published by Dr. Leslie O. Simpson Ph.D., Dunedin, New Zealand.

• Mukherjee TM, Smith K, Maros K. Abnormal red-blood-cell morphology in myalgic encephalomyelitis. Lancet 1987;2:328-329.20. Simpson LO. Nondiscocytic erythrocytes inmyalgic encephalomyelitis. N Z Med J 1989;102:126-127.21.