Supplemental Oxygen Can Remedy both Low and High Carbon Dioxide Blood Levels to Improve Endurance
 
One of our beloved WinterGreen Research executives became obese and had trouble exercising.  At the pool, she had very little endurance swimming.   One of the physicians who swims with us, a world-famous director of a leading medical laboratory said, "Her lungs are too small."
 
By this he meant, he explained, that when she was young, in her twenties she had normal weight, the lungs were a certain size, and could manage oxygen in and carbon dioxide out properly for health.  But as our executive grew fat the lungs stayed the same size, creating a difficulty in getting a proper balance of oxygen and carbon dioxide in the body. 
 
Our physician colleague explained that fat manufactures carbon dioxide in the body, and breathe in, breathe out was not sufficient to create a proper balance of  oxygen and carbon dioxide in the body as our friend grew obese.  This white paper grew out of that experience.    
 
70% of the heart disease in the world is not adequately diagnosed, properly understood, or treated.  This is because the gold standard for heart diagnosis, the standard stress test, diagnoses heart blockages but not PAH.   Chronic fatigue, long term Covid are not diagnosed by any of the following standard hearth disease tests. 
 
Current Heart Patient Initial Evaluation Testing:
Extensive blood work
Pulmonary function testing
Echocardiography
Cardiac catheterization
Radiographic imaging
Nuclear imaging modalities
Cardiac stress testing
Cardiopulmonary exercise testing (CPET) noninvasive, not catheterization, just stress test exercise machine 
Source:  WinterGreen Research, Inc.  
 
Patients may undergo 20 or more tests as per the above list with no definitive diagnosis.  These tests do not show that under conditions of intense exercise the blood vessels and arteries between the heart and lungs may not properly oxygenate the organs, leading to fatigue during exercise.
 
Only the iCPET that uses a metabolic cart instead of a pulse oximeter is able to diagnose PAH definitively.  The PAH diagnosis from iCPET is definitive enough of PAH to get insurance reimbursement for chronic fatigue syndrome, while the other tests listed  above do not provide a definitive diagnosis and patients do not get disability insurance.