ME/CFS Primer/Education Bulletins Results of Head Upright Tilt Table Test
IACFS/ME Bulletin

Results of Head Upright Tilt Table Test as a Predictor of Disability in a Group of Chronic Fatigue Syndrome Patients

Susan M. Levine1*, MD

Madeline Sterling2, MD/MPH candidate at Robert Wood Johnson Medical School


* Requests for reprints should be addressed to:

Susan Levine, MD

115 East 72nd Street, Suite 1A

New York, NY 10021

T 212 472 4816; F 212 472 9660; e-mail





Background: Chronic Fatigue Syndrome (CFS) is a complex illness characterized by the presence of debilitating fatigue, myalgias, sore throats, headaches and cognitive disturbances. Autonomic dysfunction or orthostatic intolerance (OI) characterized by the presence of dizziness, palpitations and frank syncope has been implicated as a cause of some of the debility experienced by a subgroup of CFS patients. 


Methods: Using the results of Head Upright Tilt Table Testing (HUT), in addition to the frequency of symptoms of both CFS and OI reported by 15 subjects chosen randomly from S.L.’s private practice, we sought to determine whether the presence of autonomic dysfunction was associated with a likelihood of disability among these patients. 

Results: Of the CFS patients studied 13/15 had a positive HUT. Twelve of the thirteen patients who had a positive outcome on HUT were fully disabled and receiving disability benefits. Three of the thirteen patients who were positive had a history of syncopal episodes and demonstrated syncope on HUT.  

Conclusion: Results of this study suggest that HUT in addition to a strong history of autonomic symptoms, especially syncope, may be useful in determining disability status among CFS patients. It is important to note that methodological differences among testing sites including experience with the method in general, angle of tilt, and monitoring of ambient conditions during HUT, may affect the interpretability of the HUT data. In addition, variability among CFS patients including comorbid medical conditions, such as presence of Mitral Valve Prolapse or Asthma or the use of vasoactive medications prior to testing, may influence the outcome of this procedure.




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