Post-exertional malaise

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Revision as of 19:49, September 30, 2016 by Kmdenmark (talk | contribs) (added study and ref: closed ref)

Post-exertional malaise (PEM) is a worsening of many ME/CFS symptoms as a result of physical or mental exertion. It is often referred to as "the marker" by patients, ME/CFS organizatons, clinicians and researchers that work in the ME/CFS field. PEM can last for days to weeks after the exertion.[1][2]

Worsening symptoms include chronic fatigue, flu-like symptoms, brain fog (cognitive dysfunction), unrefreshing sleep, chronic pain, orthostatic intolerance, neurally mediated hypotension, POTS and more. "As with the severity, the exertion needed to trigger PEM theories case-by-case. For some, it might kick in after a little bit of exercise on top of a day's regular activities. For others, is incredible as it may seem, it can just take a trip to the mailbox, a shower, or sitting upright for an hour." [3][4][5][6] Onset of PEM can be delayed 24-72 hours.[7]

A 2016 DePaul University study focused on deciphering if post-exertional malaise was a generalized, full-body fatigue and/or a muscle-specific fatigue. The results suggested that PEM is composed of two empirically different experiences, one for generalized fatigue and one for muscle-specific fatigue.[8]

2015 Institute of Medicine report[edit | edit source]

PEM chart from the 2015 Institute of Medicine report

This landmark report published in 2015 by the United States Institute of Medicine report, which assessed all the evidence available, concluded:

"There is sufficient evidence that PEM is a primary feature that helps distinguish ME/CFS from other conditions"

Pages 84-86 of the report describe the evidence for post-exertional malaise in ME/CFS patients.[9]

Prevalence[edit | edit source]

Symptom recognition[edit | edit source]

Notable studies[edit | edit source]

Post-exertional worsening of symptoms, VanNess et al 2010.png

Notable articles[edit | edit source]

Talks & interviews[edit | edit source]

Possible causes[edit | edit source]

Potential treatments[edit | edit source]

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. Johnson, C, Health Rising: ME/CFS Symptoms, retrieved Mar 2016 Check date values in: |access-date= (help)
  2. Fighting Fatigue, Post-Exertional Malaise – A Hallmark Symptom of ME/CFS, retrieved Mar 2016 Check date values in: |access-date= (help)
  3. What Is Post-exertional Malaise - Very Well - Adrienne Dellwo
  4. Post Exertional Malaise - Very Well - Adrienne Dellwo
  5. Chronic Fatigue Syndrome - Web MD
  6. PEM Series - Solve ME/CFS - Jenny Spotila
  7. What Health - International CFS/ME Awareness Day 2017 - CFIDS Association of America
  8. 8.0 8.1 McManimen, SL; Sunnquist, ML; Jason, LA (2016), "Deconstructing post-exertional malaise: An exploratory factor analysis.", Journal of Health Psychology, doi:10.1177/1359105316664139, PMID 27557649
  9. Institute of Medicine report pages 84-86, search term exercise
  10. Meyer, JD; Light, AR; Shukla, SK; Clevidence, D; Yale, S; Stegner, AJ; Cook, DB (October 2, 2013), "Post-exertion malaise in chronic fatigue syndrome: symptoms and gene expression", Fatigue: Biomedicine, Health & Behavior, 1 (4): 190-209, doi:10.1080/21641846.2013.838444
  11. Jason, LA; Zinn, ML; Zinn, MA (September 2015), "Myalgic Encephalomyelitis: Symptoms and Biomarkers", Current Neuropharmacology, 13(5): 701-734, doi:10.2174/1570159X13666150928105725
  12. Shukla, SK; Cook, D; Meyer, JD; et al. (December 18, 2015), "Changes in Gut and Plasma Microbiome following Exercise Challenge in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)", Plos One, 10(12), doi:10.1371/journal.pone.0145453
  13. ME Blogg (December 30, 2015), Suggestion to replace PEM by PAR
  14. Cook, DB (November 19, 2015), "Deciphering Post Exertion Malaise: The Intersection of Biology and Behavior", Solve ME/CFS (video)
  15. Spotila, JM (2010), "Post-Exertional Malaise in Chronic Fatigue Syndrome" (PDF), Solve ME/CFS
  16. Spotila, JM (May 23, 2012), "Post-Exertional Malaise: Cause and Effect", Solve ME/CFS
  17. About Health (October 8, 2015), Definition of Post-Exertional Malaise
  18. Post-Exertional Malaise - The ME/CFS Ghost

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