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SZAFRANIEC, Artur, KRĘŻEL, Olga, KRĘŻEL, Maciej, KALINOWSKA, Zuzanna, ALEKSANDROWICZ, Hanna and RYBIŃSKA, Marcelina. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Post-Exertional Malaise and the Biologyof Energy Failure. Journal of Education, Health and Sport. 2026;88:69423. eISSN 2391-8306. https://doi.org/10.12775/JEHS.2026.88.69423
Its hallmark feature is post-exertional malaise (PEM), a delayed and prolonged worsening of symptoms after minimal physical or cognitive effort.
Common symptoms include unrefreshing sleep, cognitive impairment, pain, flu-like complaints, sensory hypersensitivity, and autonomic dysfunction such as orthostatic intolerance.
Diagnosis is clinical and requires exclusion of alternative medical and psychiatric conditions, with commonly used frameworks including the CDC/Fukuda and International Consensus Criteria.
Evidence supports a multifactorial pathophysiology involving immune dysregulation, metabolic and mitochondrial abnormalities, neuroendocrine disturbance, gut dysbiosis, and autonomic dysfunction - collectively suggesting impaired energy homeostasis.
No validated biomarker exists, though multi-omic immune and metabolic signatures remain under investigation.
Management is supportive, emphasizing individualized pacing and treatment of comorbidities.
SZAFRANIEC, Artur, KRĘŻEL, Olga, KRĘŻEL, Maciej, KALINOWSKA, Zuzanna, ALEKSANDROWICZ, Hanna and RYBIŃSKA, Marcelina. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Post-Exertional Malaise and the Biologyof Energy Failure. Journal of Education, Health and Sport. 2026;88:69423. eISSN 2391-8306. https://doi.org/10.12775/JEHS.2026.88.69423
Keywords
Chronic fatigue, chronic infections, APT, Immune dysregulation, Post-exertional malaise, Neuroendocrine systemAbstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe, heterogeneous multisystem disorder defined by persistent fatigue lasting ≥6 months that is disproportionate to exertion, not relieved by rest, and associated with substantial functional decline.Its hallmark feature is post-exertional malaise (PEM), a delayed and prolonged worsening of symptoms after minimal physical or cognitive effort.
Common symptoms include unrefreshing sleep, cognitive impairment, pain, flu-like complaints, sensory hypersensitivity, and autonomic dysfunction such as orthostatic intolerance.
Diagnosis is clinical and requires exclusion of alternative medical and psychiatric conditions, with commonly used frameworks including the CDC/Fukuda and International Consensus Criteria.
Evidence supports a multifactorial pathophysiology involving immune dysregulation, metabolic and mitochondrial abnormalities, neuroendocrine disturbance, gut dysbiosis, and autonomic dysfunction - collectively suggesting impaired energy homeostasis.
No validated biomarker exists, though multi-omic immune and metabolic signatures remain under investigation.
Management is supportive, emphasizing individualized pacing and treatment of comorbidities.
