Overtraining syndrome (OTS) as PEM for healthy people?

And it can happen after minor exertion that isn't even close to strain muscles enough to be sore. I mentioned it some time ago, I've been doing a bit better and doing some minor weight lifting for about 8 months now, and I'm still stuck at 15 lbs weights and can only do so once every couple days at best, or I get PEM, palpitations, dizziness, weakness, and so on. A single set of 8 reps at 15 lbs isn't nearly enough to strain muscles and cause soreness. And yet: PEM.

When I started I caused PEM multiple times from light stretching or moving my arms above my head, basically "lifting" nothing.

Seriously anyone who pushes the idea that DOMS is what we think PEM is, and we have seen at least one major psychosomatic ideologue claiming so (Carson, I think) just reveal themselves as not paying any attention at all.

 

I think this is the crux of ME/CFS patients needing to lie down that @Jonathan Edwards talked about. Just sitting up is an exertion enough that the patients need to lie down in order to get relief. It's not a symptom by and of itself; it's the very nature of ME/CFS that any exertion, be it sitting up or talking, can make you feel worse. Sitting up effects ME/CFS patients differently from, say, COVID patients because of the different hypersensitivity to exertion.

 

I don't know what Carson said, but it would be wrong if anybody said PEM is DOMS or vice versa. Nobody here is saying that PEM is DOMS or vice versa as far as I know. But what's underneath DOMS could be the same process that precipitates PEM. DOMS is an acute (adaptive) response to maximal exercise whereas PEM could a pathological response to the same process created by a minor exertion. It fits perfectly with hypothesis that PEM is a hypersensitivity to low grade inflammation. And things that triggers low grade inflammation -- exertion, alcohol, pollen, stress, flu vaccine, etc -- appears to be the things that make ME/CFS worse. Exertion in particular creates inflammation that last several days after a day of delay.

edit: added "flu vaccine" to the list

 

I would think that is possible, though I'm not sure what that would prove. DOMS is caused by microtear, or, more precisely, by the immune system trying to repair the damage in muscle fiber. It can be very localized, possibly keeping the ensuing inflammation spike minimal enough not to trigger PEM. Conversely, it should be possible for an exertion to spike up inflammation enough without causing microtear anywhere. That's obviously the case for ME/CFS patients who can't exert nearly enough to cause microtear. In both cases, however, the inflammation spike from the exertion is delayed and last several days.