Tuesday, July 30, 2013

Doctors recommending exercise for ME patients?

I'm saving this as my standard answer to any doctor recommending exercise to patients with M.E.; you are welcome to yoink and use it in full.

“Post- Exertional Neuroimmune Exhaustion (PENE pen-e)

Normal fatigue is proportional to the intensity and duration of activity, followed by a quick restoration of energy. PENE is characterized by a pathological low threshold of physical and mental fatigability, exhaustion, pain, and an abnormal exacerbation of  symptoms in response to exertion. It is followed by a prolonged recovery period. Fatigue and pain are part of the body’s global protection response and are indispensable bioalarms that alert patients to modify their activities in order to prevent further damage.

The underlying pathophysiology of PENE involves a profound dysfunction of the regulatory control network within and between the nervous systems. This interacts with the immune and endocrine systems affecting virtually all body systems, cellular metabolism and ion transport. The dysfunctional activity/rest control system and loss of homeostasis result in impaired aerobic energy production and an inability to produce sufficient energy on demand. A test-retest cardiopulmonary exercise study revealed a drop of 22% in peak VO2 and 27% in VO2 at AT on the second day evaluation. Both submaximal and self-paced exercise resulted in PENE. These impairments and the loss of invigorating effects distinguish ME from depression.”

From the International Consensus Primer for Medical Practitioners. 

primer, noun: an elementary textbook that serves as an introduction to a subject of study or is used for teaching children to read: a first-year philosophy primer – OED

Any doctor not aware of this information should go back to the primer and study. Thank you.


  1. P.S. For emphasis you can link them this published research proving we react abnormally to exercise: http://ptjournal.apta.org/content/early/2013/06/26/ptj.20110368.abstract

  2. Hell, on Wheels! Here's an article about an even better study, using cycling two days in a row to measure the effects of exercise on ME victims versus health controls: http://www.cortjohnson.org/blog/2013/07/30/busted-exercise-study-finds-energy-production-system-is-broken-in-chronic-fatigue-syndrome/