New views on carbon monoxide: How blood protects body and health

Since the Baltimore Post-Examiner published an extensive article ‘Carbon Monoxide: Deadly killer on the loose, new facts have emerged from a research project on carbon monoxide, done by the Health Council of the Netherlands.

This project involved the study of recent international scientific literature and discussions with expert toxicologists and medical specialists from many countries.

The prevailing opinion among doctors and other experts is that carbon monoxide (or CO by its chemical formula) reduces the ability of the blood to transport oxygen, which causes organs to suffer a shortage of oxygen, the most sensitive organs first: brain, heart, and lungs. And that happens fast: a concentration of only 1% (or 10.000 ppm) CO in the air causes coma within 10 seconds and death within 10 minutes! This is the fast, or ‘acute’ CO intoxication.

But recent findings of the toxic effects of CO show that the mechanism is more complex and even more dangerous than the simple ‘lack of oxygen’ explanation, as was already explained in the previous article.

This recent research has shown that the extremely small quantities of ‘endogenous’ CO that are produced by the human body itself, play an important part in essential biological processes, like regulation of blood pressure, heart rate, biological clock, metabolism of food and medication, distribution of oxygen and the signal transfer in the nervous system. CO is a kind of neurotransmitter that acts everywhere in the body.

But these delicate and essential biological processes, that are controlled by endogenous CO, can be severely disrupted by ‘exogenous’ CO that is inhaled from the outside and enters the body through the lungs. Some experts think that the hemoglobin in our blood, which has a 250 fold affinity for CO over oxygen, must be seen as a filter that catches as much as possible CO, and thus protects the body. It is the part of the CO that escapes this blood-barrier and that reaches the cells of the tissues, the organs and especially the nervous system, that does the real damage to our health, slowly but effectively. The effect is like blowing iron filings into a computer: overloaded connections and short circuits in many places!

There are indications that the fetus is particularly sensitive to the disruptive effects of CO, so that exposure to CO during pregnancy can affect the neurological development of the fetus. Also, cardiac patients are particularly susceptible to the negative effects of CO.

Because this process of passing through the blood barrier and penetrating the bodily tissues and the cells of the nervous system takes time, it is called the ‘chronic’ CO intoxication. And where the acute CO intoxication causes lack of oxygen in the organs, the chronic form can cause a wide range of psychic and neurologic symptoms and problems, which can also happen in one and the same person (for a list of the symptoms, see the previous article of June 15, 2019).

This means that such ‘complex’ patients are often treated by different medical specialists, like a psychiatrist, a cardiologist, and a neurologist, while the different problems and symptoms can have one underlying common cause: carbon monoxide!

So in such complex cases, the medical doctor should always make sure if it is a CO intoxication or not, before treatment and/or medication are started. Also because CO and psychoactive drugs, like anti-depressants, may enhance each other’s negative effects and thus make matters even worse for the patient.

The diagnosis for acute CO intoxication is done by analyzing the CO in the blood, the ‘carboxyhemoglobin’ content, or COHb.  But this does not work for the chronic intoxication, because that is caused by the CO that has passed the blood barrier and settled in the body tissues. But for that, simple and fast breath analyses can be used, which is actually far more sensitive and cheaper than COHb analyses (except that it is an unreliable test for smokers, who have a permanent chronic CO intoxication).