Post-exertional malaise

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, and clinicians and researchers that work in the ME/CFS field.

Notable studies

 * Post-exertion malaise in chronic fatigue syndrome: symptoms and gene expression
 * Myalgic Encephalomyelitis: Symtoms and Biomarkers - Jasona et al., Current Neuropharmacology
 * Changes in Gut and Plasma Microbiome following Exercise Challenge in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) - Shukla et al., Plos One

Notable articles

 * Suggestion to replace PEM by PAR (Post Activity Relapse) - ME Blogg

Talks & interviews

 * Post-Exertion Malaise: The Intersection of Biology and Behavior - Dr. Dane Cook, Solve ME/CFS, November 2015 youtube

Learn more

 * 2013, PEM series (Jennie Spotila)
 * Post-exertional malaise cause and effect
 * Post-Exertional Malaise About.com FMS/ME/CFS