Low Blood Volume

Blood volume refers to the total amount of fluid circulating in your circulatory system. Normal blood volume for most people is about five liters. Women tend to have less; but during pregnancy they have about 50% more.

When blood volume is low the cardiovascular system constricts blood vessels. Our blood vessels are made tighter to help with our decreased blood volume. This is called vasoconstriction.

When blood volume is low, the pulse and respiratory rate increases while the blood pressure decreases. In the B6T Smart Understanding B6 Toxicity Facebook group, we have witnessed a significant correlation between low blood volume and low blood pressure. We do have exceptions.

Nearly all cells in the body require blood to replenish nutrients and a remove waste. When a tissue loses it’s blood supply, it can lead to tissue death.

This article sums up blood volume as we know it: Physiology, Blood Volume


Small Fiber Polyneuropathy

Those with Small Fiber Polyneuropathy (SFPN) due to B6 Toxicity have less blood in their circulatory system than the normal five liters. We are a liter or two low.

We know from the work of Dr. Anne Oaklander and her colleges at Neuropathy Commons that those with SFPN have damaged nerves that monitor our blood volume. These damaged nerves are sending the wrong signals about the level of our blood in our circulatory system.

Water and Salt

We know we can’t immediately fix the damaged nerves that regulate blood volume. We do know from the research that we can support the low blood volume until we heal the nerves that regulate it. We support the low blood volume with the water and salt that is recommended in the B6T Protocol.

The water and the salt is keeping our blood volume at closer to the five liters that we need. This is why it is good for us to spread the water and salt in the B6T Protocol throughout the day and night.

The excess water and sodium is now getting nutrients to the cells and allowing the waste to be removed. The group’s theory is that included in that waste is the excess B6 that was stored in the nerve cells during your dehydrating event. Our B6 damaged cells are also benefiting from the increased blood volume for the extra nutrients needed.

The water in the protocol has changed through the groups history. When we lowered the water from 3 to 4 liters to 2 to 3 liters we saw that we were not removing the excess B6 from the blood fast enough. We had members who were three to four months into the protocol and still had high B6 blood numbers. This meant we were NOT curing the dehydration. The B6 blood work needs to be at a low normal for us to start accessing the excess B6 in the nerve tissues.

We immediately pulled the water back up to the 3 to 4 liters of water. We remind people often in the group that one of our star healers drank a gallon of water a day. She is a small 5’2 woman. The protocol now is 3 to 4 liters of water a day with 1/8 teaspoon of salt in 2 to 3 of those liters (total salt is 1/4 to 3/8’s of a teaspoon). We also recommend the water and salt be spread throughout the day and night.

Low blood volume symptoms are headaches, migraines, brain fog, passing out, lightheadedness and the biggest one is the anxiety. Once we trick our blood volume into thinking we have five liters then these symptoms go away.


We can’t have a discussion on low blood volume without a discussion on vasodilators. As mentioned before our body reacts to low blood volume by tightening the blood vessel through vasoconstriction. A vasodilator does the exact opposite. It widens the blood vessels. A vasodilator is making it harder for our already low blood volume to reach the cells.

Vasodilators can create the symptoms as mentioned above, but we also know they are limiting the blood flow to parts of your body. Once the vasodilators are removed you are getting blood to the those areas damaged by lack of blood flow.

For more information on Low Blood Volume, please see the following articles:


Myocardial Ischemia

Physiology, Blood Volume

Blood Volume Testing

Common Prescription Drugs Alter Blood’s Flow


Low Blood Volume and Chronic Fatigue

Although Chronic Fatigue is not associated with B6 toxicity, it is associated with low blood volume and the following excerpt from Healthrising.org discusses the importance of increasing salt to increase blood volume.

“You guys are about a litre short in blood volume, ok? If I’m sitting at five litres, you’re sitting at four. So, you’re really, really sensitive to blood volume changes. If you’re a little dry, you crash. ”
Dr. Nancy Klimas

Many people with Chronic Fatigue Syndrome are about a liter short of blood.

The low blood volume finding in chronic fatigue syndrome has been consistently replicated; there is no doubt that low blood volume is common in this disorder. Low blood volume can cause, among other things, reduced blood flows to the brain (cognitive difficulties), problems standing (orthostatic intolerance), increased heart rates and reduced heart functioning. While not the entire answer to chronic fatigue syndrome, increasing blood volume can be quite helpful.

Non-Drug Approaches

Elevating Your Head While Sleeping

In what’s surely the easiest practice simply elevate the head of the bed six inches by putting some risers under the bed legs at the head of the bed (or by using a body-length wedge shaped cushion. NASA uses this approach to recondition its astronauts after spaceflights.  One person found a dramatic improvement in his sleep after doing this for a week.


“The reduction in salt, which is a good idea for most people, may push orthostatic intolerant people into having symptoms of OT”
-Dr. Peter Rowe

Many people with chronic fatigue syndrome crave salt.  Increasing your salt (with your doctor’s permission) and fluid intake can increase your blood volume increasing blood flows to your heart and brain, enabling you to stand more easily and think more clearly.

Increasing salt intake will only work, though, if you increase your fluid intake as well for (see below). Increasing salt intake should be done slowly and is often achieved simply by eating saltier foods. Some ME/CFS and POTS patients who already had low salt intake have had dramatic improvements by increasing their salt intake. Do not increase your salt intake, however, if you have high blood pressure.

Be consistent! – Dr. Rowe suggests that patients who make a serious (i.e. consistent) effort at increasing their fluid intake will benefit the most. He recommends drinking a glass of liquid every two hours with a goal of drinking at least two liters of water a day (approximately half a gallon).  If you’re trying to increase both blood volume and salt tomato juice is an excellent choice.

More Articles on B6 and Low Blood Volume

At OHSU, Measuring Blood Volume Quickly and Accurately As of 3/22/23 there has been no update on this new device.

Changes in blood volume following administration of oral rehydration solutions

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