Pacing with a heart rate monitor

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Theory[edit | edit source]

People with Myalgic Encephalomyelitis have dysfunctional mitochondria[1]. This limits their ability to generate cellular energy. Doing activities that exceed available energy, usually triggers a flood of cytokines, and other negative affects, known as post exertional malaise.[2]

Some researchers believe that each time PEM is triggered, it is reactivating the disease process of ME.[3]

Using a heart rate monitor, to measure heart rate, heart rate variability, and other factors, allows people with ME to observe their energy usage, and learn how to stay within their safe limits.[4]

This pacing method is often used in conjunction with other treatments (electrolyte loading, pharmaceuticals to assist blood volume & cardiovascular function, extreme resting and meditation, etc).[5]

Evidence[edit | edit source]

Anecdotally, some people experience gradual improvements in their health, with occasional setbacks due to over-exertion, infections & immune reactivity.[6]

Clinicians[edit | edit source]

Risks and Safety[edit | edit source]

Costs and Availability[edit | edit source]

Notable studies[edit | edit source]

Examples[edit | edit source]

Learn More[edit | edit source]


See also[edit | edit source]

References[edit | edit source]

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myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

cytokine any class of immunoregulatory proteins secreted by cells, especially immune cells. Cytokines are small proteins important in cell signaling that modulate the immune system. (Learn more: me-pedia.org)

post-exertional malaise (PEM) - A notable exacerbation of symptoms brought on by small physical or cognitive exertions. PEM may be referred to as a "crash" or "collapse" and can last for days or weeks. Symptoms can include cognitive impairments, muscle pain, trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, and others.

heart rate monitor (HRM) - A device that measures your heart rate (pulse rate). Heart rate monitors may come as a chest strap, wrist strap, smartwatch, or even as a mobile phone app. Heart rate monitors are often used by ME/CFS patients to pace their exertion, in order to avoid post-exertional malaise (PEM). For more information, see pacing with a heart rate monitor.

heart rate (HR) - the number of times the heart beats within a certain time period, usually a minute

Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) - Chronic Fatigue and Immune Dysfunction Syndrome is another term for Chronic Fatigue Syndrome, but one which emphasizes the immunological aspects of the disease. Popular in the 1990s, this term has apparently fallen into disuse.

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